These authors illustrated 1) combination treatment of GEM/DOX increased CerS1 mRNA by 30% in UM-SCC-22A cells, 2) CerS1 overexpression and subsequent C18-ceramide upregulation enhanced GEM/DOX -induced cell death through caspase-3 activation, and 3) GEM/DOX treatment in SCID mice with UM-SCC-22A xenografts inhibited tumor growth, and these chemically treated tumors showed a seven-fold increase in C18-cermide concomitant with decreased C16-ceramide levels [104]. Here, CERS1 is linked to neoplasm.