The Role of Medicinal Herbs and Phytochemicals in Cancer Management: A Review

Authors
  • Chema Drira

    Department of Pharmacy, Marrow Bone Transplant Center , Tunisia. , Tunis El Manar University image/svg+xml
  • Ikram Fazaa

    Department of Pharmacy, Marrow Bone Transplant Center , Tunisia. , Tunis El Manar University image/svg+xml
  • Leila Achour

    Department of Pharmacy, Marrow Bone Transplant Center , Tunisia. , Tunis El Manar University image/svg+xml
  • Yosr Trabelsi

    Department of Pharmacy, Marrow Bone Transplant Center , Tunisia.
  • Mounsef Freddy

    Department of Pharmacy, Hospital of Saint-Etienne, France.
  • Cherif Dorra

    University of Monastir image/svg+xml
Keywords:
Herbs, Phytochemicals, Anticancer, Autophagy, Apoptosis
Abstract

Bioactive compounds have demonstrated notable potential in the management of cancer and are recognized for their diverse therapeutic applications. Among these, phytochemicals have garnered significant attention for their capacity to modulate key cellular mechanisms involved in cancer development, particularly autophagy and apoptosis. The current body of evidence indicates that these naturally derived compounds may influence cancer pathogenesis by regulating interconnected pathways. Consequently, the targeting of the autophagy-apoptosis signaling axis using phytocompounds emerges as a promising adjunct strategy alongside conventional chemotherapeutic regimens. In order to enhance comprehension of the autophagy-apoptosis pathway's role in cancer pathobiology and its potential as a therapeutic target for the development of anticancer drugs, this review will attempt to delve into its molecular dynamics. A variety of credible scientific databases were systematically searched to retrieve data for this review. The effectiveness of phytochemicals as cancer treatments was assessed using a holistic method that took into account the compounds' molecular signaling connections, pharmacological profiles, and action mechanisms. From a cancer biology perspective, significant factors such as caspase activity, Nrf2, NF-κB, and the autophagy-apoptosis pathway are studied.

References

Abiri, O. T., Sheriff, M. S., Smalle, I. O., Bell, N. V. T., Kamara, I. F., Kamara, T. B., Cummings-John, C., Coker, J., Bah, A. J., Kanu, J. S., Luke, R., Kamara, L., Smith, J., & Samai, M. (2024). Complementary and alternative medicine use and its impact on quality of life among cancer patients in Freetown, Sierra Leone: considerations for a resource-limited setting. Discover Medicine, 1(1), 150. https://doi.org/10.1007/s44337-024-00153-0

Ameer, S. F., Mohamed, M. Y., Elzubair, Q. A., Sharif, E. A. M., & Ibrahim, W. N. (2024). Curcumin as a novel therapeutic candidate for cancer: can this natural compound revolutionize cancer treatment? Frontiers in Oncology, 14. https://doi.org/10.3389/fonc.2024.1438040

Ashadul Sk, Md., K., H., Matada, G. S. P., Pal, R., B.V., M., Mounika, S., E., H., M.P., V., & D., A. (2025). Current developments in PI3K-based anticancer agents: Designing strategies, biological activity, selectivity, structure-activity correlation, and docking insight. Bioorganic Chemistry, 154, 108011. https://doi.org/10.1016/j.bioorg.2024.108011

Asiimwe, J. B., Nagendrappa, P. B., Atukunda, E. C., Kamatenesi, M. M., Nambozi, G., Tolo, C. U., Ogwang, P. E., & Sarki, A. M. (2021). Prevalence of the Use of Herbal Medicines among Patients with Cancer: A Systematic Review and Meta-Analysis. Evidence-Based Complementary and Alternative Medicine, 2021, 1–18. https://doi.org/10.1155/2021/9963038

Auyeung, K. K.-W., & Ko, J. K.-S. (2010). Novel herbal flavonoids promote apoptosis but differentially induce cell cycle arrest in human colon cancer cell. Investigational New Drugs, 28(1), 1–13. https://doi.org/10.1007/s10637-008-9207-3

Au-Yeung, K. K.-W., Liu, P.-L., Chan, C., Wu, W.-Y., Lee, S. S.-T., & Ko, J. K.-S. (2008). Herbal Isoprenols Induce Apoptosis in Human Colon Cancer Cells Through Transcriptional Activation of PPARγ. Cancer Investigation, 26(7), 708–717. https://doi.org/10.1080/07357900801898656

