Herbal Drugs in Cancer Treatment: Current Advances, Efficacy, And Future Prospects in Modern Medicine

Khot Nikhil, Lohar Dayanand, Khamkar Sakshi, Lokare Sonakshi, Karande Sankalp, Torskar Sourabh, Jamadar Wajid,

doi:10.5281/zenodo.15380959

Review Paper | Open Access
Volume 02 | Issue 05 | Article Id IJSRT/250304195

Herbal Drugs in Cancer Treatment: Current Advances, Efficacy, And Future Prospects in Modern Medicine
Khot Nikhil* Lohar Dayanand Khamkar Sakshi Lokare Sonakshi Karande Sankalp Torskar Sourabh Jamadar Wajid
Ashokrao Mane College of Pharmacy Peth Vadgaon 416112 Maharashtra India

Abstract

Cancer remains one of the leading causes of mortality worldwide, prompting continuous exploration of effective, safe, and affordable treatment options. Herbal drugs, derived from medicinal plants, have gained increasing attention as potential therapeutic agents due to their bioactive compounds with anticancer properties. Recent advances in phytochemistry and molecular pharmacology have elucidated the mechanisms through which herbal compounds such as curcumin, resveratrol, quercetin, and berberine exert anti-proliferative, pro-apoptotic, anti-angiogenic, and immune-modulatory effects on cancer cells. Clinical and preclinical studies have shown promising results, highlighting the potential of herbal drugs to enhance the efficacy of conventional therapies and reduce treatment-associated toxicity. Despite their therapeutic promise, challenges such as variability in plant composition, lack of standardization, limited bioavailability, and regulatory hurdles remain. This review explores the current landscape of herbal drugs in cancer therapy, evaluates their clinical efficacy, and discusses future directions for integrating these natural compounds into mainstream oncological treatment, emphasizing the need for rigorous scientific validation and technological innovations to unlock their full potential.

Keywords

Herbal medicine, cancer therapy, phytochemicals, natural compounds, chemotherapy adjuvant, anticancer efficacy, modern medicine, drug development

Introduction

In both high-income countries (HICs) and low- and middle-income ones (LMICs), cancer is a major cause of death worldwide among women. Furthermore, in high-, mid-, and low-income countries alike, the burden of cancer is increasing, prompting an additional impact due to population growth and aging. Females constitute 49.5% of total world population; however, they form a greater proportion of the population over 60 years, [2] where cancer is incident almost exclusively in HICs and LMICs, due to contrasting life expectancy and leading causes of death. To reduce the incidence of the abovementioned cancers, the prevention of carcinogenic infections and efforts aimed at lifestyle improvement are essential. [3] In low-income countries, infection-related cancers are predominant. In contrast, in high-income countries lung, colorectal [4], and breast cancer, which are strongly associated with lifestyle-related risk factors, including cigarette smoking, alcohol consumption [5] , and obesity, display high incidence rates. In addition, the prevalence of cancer-screening tests and the identification of high-risk patients [6], including those with inherited cancer syndromes, are important for improving survival. [7] There is scant communication between patients and health care providers with respect to CIM and herbal remedies [8] Unmonitored use can cause many adverse effects and herb-drug interactions, especially for cancer patients currently undergoing treatment [9]. For example, herbs with potent antioxidant properties may antagonize radiation therapy and selected chemotherapeutic agents [10] hemorrhagic potential of anticoagulant herbs may further enhance the action of anticoagulant/ant platelet drugs with a consequent increase in risk for bleeding phytoestrogenic herbs may alter the pharmacokinetics of hormonal therapies immunomodulant herbs may antagonize the action of immunosuppressive drugs Research into ethno botanical evidence is a key contributor in the search for herbs possesing anticancer activity[11] ; A few medicinal herbs, such as Catharanthus roseus and Pacific yew (Taxus brevifolia), have been in use for centuries as traditional medicine and, in later years, found their way as sources of chemotherapy drugs (vincristine/vinblastine and taxanes[12] More, drug-derived types from herbs include morphine (which is derived from the opium poppy-Papaver somniferous , psychoactive substances from Cannabis sativa, and have both been used for therapeutic pain relief and enhancement of the patient's well-being[13] . Further search for other herbs can, therefore, lead to identification of more herbs with anticancer activity such as ayurvedic medicine in India and shamans in the Amazon rain forest. [14] The purpose of intervention is to provide benefits to beneficiaries. Most importantly, for clinical trials this means measuring the differential impact of treatments against some outcome [15]. Thus, the selection of appropriate outcomes becomes critical to the assessment of whether any intervention is superior to others [16]. This review is about research explaining the selection of outcome measures for use in clinical trials for children below 16 years [17]. On that note, for the purpose of this review, a child is defined by age, and not in the literal sense of offspring. [18]

