Although Adriamycin activates intrinsic apoptotic pathways, and the endogenous apoptosis modulators Bcl-2 and p53 regulate Adriamycin-dependent apoptosis [40,41], a cellular lipid messenger, ceramide, generated by Ariamycin was recently revealed to contribute to the development of resistance in a number of cancer cell types [42]. This evidence concerns the gene TP53 and cancer.