Ayoade, O. F., Caturegli, G., Canavan, M. E., Resio, B. J., Berger, E. R., & Boffa, D. J. (2026). Use of Complementary and Alternative Medicine in the Management of Breast Cancer. JAMA Network Open, 9(3), e260337. https://doi.org/10.1001/jamanetworkopen.2026.0337

Baak, J. P. A. A., Gyllenhaal, C., Liu, L., Guo, H., & Block, K. I. (2011). Prognostic Proof and Possible Therapeutic Mechanisms of Herbal Medicine in Patients With Metastatic Lung and Colon Cancer. Integrative Cancer Therapies, 10(3), NP1–NP11. https://doi.org/10.1177/1534735411421172

Bel’skaya, L. V., & Dyachenko, E. I. (2024). Oxidative Stress in Breast Cancer: A Biochemical Map of Reactive Oxygen Species Production. Current Issues in Molecular Biology, 46(5), 4646–4687. https://doi.org/10.3390/cimb46050282

Bray, F., Laversanne, M., Sung, H., Ferlay, J., Siegel, R. L., Soerjomataram, I., & Jemal, A. (2024). Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: A Cancer Journal for Clinicians, 74(3), 229–263. https://doi.org/10.3322/caac.21834

Chen, Y., Li, Z., Gao, F., Zhang, ying, Sun, H., & Li, P. (2009). Effects of combined Chinese drugs and chemotherapy in treating advanced non-small cell lung cancer. Chinese Journal of Integrative Medicine, 15(6), 415–419. https://doi.org/10.1007/s11655-009-0415-2

Ehrlich, M., Gama-Sosa, M. A., Huang, L.-H., Midgett, R. M., Kuo, K. C., McCune, R. A., & Gehrke, C. (1982). Amount and distribution of 5-methylcytosine in human DNA from different types of tissues or cells. Nucleic Acids Research, 10(8), 2709–2721. https://doi.org/10.1093/nar/10.8.2709

Ernst, E., & Cassileth, B. R. (1998). The prevalence of complementary/alternative medicine in cancer: a systematic review. Cancer, 83(4), 777–782. https://doi.org/https://doi.org/10.1002/(sici)1097-0142(19980815)83:4%3C777::aid-cncr22%3E3.0.co;2-o

Feldmann, G., Dhara, S., Fendrich, V., Bedja, D., Beaty, R., Mullendore, M., Karikari, C., Alvarez, H., Iacobuzio-Donahue, C., Jimeno, A., Gabrielson, K. L., Matsui, W., & Maitra, A. (2007). Blockade of Hedgehog Signaling Inhibits Pancreatic Cancer Invasion and Metastases: A New Paradigm for Combination Therapy in Solid Cancers. Cancer Research, 67(5), 2187–2196. https://doi.org/10.1158/0008-5472.CAN-06-3281

Ferro, M. A., Leis, A., Doll, R., Chiu, L., Chung, M., & Barroetavena, M.-C. (2007). The impact of acculturation on the use of traditional Chinese medicine in newly diagnosed Chinese cancer patients. Supportive Care in Cancer, 15(8), 985–992. https://doi.org/10.1007/s00520-007-0285-0

Fesik, S. W., & Shi, Y. (2001). Controlling the Caspases. Science, 294(5546), 1477–1478. https://doi.org/10.1126/science.1062236

Franek, K. J., Zhou, Z., Zhang, W.-D., & Chen, W. Y. (2005). In vitro studies of baicalin alone or in combination with Salvia miltiorrhiza extract as a potential anti-cancer agent. International Journal of Oncology, 26(1), 217–224.

Garutti, M., de Scordilli, M., Alberti, M., Mazzeo, R., Michelotti, A., Fagioli, S., Del Conte, A., Casirati, A., Caccialanza, R., Bartolini, E., & Puglisi, F. (2026). Vitamins and minerals and their role in cancer: a comprehensive review. Frontiers in Nutrition, 12. https://doi.org/10.3389/fnut.2025.1686777

Gerber, B., Scholz, C., Reimer, T., Briese, V., & Janni, W. (2006). Complementary and alternative therapeutic approaches in patients with early breast cancer: a systematic review. Breast Cancer Research and Treatment, 95(3), 199–209. https://doi.org/10.1007/s10549-005-9005-y

