BIRC5 and cancer: In a previous study, β-elemene was demonstrated to be effective in cancer management by multiple mechanisms, including the inhibition of MAPK/ERK and PI3K/Akt/mTOR signaling pathways [25, 53], the activation of p38 MAPK and/or JNK [54], the downregulation of survivin and hypoxia-inducible factor-1a (HIF-1α) [55], decreasing Bcl-2 expression [56], and inducing cell cycle arrest [57] as well as cell apoptosis [58, 59].