Survivin is a cancer-associated gene that functions to promote cell survival, cell division, and angiogenesis and is a marker of poor prognosis. Histone deacetylase inhibitors induce apoptosis and re-expression of epigenetically silenced tumor suppressor genes in cancer cells. In association with increased expression of the tumor suppressor gene transforming growth factor  receptor II (TGFRII) induced by the histone deacetylase inhibitor belinostat, we observed repressed survivin expression. We investigated the molecular mechanisms involved in survivin down-regulation by belinostat downstream of reactivation of TGF signaling. We identified two mechanisms. At early time points, survivin protein half-life was decreased with its proteasomal degradation. We observed that belinostat activated protein kinase A at early time points in a TGF signaling-dependent mechanism. After longer times (48 h), survivin mRNA was also decreased by belinostat. We made the novel observation that belinostat mediated cell death through the TGF/protein kinase A signaling pathway. Induction of TGFRII with concomitant survivin repression may represent a significant mechanism in the anticancer effects of this drug. Therefore, patient populations exhibiting high survivin expression with epigenetically silenced TGFRII might potentially benefit from the use of this histone deacetylase inhibitor.The mutational events involved in the initiation and progression of colorectal cancer have been well documented (1). However, it is now recognized that in addition to these alterations in DNA sequence epigenetic modifications of the genome play a major role in contributing to the malignant phenotype (1, 2). The critical balance between histone acetylation by histone acetyltransferases and deacetylation by histone deacetylases (HDACs) 3 represents a key epigenetic layer involved in gene regulation (3). The class I HDACs are overexpressed in many tumor types compared with normal tissues (4), and this overexpression is generally associated with poor prognosis (5, 6). These findings have resulted in the development of drugs that target HDACs. The second generation HDAC inhibitors (HDACis) target class I and II HDACs. These drugs induce differentiation, cell growth arrest, and apoptosis in cell lines in vitro and in vivo indicating that the increased activity of these enzymes in cancer contributes to tumor progression (7-9). However, the key mechanisms and pathways through which HDAC inhibition leads to tumor cell apoptosis have not been well defined.Transforming growth factor  (TGF) signaling has been shown to contribute to a variety of cellular functions including growth inhibition and induction of differentiation and apoptosis as well as cell motility and adhesion (10). It has been demonstrated that transcriptional loss of TGF receptor expression leading to attenuation of TGF signaling is a frequent occurrence in a wide range of cancers in vitro and in vivo and is associated with poor patient prognosis (11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(...