Mechanism Action of Herbal Drugs On Cancer Treatment:

There are a lot of herbs that contain bioactive compounds which can act against the oxidative stress inflicted on the body. They include polyphenolic, flavonoid, and vitamin antioxidants that neutralize the [19] free radical activity that occurs in the body. Free radicals are unstable molecules capable of damaging the cells and DNA within the organism. The consequence is cancer [20]. Thus, the herbal medicines may protect the cells from damage caused by carcinogens via the mediation of oxidative stress. [21] For instance, curcumin (known in turmeric) effectively prevents DNA damage leading to cancer in humans by providing enormous antioxidant impact. [22] One way in which new blood vessels from angiogenesis develop is the formation of new blood vessels that would supply nutrients for growing tumors. [23] These new blood vessels can be starved by herbal compounds, hence preventing the growth or spreading of the tumor.

Reference

Dare AJ, Knapp GC, Romanoff A, Olasehinde O, Famurewa OC, Komolafe AO, Olatoke S, Katung A, Alatise OI, Kingham TP. High-burden cancers in Middle-income countries: a review of Prevention and early detection strategies targeting At-risk populations. Cancer Prevention Research. 2021 Dec 1;14(12):1061-74.
Diczfalusy E, Benagiano G. Women and the third and fourth age. International Journal of Gynecology & Obstetrics. 1997 Jul 1;58(1):177-88.
Ayenigbara IO. Risk-reducing measures for cancer prevention. Korean Journal of Family Medicine. 2023 Mar 20;44(2):76.
Arnold M, Sierra MS, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global patterns and trends in colorectal cancer incidence and mortality. Gut. 2017 Apr 1;66(4):683-91.
Vegunta S, Lester SP, Pruthi S, Mussallem DM. Effects of major lifestyle factors on breast cancer risk: impact of weight, nutrition, physical activity, alcohol and tobacco. Breast Cancer Management. 2020 Dec 1;9(4): BMT51.
Fedewa SA, Sauer AG, Siegel RL, Jemal A. Prevalence of major risk factors and use of screening tests for cancer in the United States. Cancer Epidemiology, Biomarkers & Prevention. 2015 Apr 1;24(4):637-52.
Kastrinos F, Syngal S. Inherited colorectal cancer syndromes. The Cancer Journal. 2011 Nov 1;17(6):405-15.
Gonzalez AS. Communication barriers between patients and healthcare providers regarding disclosure of herbal product use.
Asokkumar K, Ramachandran S. Herb-drug interactions: Focus on adverse drug reactions and pharmacovigilance of herbal medicines. InHerbal Medicine in India: Indigenous Knowledge, Practice, Innovation and its Value 2019 Sep 11 (pp. 547-571). Singapore: Springer Singapore.
Zhang Y, Huang Y, Li Z, Wu H, Zou B, Xu Y. Exploring natural products as radioprotective agents for cancer therapy: Mechanisms, challenges, and opportunities. Cancers. 2023 Jul 12;15(14):3585.
Merrouni IA, Elachouri M. Anticancer medicinal plants used by Moroccan people: Ethnobotanical, preclinical, phytochemical and clinical evidence. Journal of Ethnopharmacology. 2021 Feb 10; 266:113435.
Mani DN, Shukla SE, Shukla YN. Medicinal plant-derived therapeutics for treatment of neoplasms in modern and traditional systems of medicine. Journal of Medicinal and Aromatic Plant Sciences. 2020;42(1-2):1-29.