Guo, Q., Jin, Y., Chen, X., Ye, X., Shen, X., Lin, M., Zeng, C., Zhou, T., & Zhang, J. (2024). NF-κB in biology and targeted therapy: new insights and translational implications. Signal Transduction and Targeted Therapy, 9(1), 53. https://doi.org/10.1038/s41392-024-01757-9

Gutsche, L. C., Dörfler, J., & Hübner, J. (2025). Curcumin as a complementary treatment in oncological therapy: a systematic review. European Journal of Clinical Pharmacology, 81(1), 1–33. https://doi.org/10.1007/s00228-024-03764-9

Ha, T.-Y. (2011). MicroRNAs in Human Diseases: From Cancer to Cardiovascular Disease. Immune Network, 11(3), 135. https://doi.org/10.4110/in.2011.11.3.135

Hargreaves, D. C., & Crabtree, G. R. (2011). ATP-dependent chromatin remodeling: genetics, genomics and mechanisms. Cell Research, 21(3), 396–420. https://doi.org/10.1038/cr.2011.32

Hofseth, L. J., & Wargovich, M. J. (2007). Inflammation, Cancer, and Targets of Ginseng. The Journal of Nutrition, 137(1), 183S-185S. https://doi.org/10.1093/jn/137.1.183S

Hurley, J. H., & Young, L. N. (2017). Mechanisms of Autophagy Initiation. Annual Review of Biochemistry, 86(1), 225–244. https://doi.org/10.1146/annurev-biochem-061516-044820

Jang, Y., & Kim, C. Y. (2024). The Role of Vitamin E Isoforms and Metabolites in Cancer Prevention: Mechanistic Insights into Sphingolipid Metabolism Modulation. Nutrients, 16(23), 4115. https://doi.org/10.3390/nu16234115

Jenča, A., Mills, D., Ghasemi, H., Saberian, E., Jenča, A., Karimi Forood, A. M., Petrášová, A., Jenčová, J., Jabbari Velisdeh, Z., Zare-Zardini, H., & Ebrahimifar, M. (2024). Herbal Therapies for Cancer Treatment: A Review of Phytotherapeutic Efficacy. Biologics: Targets and Therapy, Volume 18, 229–255. https://doi.org/10.2147/BTT.S484068

Jeon, H., Wang, S., Song, J., Gill, H., & Cheng, H. (2025). Update 2025: Management of Non Small-Cell Lung Cancer. Lung, 203(1), 53. https://doi.org/10.1007/s00408-025-00801-x

Jiang, W.-Y. (2005). Therapeutic wisdom in traditional Chinese medicine: A perspective from modern science. Discovery Medicine, 5(29), 455–461.

Jimoh, A. O., Hudu, S. A., Aliyu, U. M., Adamu, A. A., Bello, N., Tahir, A., & Abubakar, N. (2025). Exploring the use of complementary and alternative medicine among cancer patients in Africa: A systematic review. Scientific African, 29, e02852. https://doi.org/10.1016/j.sciaf.2025.e02852

Ju, L.-X., Chen, Z., & Ren, R.-Z. (2005). Progress in research on the treatment of primary liver cancer with traditional Chinese medicine for activating blood to resolve stasis. Zhong Xi Yi Jie He Xue Bao = Journal of Chinese Integrative Medicine, 3(6), 491–494. https://doi.org/10.3736/jcim20050620

Konieczna, J., Chaplin, A., Paz-Graniel, I., Croker, H., Becerra-Tomás, N., Markozannes, G., Tsilidis, K. K., Dossus, L., Gonzalez-Gil, E. M., Park, Y., Krebs, J., Weijenberg, M. P., Baskin, M. L., Copson, E., Lewis, S. J., Seidell, J. C., Chowdhury, R., Hill, L., Chan, D. S., & Romaguera, D. (2025). Adulthood dietary and lifestyle patterns and risk of breast cancer: Global Cancer Update Programme (CUP Global) systematic literature review. The American Journal of Clinical Nutrition, 121(1), 14–31. https://doi.org/10.1016/j.ajcnut.2024.10.003

Kudamba, A., A Okurut, S., M Kafeero, H., Nsubuga, H., Walusansa, A., & E. Ssenku, J. (2022). Assessment of Knowledge, Perception, Attitude, Risk Factors Prevention, and Treatment Options of Cancer among Natives in Elgon Sub-Region, Uganda. Fortune Journal of Health Sciences, 05(03). https://doi.org/10.26502/fjhs.074

