Upon colonization, interaction with fibroblasts in the lung triggers a phenotypic switch in the disseminated tumor cells to a proliferative, epithelial phenotype with activation of BMP-dependent SMAD 1-5 signaling, and downregulation of TGFβ-dependent SMAD 2/3 signaling to promote tumor outgrowth (93) (Figure 1D). The gene discussed is TGFB1; the disease is neoplasm.