Lee P. Opium Culture: The Art and Ritual of the Chinese Tradition. Inner Traditions/Bear & Co; 2006.
Coelho TA, dos Santos Barbosa AK, dos Santos Moraes JJ, Gomes SQ, de Paula da Silva CH. Use of Phytotherapeutics in the Amazon with a Focus on the Metropolitan Region of Belém: Traditional Applications and Computational Studies of Bioactive Compounds. InProgress in Hydrogen Energy, Fuel Cells, Nano-Biotechnology and Advanced, Bioactive Compounds 2024 Dec 16 (pp. 281-300). Cham: Springer Nature Switzerland.
Barnett JE, Lazarus AA, Vasquez MJ, Moorehead-Slaughter O, Johnson WB. Boundary issues and multiple relationships: Fantasy and reality. Professional psychology: Research and practice. 2007 Aug;38(4):401a.
Paterson C, Baarts C, Launsø L, Verhoef MJ. Evaluating complex health interventions: a critical analysis of the'outcomes' concept. BMC Complementary and Alternative Medicine. 2009 Dec; 9:1-1.
Sinha IP, Altman DG, Beresford MW, Boers M, Clarke M, Craig J, Alberighi OD, Fernandes RM, Hartling L, Johnston BC, Lux A. Standard 5: selection, measurement, and reporting of outcomes in clinical trials in children. Pediatrics. 2012 Jun 1;129(Supplement_3): S146-52.
Springer K. Young children's understanding of a biological basis for parent?offspring relations. Child Development. 1996 Dec;67(6):2841-56.
Akbari B, Baghaei?Yazdi N, Bahmaie M, Mahdavi Abhari F. The role of plant?derived natural antioxidants in reduction of oxidative stress. BioFactors. 2022 May;48(3):611-33.
Pryor WA. Cancer and free radicals. InAntimutagenesis and anticarcinogenesis mechanisms 1986 Jan 1 (pp. 45-59). Boston, MA: Springer US.
Lee JH, Shu L, Fuentes F, Su ZY, Kong AN. Cancer chemoprevention by traditional chinese herbal medicine and dietary phytochemicals: targeting nrf2-mediated oxidative stress/anti-inflammatory responses, epigenetics, and cancer stem cells. Journal of traditional and complementary medicine. 2013 Jan 1;3(1):69-79.
Gupta N, Verma K, Nalla S, Kulshreshtha A, Lall R, Prasad S. Free radicals as a double-edged sword: The cancer preventive and therapeutic roles of curcumin. Molecules. 2020 Nov 18;25(22):5390.
Dvorak HF. Tumor stroma, tumor blood vessels, and antiangiogenesis therapy. The Cancer Journal. 2015 Jul 1;21(4):237-43.
Menon VP, Sudheer AR. Antioxidant and anti-inflammatory properties of curcumin. The molecular targets and therapeutic uses of curcumin in health and disease. 2007 Sep:105-25.
Mbese Z, Khwaza V, Aderibigbe BA. Curcumin and its derivatives as potential therapeutic agents in prostate, colon and breast cancers. Molecules. 2019 Nov 30;24(23):4386.
Singh BN, Shankar S, Srivastava RK. Green tea catechin, epigallocatechin-3-gallate (EGCG): mechanisms, perspectives and clinical applications. Biochemical pharmacology. 2011 Dec 15;82(12):1807-21.
Bahmani M, Shirzad H, Shahinfard N, Sheivandi L, Rafieian-Kopaei M. Cancer phytotherapy: Recent views on the role of antioxidant and angiogenesis activities. Journal of evidence-based complementary & alternative medicine. 2017 Apr;22(2):299-309.
Safarzadeh E, Shotorbani SS, Baradaran B. Herbal medicine as inducers of apoptosis in cancer treatment. Advanced pharmaceutical bulletin. 2014 Aug 25;4(Suppl 1):421.
