“…Synergistic interactions have been reported between TRAIL and a number of therapeutic agents, including IFN-alpha 35) , genotoxic agents such as doxorubicin, cisplatin, or etoposide [36][37][38][39][40][41] , irinotecan 24,29,34,[42][43][44] , gamma-radiation 45,46) , and cyclooxygenase-2 inhibitors 47) . Although the mechanisms of these synergies are not completely understood and are likely to vary between therapies, the following mechanisms have been suggested to influence the combination treatments synergies detected to date: receptor up-regulation, modulation of Bcl-2 family members, up-regulation of caspases, down-regulation of c-FLIP, which is an endogenous inhibitor of "extrinsic" caspase-8 activation, and inhibition of IAP family members, which inhibit "intrinsic" caspase-3 activation.…”