Kupfer, J. T., Boekweg, N., Zheng, H., Puckett, J., & Ramana, K. V. (2025). Significance of Vitamins A and E in Cancer Progression and Prevention. International Journal of Molecular Sciences, 26(23), 11588. https://doi.org/10.3390/ijms262311588

Kyrø, C., Grand, M. K., Bigaard, J., Rossing, M., Knoop, A. S., Kroman, N., Mellemkjær, L., Dahm, C. C., Bidstrup, P. E., Tjønneland, A., & Olsen, A. (2025). Dietary Supplement Use and Life Expectancy After Breast Cancer–The Danish Diet, Cancer and Health Cohort. The Journal of Nutrition, 155(12), 4502–4513. https://doi.org/10.1016/j.tjnut.2025.09.035

Labrie, M., Brugge, J. S., Mills, G. B., & Zervantonakis, I. K. (2022). Therapy resistance: opportunities created by adaptive responses to targeted therapies in cancer. Nature Reviews Cancer, 22(6), 323–339. https://doi.org/10.1038/s41568-022-00454-5

Li, F., Tian, J., Zhang, L., He, H., & Song, D. (2024). A multi-omics approach to reveal critical mechanisms of activator protein 1 (AP-1). Biomedicine & Pharmacotherapy, 178, 117225. https://doi.org/10.1016/j.biopha.2024.117225

Lin, H.-S., & Li, D.-R. (2007). Multi-center randomized clinical study on Shenqi-fuzheng injection combined with chemotherapy in the treatment for lung cancer. Zhonghua Zhong Liu Za Zhi [Chinese Journal of Oncology], 29(12), 931–934.

Lin, L., Zhou, D., Liu, K., Wang, F., Lan, S., & Ye, X. (2005). Analysis on the prognostic factors in patients with large hepatocarcinoma treated by shentao ruangan pill and hydroxycamptothecine. Zhongguo Zhong Xi Yi Jie He Za Zhi Zhongguo Zhongxiyi Jiehe Zazhi = Chinese Journal of Integrated Traditional and Western Medicine, 25(1), 8–11.

Liu, Q., Zhang, Y.-B., Ma, C.-H., Yue, X.-Q., & Ling, C.-Q. (2005). Analysis of literature on therapeutic methods and medicines of traditional Chinese medicine for primary liver cancer. Zhong Xi Yi Jie He Xue Bao = Journal of Chinese Integrative Medicine, 3(4), 260–262. https://doi.org/10.3736/jcim20050403

Mahadiuzzaman, A. S. M., Dain Md Opo, F. A., & Alkarim, S. (2024). Stem cell-based targeted therapy in pancreatic cancer: Current approaches and future prospects. Tissue and Cell, 89, 102449. https://doi.org/10.1016/j.tice.2024.102449

Maskarinec, G., Shumay, D. M., Kakai, H., & Gotay, C. C. (2000). Ethnic Differences in Complementary and Alternative Medicine Use Among Cancer Patients. The Journal of Alternative and Complementary Medicine, 6(6), 531–538. https://doi.org/10.1089/acm.2000.6.531

Mathijssen, R. H. J., Verweij, J., de Bruijn, P., Loos, W. J., & Sparreboom, A. (2002). Effects of St. John’s wort on irinotecan metabolism. Journal of the National Cancer Institute, 94(16), 1247–1249. https://doi.org/10.1093/jnci/94.16.1247

Meng, M.-B., Cui, Y.-L., Guan, Y.-S., Ying, Z., Zheng, M.-H., Yuan, C.-K., & Zhang, R.-M. (2008). Traditional Chinese Medicine Plus Transcatheter Arterial Chemoembolization for Unresectable Hepatocellular Carcinoma. The Journal of Alternative and Complementary Medicine, 14(8), 1027–1042. https://doi.org/10.1089/acm.2008.0060

Meng, Z., Yang, P., Shen, Y., Bei, W., Zhang, Y., Ge, Y., Newman, R. A., Cohen, L., Liu, L., Thornton, B., Chang, D. Z., Liao, Z., & Kurzrock, R. (2009). Pilot study of huachansu in patients with hepatocellular carcinoma, nonsmall‐cell lung cancer, or pancreatic cancer. Cancer, 115(22), 5309–5318. https://doi.org/10.1002/cncr.24602