Jang WY, Hwang JY, Cho JY. Ginsenosides from Panax ginseng as key modulators of NF-κB signaling are powerful anti-inflammatory and anticancer agents. International Journal of Molecular Sciences. 2023 Mar 24;24(7):6119.
Cao Y. Tumor angiogenesis and therapy. Biomedicine & pharmacotherapy. 2005 Oct 1;59: S340-3.
Binion DG, Otterson MF, Rafiee P. Curcumin inhibits VEGF-mediated angiogenesis in human intestinal microvascular endothelial cells through COX-2 and MAPK inhibition. Gut. 2008 Nov 1;57(11):1509-17.
Talib WH, Atawneh S, Shakhatreh AN, Shakhatreh GA, Hamed RA, Al-Yasari IH. Anticancer potential of garlic bioactive constituents: Allicin, Z-ajoene, and organosulfur compounds. Pharmacia. 2024 Jan 24; 71:1-23.
Ratan ZA, Youn SH, Kwak YS, Han CK, Haidere MF, Kim JK, Min H, Jung YJ, Hosseinzadeh H, Hyun SH, Cho JY. Adaptogenic effects of Panax ginseng on modulation of immune functions. Journal of ginseng research. 2021 Jan 1;45(1):32-40.
Jang WY, Hwang JY, Cho JY. Ginsenosides from Panax ginseng as key modulators of NF-κB signaling are powerful anti-inflammatory and anticancer agents. International Journal of Molecular Sciences. 2023 Mar 24;24(7):6119.
Mozaffari F, Lindemalm C, Choudhury A, Granstam-Björneklett H, Helander I, Lekander M, Mikaelsson E, Nilsson B, Ojutkangas ML, Österborg A, Bergkvist L. NK-cell and T-cell functions in patients with breast cancer: effects of surgery and adjuvant chemo-and radiotherapy. British journal of cancer. 2007 Jul;97(1):105-11.
Al-Yasiry AR, Kiczorowska B. Frankincense-therapeutic properties. Advances in Hygiene & Experimental Medicine/Postepy Higieny i Medycyny Doswiadczalnej. 2016 Jan 1;70.
properties and inhibits many of those enzymes involved in inflammation and tumor growth. It also induces apoptosis in cancer cells and inhibits angiogenesis.
Keibel A, Singh V, Sharma MC. Inflammation, microenvironment, and the immune system in cancer progression. Current pharmaceutical design. 2009 Jun 1;15(17):1949-55.
Wang RA, Li QL, Li ZS, Zheng PJ, Zhang HZ, Huang XF, Chi SM, Yang AG, Cui R. Apoptosis drives cancer cells proliferate and metastasize. Journal of cellular and molecular medicine. 2013 Jan;17(1):205-11.
Kai Z, Michela P, Antonio P, Annamaria P. Biological active ingredients of traditional Chinese herb Astragalus membranaceus on treatment of diabetes: a systematic review. Mini reviews in medicinal chemistry. 2015 Apr 1;15(4):315-29.
Wargo JA, Reuben A, Cooper ZA, Oh KS, Sullivan RJ. Immune effects of chemotherapy, radiation, and targeted therapy and opportunities for combination with immunotherapy. InSeminars in oncology 2015 Aug 1 (Vol. 42, No. 4, pp. 601-616). WB Saunders.
Li S, Sun Y, Huang J, Wang B, Gong Y, Fang Y, Liu Y, Wang S, Guo Y, Wang H, Xu Z. Anti-tumor effects and mechanisms of Astragalus membranaceus (AM) and its specific immunopotentiation: Status and prospect. Journal of ethnopharmacology. 2020 Aug 10; 258:112797.
Bentzen SM. Preventing or reducing late side effects of radiation therapy: radiobiology meets molecular pathology. Nature Reviews Cancer. 2006 Sep 1;6(9):702-13.
Lee KW, Ching SM, Hoo FK, Ramachandran V, Swamy MK. Traditional medicinal plants and their therapeutic potential against major cancer types. Anticancer Plants: Natural Products and Biotechnological Implements: Volume 2. 2018:383-410.
