NPNT has been shown to confer apoptosis resistance in H295R cells by modulating the expression of prosurvival protein BCL2, whose role is to block caspase activation.32 This detachment of cells from the ECM often results in apoptotic cell death known as anoikis.42 Excess secretion of ECM components suppresses the physiological induction of anoikis in maintaining normal tissue architecture43 and could explain the high levels of NPNT expression in adrenocortical carcinoma and immortalized H295R cells (Figure 1B). This evidence concerns the gene BCL2 and adrenal cortex carcinoma.