For the first time in bladder cancer cells, we revealed that ciglitazone-mediated up-regulation of TRAIL and a marked decrease of c-FLIP and survivin mediated in part through a proteosomal degradation process contribute to ciglitazone-induced cell death and to the sensitizing effect of this TZD on TRAIL-induced apoptosis. Here, BIRC5 is linked to urinary bladder carcinoma.