Valková V, ?úranová H, Bil?íková J, Habán M. Milk thistle (Silybum marianum): a valuable medicinal plant with several therapeutic purposes. The Journal of Microbiology, Biotechnology and Food Sciences. 2020 Feb 1;9(4):836.
Saeidnia S, Abdollahi M. Antioxidants: friends or foe in prevention or treatment of cancer: the debate of the century. Toxicology and applied pharmacology. 2013 Aug 15;271(1):49-63.
Marian MJ. Dietary supplements commonly used by cancer survivors: are there any benefits? Nutrition in Clinical Practice. 2017 Oct;32(5):607-27.
Sharma AN, Dewangan HK, Upadhyay PK. Comprehensive review on herbal medicine: emphasis on current therapy and role of phytoconstituents for cancer treatment. Chemistry & biodiversity. 2024 Mar;21(3):e202301468.
Yin SY, Wei WC, Jian FY, Yang NS. Therapeutic applications of herbal medicines for cancer patients. Evidence?Based Complementary and Alternative Medicine. 2013;2013(1):302426.
Xu J, Song Z, Guo Q, Li J. Synergistic effect and molecular mechanisms of traditional Chinese medicine on regulating tumor microenvironment and cancer cells. BioMed Research International. 2016;2016(1):1490738.
Yin SY, Wei WC, Jian FY, Yang NS. Therapeutic applications of herbal medicines for cancer patients. Evidence?Based Complementary and Alternative Medicine. 2013;2013(1):302426.
Nisar MF, Wan C, Büsselberg D, Calina D, Sharifi-Rad J. Current mechanistic insights into Withaferin A: a promising potential adjuvant anticancer agent from Withania somnifera. Naunyn-Schmiedeberg's Archives of Pharmacology. 2024 Nov 30:1-21.
Prabhu A. Anti-angiogenic, apoptotic and matrix metalloproteinase inhibitory activity of Withania somnifera (ashwagandha) on lung adenocarcinoma cells. Phytomedicine. 2021 Sep 1; 90:153639.
Dutta R, Khalil R, Green R, Mohapatra SS, Mohapatra S. Withania somnifera (Ashwagandha) and withaferin A: Potential in integrative oncology. International journal of molecular sciences. 2019 Oct 25;20(21):5310.
Lu L, Kanwar J, Schmitt S, Cui QC, Zhang C, Zhao C, Dou QP. Inhibition of tumor cellular proteasome activity by triptolide extracted from the Chinese medicinal plant ‘thunder god vine’. Anticancer research. 2011 Jan 1;31(1):1-0.
Jen?a A, Mills DK, Ghasemi H, Saberian E, Jen?a A, Karimi Forood AM, Petrášová A, Jen?ová J, Jabbari Velisdeh Z, Zare-Zardini H, Ebrahimifar M. Herbal therapies for cancer treatment: A review of phytotherapeutic efficacy. Biologics: Targets and Therapy. 2024 Dec 31:229-55.
Li FS, Weng JK. Demystifying traditional herbal medicine with modern approach. Nature plants. 2017 Jul 31;3(8):1-7.
Chen D, Zhao J, Cong W. Chinese herbal medicines facilitate the control of chemotherapy-induced side effects in colorectal cancer: progress and perspective. Frontiers in Pharmacology. 2018 Dec 7; 9:1442.
Li FS, Weng JK. Demystifying traditional herbal medicine with modern approach. Nature plants. 2017 Jul 31;3(8):1-7.
Qi F, Zhao L, Zhou A, Zhang B, Li A, Wang Z, Han J. The advantages of using traditional Chinese medicine as an adjunctive therapy in the whole course of cancer treatment instead of only terminal stage of cancer. Bioscience trends. 2015 Feb 28;9(1):16-34.
Archibald D. The Anticancer Garden in Australia. Rhaetian Management Pty. Limited; 2020.
