Our data showed a marked increase in cytochrome c level and caspase-3 in the SEC tissues with both monotherapy and combination compared with the nontreated SEC group with the highest expression in the combined therapy group, as ZnO-NPs synergized with sorafenib inducing upregulation of cytochrome c and caspase-3 gene expression causing tumor cell death. The gene discussed is CASP3; the disease is neoplasm.