Scheme of synergistic induction of apoptosis by BV6/dexamethasone cotreatment. BV6 and dexamethasone cooperate to cause rapid downregulation of cIAP proteins, which in turn triggers the formation of the ripoptosome, a cytosolic complex of RIP1, FADD, and caspase-8. Ripoptosome assembly drives caspase-8 activation, leading to Bak activation, ROS production, cytochrome C release, caspase-3 activation, and cell death. Also, BV6 and dexamethasone act together to downregulate XIAP, which promotes caspase-3 activation and cell death. In addition, BV6 binds to and antagonizes XIAP.