Purpose: h 2 -Microglobulin (h2M), a soluble protein secreted by cancer and host inflammatory cells, has various biological functions, including antigen presentation. Because aberrant expression of h2M has been reported in human renal cell carcinoma, we investigated the effects of h2M overexpression on cancer cell growth and analyzed its molecular signaling pathway. Experimental Design: We established clonal cell lines that overexpressed h2M in human renal cell carcinoma (SN12C) cells and then examined cell growth in vitro and in vivo and studied the h2M-mediated downstream cell signaling pathway. Results: Our results showed that h2M expression positively correlates with (a) in vitro growth on plastic dishes and as Matrigel colonies, (b) cell invasion and migration in Boyden chambers, and (c) vascular endothelial growth factor (VEGF) expression and secretion by cells. We found, in addition, that h2M mediates its action through increased phosphorylation of cyclic AMPr esponsive element-binding protein (CREB) via the protein kinase A-CREB axis, resulting in increased VEGF expression and secretion. In convergence with this signal axis, h2M overexpression also activated both phosphatidylinositol 3-kinase/Akt and mitogen-activated protein kinase pathways. h2M overexpression induced accelerated growth of SN12C in mouse subcutis and bone. Interrupting the h2M signaling pathway using small interfering RNA led to apoptosis with increased activation of caspase-3 and caspase-9 and cleaved poly(ADP-ribose) polymerase. Conclusions: Our results showed for the first time that the h2M-protein kinase A-CREB-VEGF signaling axis plays a crucial role in support of renal cell carcinoma growth and progression and reveals a novel therapeutic target. b 2 -Microglobulin (b2M), a well-known housekeeping gene, is a 12-kDa nonglycosylated polypeptide composed of 100 amino acids. h2M is synthesized by all nucleated cells and forms complexes with the heavy chain of MHC class I (1). MHC class I or HLA antigen plays an important role in tumor immunity because cancer cells present peptides that are degraded by proteasome but still recognized by cytotoxic T cells (2 -4). The expression of MHC class I antigen has been observed in some cancer cells, but down-regulation or loss of HLA molecules on the surface of cancer cells is often associated with the progression of several tumor types (5 -8) due in part to the ability of cancer cells to evade host immune surveillance and subsequent elimination by cytotoxic T cells. However, the biological functions of h2M in cancer and bone metastasis are still unknown.h2M protein expression by normal and cancer cells and its clinical usefulness has been the subject of investigation for the past two decades. With few of these studies showing a direct mitogenic action of h2M (9), no study has attempted to delineate the potential signaling function of h2M in cancer cells. h2M is a soluble factor synthesized and secreted by cancer and inflammatory cells. Increased synthesis and release of h2M occur in seve...