A “switch” in the actions of IGFBP-3 from apoptotic to antiapoptotic was shown to be dependent on the presence of matrix components, with exogenous IGFBP-3 promoting breast cancer cell survival in the presence of fibronectin, but accentuating apoptosis triggered by ceramide in the absence of fibronectin [41]. The gene discussed is IGFBP3; the disease is breast cancer.