PMAIP1 and neoplasm: Due to the activity of BH3-only proteins like PUMA and NOXA, pro-apoptotic proteins get released from their binding, leading to subsequent mitochondrial activation and initiation of the downstream apoptosis cascade.3 Anti-apoptotic proteins are overexpressed in different tumor entities, supporting cell death avoidance as classical hallmark of cancer.4, 5 In CRC, high Bcl-xL expression has been shown to correlate with lower tumor differentiation and poorer overall patient survival.6 In contrast, high Bcl-2 levels seem to correlate with a good clinical outcome.7