Karikas GA. Anticancer and chemopreventing natural products: some biochemical and therapeutic aspects. J buon. 2010 Dec;15(4):627-38
Majolo F, Delwing LK, Marmitt DJ, Bustamante-Filho IC, Goettert MI. Medicinal plants and bioactive natural compounds for cancer treatment: Important advances for drug discovery. Phytochemistry Letters. 2019 Jun 1; 31:196-207.
Albahri G, Badran A, Abdel Baki Z, Alame M, Hijazi A, Daou A, Baydoun E. Potential anti-tumorigenic properties of diverse medicinal plants against the majority of common types of cancer. Pharmaceuticals. 2024 Apr 30;17(5):574.
Ala’a Mohammad AY. In vitro Anticancer Potential of Jordanian Ephedra Species.
Berretta M, Dal Lago L, Tinazzi M, Ronchi A, La Rocca G, Montella L, Di Francia R, Facchini BA, Bignucolo A, Montopoli M. Evaluation of concomitant use of anticancer drugs and herbal products: from interactions to synergic activity. Cancers. 2022 Oct 23;14(21):5203.
Leary M, Heerboth S, Lapinska K, Sarkar S. Sensitization of drug resistant cancer cells: a matter of combination therapy. Cancers. 2018 Dec 4;10(12):483.
Chen H, Liu RH. Potential mechanisms of action of dietary phytochemicals for cancer prevention by targeting cellular signaling transduction pathways. Journal of agricultural and food chemistry. 2018 Mar 2;66(13):3260-76.
Hossain CM, Gera ME, Ali KA. Current status and challenges of herbal drug development and regulatory aspect: a global perspective. Asian J. Pharm. Clin. Res. 2022; 15:31-41.
Shaban NS, Abdou KA, Hassan NE. Impact of toxic heavy metals and pesticide residues in herbal products. Beni-suef university journal of basic and applied sciences. 2016 Mar 1;5(1):102-6.
Cassileth BR. Evaluating complementary and alternative therapies for cancer patients. CA: a cancer journal for clinicians. 1999 Nov;49(6):362-75.
Fu B, Wang N, Tan HY, Li S, Cheung F, Feng Y. Multi-component herbal products in the prevention and treatment of chemotherapy-associated toxicity and side effects: A review on experimental and clinical evidences. Frontiers in Pharmacology. 2018 Nov 29; 9:1394.
Corns CM. Herbal remedies and clinical biochemistry. Annals of clinical biochemistry. 2003 Sep 1;40(5):489-507.
Baer-Dubowska W, Bartoszek A, Malejka-Giganti D. Carcinogenic and anticarcinogenic food components. CRC press; 2005 Sep 22.
Seeff LB, Bonkovsky HL, Navarro VJ, Wang G. Herbal products and the liver: a review of adverse effects and mechanisms. Gastroenterology. 2015 Mar 1;148(3):517-32.
Ernst E. Adverse effects of herbal drugs in dermatology. British Journal of Dermatology. 2000 Nov 1;143(5):923-9.
Basnet P, Skalko-Basnet N. Curcumin: an anti-inflammatory molecule from a curry spice on the path to cancer treatment. Molecules. 2011 Jun 3;16(6):4567-98.
Hicks J. The use of nutrition and dietary supplements as complimentary Care in Children with Cancer. Cure Our Children. 2012;12(02).
Farhan M. Green tea catechins: Nature’s way of preventing and treating cancer. International journal of molecular sciences. 2022 Sep 14;23(18):10713.
Alamgir AN. Therapeutic use of medicinal plants and their extracts: volume 1. Cham: Springer; 2017.

Khot Nikhil

Corresponding author

Ashokrao Mane College of pharmacy peth vadgaon 416112 Maharashtra india