“…Furthermore, Digitoxin and the other cardiac glycosides have been reported as cytotoxic agents, probably not exclusively due to their activity as Na + /K + ATPase inhibitors, with consequent membrane fluidity alterations, increasing Ca 2+ levels. Additionally, through mitochondrial Na + /Ca 2+ pump activity exacerbation and triggering cytoskeleton alterations, that lead to cell cycle dysregulation with possible Mcl-1 (induced myeloid leukemia cell differentiation protein Mcl-1) and Bcl-xl (B-cell lymphoma-extra large) down-regulation, it is a possible a mechanism involving a mitochondrial apoptosis-inducing pathway [ 71 , 72 ]. Other hypotheses involve an ampler signalosome [ 73 , 74 ] leading to a multitude of effects leading to cell death, namely topoisomerase inhibition [ 75 ], EGFR/Src/Akt signaling cross-talking [ 76 ], Na + /K + ATPase, and Src endosomal trafficking and immunogenic cell death [ 74 ], p21 up-regulation and JNKs (c-Jun N-terminal kinases) activation [ 77 ], and HIF1-α (hypoxia-inducible factor 1-alpha) inhibition [ 78 ].…”