Neuroblastoma is a common childhood malignant tumor originated from the neural crest-derived sympathetic nervous system. A crucial early event in neuroblastoma pathogenesis is arrested differentiation of neuroblasts at various stages. Treatment of neuroblastoma with TPA and PDGF-BB leads to terminal differentiation of neuroblastoma cells. However, the signaling pathways that are involved in this process remain largely unknown. Here, we report that inhibition of endogenous FOXO proteins attenuated TPA/PDGF-BB mediated differentiation of neuroblastoma cells. Activated FOXO transcription factors acted on PDGFRA promoter to direct its basal mRNA expression as well as its induction upon serum deprivation. Depletion of endogenous PDGFRA in neuroblastoma cells significantly diminished neurite formation and extension under TPA/PDGF-BB treatment. Furthermore, ectopic expression of PDGFRA abolished the blockage of neuroblastoma differentiation by FOXOs inhibition. These findings define the FOXO-PDGFRA axis as crucial mechanistic components that govern TPA-induced neuroblastoma differentiation. N euroblastoma is a childhood tumor of the peripheral nervous system. This tumor is derived from immature sympathetic cells of the ganglionic lineage and is arrested at various stages of differentiation. Tremendous clinical heterogeneity, encompassing truly benign as well as extremely aggressive forms, is presented in neuroblastomas. In vivo as well as in vitro data have shown that the degree of sympathetic neuronal tumor cell differentiation influences patient outcome. Therefore, elucidation of the molecular basis governing neuroblastoma cell differentiation is crucial for identification of targets for effective therapeutic intervention in neuroblastoma (1). In vitro differentiation of neuroblastoma cell line in the presence of various agents and growth factors has been widely used to dissect the molecular mechanisms underlying neuroblastoma differentiation. A number of differentiation protocols have been published in recent years (1). Retinoic acid (RA) induces differentiation of neuroblastoma cells in vitro and is one of few targeted therapeutics currently used in the clinic for advanced neuroblastoma. However, the overall response rate to RA in neuroblastoma patients is low. In addition to RA, TPA showed very significant effects on cell growth and differentiation. When cultured in serum-free SHTE medium containing TPA and PDGF-BB (SHTE, TPA and PDGF-BB, STP in short), SH-SY5Y cells have been shown to differentiate into nonproliferative, neuron-like cells, characterized by outgrowth of varicosity-containing neuritis terminated by growth cones and by induction of neuronal sympathetic differentiation markers (i.e., GAP43, growth associated protein 43). In addition, differentiated SH-SY5Y cells become functional as they accumulate norepinephrine in dense core granules and build up an action potential, which is depolarized by acetylcholine, resulting in release of stored neurotransmitters (1). Protein kinase C (PKC) isoforms have bee...