ASC [apoptosis-associated speck-like protein containing a CARD (caspase-recruitment domain)] is a bimodel protein containing a pyrin/paad domain (PYD/PAAD) and a caspase recruitment domain (CARD) ASC is also known as TMS1 (target of methylation-induced silencing). In general proteins, like ASC/TMS1, containing PYD/PAAD and CARD domains play key roles in regulating apoptosis and inflammation signaling pathways. Mutations in a number of PYD/PAAD- and CARD-containing proteins have been linked to inflammatory diseases and cancer. There is evidence that ASC/TMS1 has roles in both apoptosis and inflammation signaling pathways.With respect to inflammation, ASC/TMS1 interacts with the CARD of procaspase-1 and induces aggregation of a protein complex called the inflammasome, thereby regulating caspase-1 activation and secretion of IL-1b. Additionally, ASC/TMS1 has been found to be subjected to methylation-mediated silencing in a significant proportion of human breast tumors and other cancers, including melanomas, glioblastomas, non-small lung cancers, gastric and colorectal cancers. The loss of ASC/TMS1 expression in breast tumors and other cancers through methylation-mediated (epigenetic) silencing suggests that ASC/TMS1 has a role in tumorigenesis. In general, it is thought that methylation-mediated gene silencing contributes to tumorigenesis by inactivating genes involved in tumor suppression, and by conferring resistance to cell death signals by silencing genes that promote apoptosis. Thus methylation-mediated silencing of ASC/TMS1 may confer a survival advantage to tumor cells by enabling them to escape apoptosis. However, the precise role of ASC/TMS1 in the pathogenesis of cancer remains to be fully elucidated.