Nevertheless, HNSCC is associated with mutations in genes such as cIAP1 [18]/BIRC2 [19], caspase-8 [20], FADD [19], and TNF [21] that affect the extrinsic apoptosis pathway indicating that this is pathway is likely to be particularly relevant when exploring SM induced cell death in HNSCC. This evidence concerns the gene TNF and head and neck squamous cell carcinoma.