In addition, the combined use of forbesione with 5-fluorouracil produced synergistic effects in inhibiting growth and proliferation in cholangiocarcinoma cancer (in vitro and in vivo studies using Ham-1 cells), through downregulating Bcl-2 and increasing expression of p53, Bax, Apaf-1, and caspase 3/-9, which induces apoptosis and results in the killing of the tumor cells [96]. The gene discussed is CASP3; the disease is neoplasm.