The expression of purinergic P2X7 receptor (P2X7R) in neuroblastoma cells is associated to accelerated growth rate, angiogenesis, metastasis and poor prognosis. Noticeably, P2X7R allows the survival of neuroblastoma cells under restrictive conditions, including serum and glucose deprivation. Previously we identified specificity protein 1 (Sp1) as the main factor involved in the transcriptional regulation of P2rx7 gene, reporting that serum withdrawal triggers the expression of P2X7R in Neuro-2a (N2a) neuroblastoma cell line. Here we demonstrate that PI3K/Akt pathway is crucial for the upregulation of P2X7R expression in serum-deprived neuroblastoma cells, circumstance that facilitates cell proliferation in the absence of trophic support. The effect exerted by PI3K/Akt is independent of both mTOR and GSK3, but requires the activation of EGF receptor (EGFR). Nuclear levels of Sp1 are strongly reduced by inhibition of PI3K/Akt pathway, and blockade of Sp1-dependent transcription with mithramycin A prevents upregulation of P2rx7 gene expression following serum withdrawal. Furthermore, atypical PKCζ plays a key role in the regulation of P2X7R expression by preventing phosphorylation and, consequently, activation of Akt. Altogether, these data indicate that activation of EGFR enhanced the expression of P2X7R in neuroblastoma cells lacking trophic support, being PI3K/ Akt/PKCζ signaling pathway and Sp1 mediating this pro-survival outcome.Nucleotides are an ubiquitous family of signaling molecules that exert different extracellular effects through interaction with two families of purinergic receptors: G-protein coupled P2Y receptors and ligand-gated P2X cation channels. So far, seven P2X subunits (P2X1-7) and eight P2Y receptors (P2Y 1,2,4,6,11,12,13,14 ) have been cloned and characterized according to their agonist sensitivity, sequence identities and signal transduction mechanism. There is a growing interest in the therapeutic potential of nucleotide receptors for the treatment of cancer 1 . Extracellular ATP, an abundant component of the tumor microenvironment, is emerging as a new and potent regulator of cancer progression and immune response modulator 2,3 . Intriguingly, whereas high doses of ATP have a strong cytotoxic effect on several tumors, lower ATP concentrations, reached after spontaneous release of this nucleotide from cells, have a growth-promoting effect 4 . Among purinergic receptors, P2X7 seems to be the best candidate to confer a growth advantage to cancer cells in vivo 5 . This receptor is highly expressed by nearly all human cancers so far investigated 1,4 , including neuroblastoma cells from both primary tumors and cell lines 6 . Neuroblastoma is a neuroendocrine tumor, responsible for 15% of pediatric cancer deaths. They may originate in any part of the sympathetic nervous system, most commonly in the adrenal medulla and sympathetic ganglia, and secondary tumors are often widespread in other organs and bone 7 . Neuroblastoma progression is frequently associated with high rates of proliferation eve...