Survivin-dependent and -independent pathways and the induction of cancer cell death by tetra-O-methyl nordihydroguaiaretic acid.

The inhibitor of apoptosis protein (IAP) family encodes a group of Baculovirus IAP repeat domain (BIR)-containing proteins that suppress apoptosis. Some of the IAPs, survivin and XIAP in particular, are differentially overexpressed in many types of human cancer and are deemed attractive anticancer targets. Here we review the regulation of survivin expression and survivin's functions in both normal and cancerous cells, and some of the current survivin-targeted cancer therapy. We further discuss the possible mechanisms of tetra-O-methyl nordihydroguaretic acid (M(4)N), a global transcription inhibitor, in the induction of cancer cell death in tumors via survivin-dependent and -independent pathways.