Mitra, S., & Dash, R. (2018). Natural Products for the Management and Prevention of Breast Cancer. Evidence-Based Complementary and Alternative Medicine, 2018(1). https://doi.org/10.1155/2018/8324696

Mustafa, M., Ahmad, R., Tantry, I. Q., Ahmad, W., Siddiqui, S., Alam, M., Abbas, K., Moinuddin, Hassan, Md. I., Habib, S., & Islam, S. (2024). Apoptosis: A Comprehensive Overview of Signaling Pathways, Morphological Changes, and Physiological Significance and Therapeutic Implications. Cells, 13(22), 1838. https://doi.org/10.3390/cells13221838

Mwaka, A. D., Abbo, C., & Kinengyere, A. A. (2020). Traditional and Complementary Medicine Use Among Adult Cancer Patients Undergoing Conventional Treatment in Sub-Saharan Africa: A Scoping Review on the Use, Safety and Risks. Cancer Management and Research, Volume 12, 3699–3712. https://doi.org/10.2147/CMAR.S251975

Nair, S. T., Abhi, C., Kamalasanan, K., Pavithran, K., Unni, A. R., Sithara, M., Sarma, M., & Mangalanandan, T. S. (2024). Pathophysiology-Driven Approaches for Overcoming Nanomedicine Resistance in Pancreatic Cancer. Molecular Pharmaceutics, 21(12), 5960–5988. https://doi.org/10.1021/acs.molpharmaceut.4c00801

Saxena, R., Welsh, C. M., & He, Y.-W. (2024). Targeting regulated cell death pathways in cancers for effective treatment: a comprehensive review. Frontiers in Cell and Developmental Biology, 12. https://doi.org/10.3389/fcell.2024.1462339

Sigafoos, A. N., Paradise, B. D., & Fernandez-Zapico, M. E. (2021). Hedgehog/GLI Signaling Pathway: Transduction, Regulation, and Implications for Disease. Cancers, 13(14), 3410. https://doi.org/10.3390/cancers13143410

Swain, S., Narayan, R. K., & Mishra, P. R. (2024). Unraveling the interplay: exploring signaling pathways in pancreatic cancer in the context of pancreatic embryogenesis. Frontiers in Cell and Developmental Biology, 12. https://doi.org/10.3389/fcell.2024.1461278

Tian, J.-H., Liu, L.-S., Shi, Z.-M., Zhou, Z.-Y., & Wang, L. (2010). A Randomized Controlled Pilot Trial of “Feiji Recipe” on Quality of Life of Non-Small Cell Lung Cancer Patients. The American Journal of Chinese Medicine, 38(01), 15–25. https://doi.org/10.1142/S0192415X10007646

Xi, Z., Dai, R., Ze, Y., Jiang, X., Liu, M., & Xu, H. (2025). Traditional Chinese medicine in lung cancer treatment. Molecular Cancer, 24(1), 57. https://doi.org/10.1186/s12943-025-02245-6

Zhang, Y., & Benet, L. Z. (2001). The Gut as a Barrier to Drug Absorption. Clinical Pharmacokinetics, 40(3), 159–168. https://doi.org/10.2165/00003088-200140030-00002

Zhong, H., Zhou, Z., Wang, H., Wang, R., Shen, K., Huang, R., & Wang, Z. (2024). The Biological Roles and Clinical Applications of the PI3K/AKT Pathway in Targeted Therapy Resistance in HER2-Positive Breast Cancer: A Comprehensive Review. International Journal of Molecular Sciences, 25(24), 13376. https://doi.org/10.3390/ijms252413376

Cover Image
Downloads
Published
2026-02-07
Section
Review Article
License

Copyright (c) 2026 Chema Drira, Ikram Fazaa, Leila Achour, Yosr Trabelsi, Mounsef Freddy, Cherif Dorra

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

How to Cite

Drira, C., Fazaa, I., Achour, L., Trabelsi, Y., Freddy, M., & Dorra, C. (2026). The Role of Medicinal Herbs and Phytochemicals in Cancer Management: A Review. Middle Eastern Cancer and Oncology Journal, 2(1), 33-40. https://doi.org/10.61706/MECOJ160177

Similar Articles

You may also start an advanced similarity search for this article.

Most read articles by the same author(s)