SMPD3 and cancer: In keeping with a possible role for alterations in the sphingolipid metabolism in immune evasion, sphingolipid pathway enzymes have been shown to modulate immune cell function in cancer [48], sphingomyelin appears to play a key role in tumor progression and immune evasion [49], and neutral sphingomyelinase 2 expression impairs melanoma growth by enhancing CD8+ T-cell responses [50].