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Notably, anlotinib also has been shown to suppress the extracellular regulated kinase ( ERK ) signaling pathway and reverse the epithelial-mesenchymal transition (EMT) process in various tumor models ( PRKAR1A can drive the ERK signaling axis in other tumors ( TFRC ) expression via the VEGFR2/AKT/HIF-1 signaling axis, thereby enhancing infiltration of immune cells such as CD8 + T lymphocytes into hepatocellular carcinoma tissue, ameliorating hypoxia, and reversing immunosuppression ( EphA2 pathway ( PRKAR1A/ERK axis