Several studies attempt to investigate the mechanisms, the in vivo anticancer activity of S. costus is related mainly to induction of apoptosis by activating pro-apoptotic proteins such as p53 and Bax, while inhibiting anti-apoptotic proteins like Bcl-2, leading to programmed cell death, cell cycle arrest, modulating certain signaling pathways, such as EGFR, which reduces the proliferation and invasion of cancer cells, and suppress PI3K/Akt and MEK/P38 pathways, reduction the inflammatory process by suppression the level of TNF-α and NF-κB, and induction of reactive oxygen species. Here, BAX is linked to cancer.