Lidocaine also enhanced the in vitro effect of 5-fluorouracil in a study examining gastric cancer cells, an effect that may be associated with lidocaine-related inhibition of the c-mesenchymal-epithelial transition factor (c-Met)/Proto-oncogene tyrosine-protein kinase Src (c-Src) pathways leading to decreased B-cell lymphoma 2 (Bcl-2) levels and increased levels of Bax and cleaved caspase-3, resulting in apoptosis.43 This evidence concerns the gene CASP3 and gastric cancer.