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Review
. 2023;26(9):987-1000.
doi: 10.22038/IJBMS.2023.69979.15222.

Integration of phytotherapy and chemotherapy: Recent advances in anticancer molecular pathways

Rouhollah Hemmati Bushehri  1 , Parnian Navabi  1 , Amir Mohammad Saeedifar  2 , Nafiseh Keshavarzian  1 , Negin Hosseini Rouzbahani  2 , Ghasem Mosayebi  1   3 , Ali Ghazavi  1   4 , Khodayar Ghorban  2 , Ali Ganji  1   3
Affiliations
Review

Integration of phytotherapy and chemotherapy: Recent advances in anticancer molecular pathways

Rouhollah Hemmati Bushehri et al. Iran J Basic Med Sci. 2023.

Abstract

Cancer is a disease characterized by abnormal and uncontrolled growth of cells, leading to invasion and metastasis to other tissues. Chemotherapy drugs are some of the primary treatments for cancer, which could detrimentally affect the cancer cells by various molecular mechanisms like apoptosis and cell cycle arrest. These treatment lines have always aligned with side effects and drug resistance. Due to their anticancer effects, medicinal herbs and their active derivative compounds are being profoundly used as complementary treatments for cancer. Many studies have shown that herbal ingredients exert antitumor activities and immune-modulation effects and have fewer side effects. On the other hand, combining phytotherapy and chemotherapy, with their synergistic effects, has gained much attention across the medical community. This review article discussed the therapeutic effects of essential herbal active ingredients combined with chemotherapeutic drugs in cancer therapy. To write this article, PubMed and Scopus database were searched with the keywords "Cancer," "Combination," "Herbal," "Traditional," and "Natural." After applying inclusion/exclusion criteria, 110 articles were considered. The study shows the anticancer effects of the active herbal ingredients by inducing apoptosis and cell cycle arrest in cancer cells, especially with a chemotherapeutic agent. This study also indicates that herbal compounds can reduce side effects and dosage, potentiate anticancer responses, and sensitize cancer cells to chemotherapy drugs.

Keywords: Cancer; Chemotherapy; Combination therapy; Herbal medicine; Molecular pathways.

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Conflict of interest statement

The authors report no conflicts of interest.

Figures

Figure 1.
Figure 1.
Antitumor effects of herbal compounds and combination with chemotherapy in cancer
Figure 2
Figure 2
Study flowchart based on PRISMA. In this study from 2000 to 2022, 110 articles were chosen from 236 reviewed articles according to inclusion/exclusion criteria
Figure 3
Figure 3
Natural herbal compounds and their combination with chemotherapy drugs affect the intrinsic signaling pathways of apoptosis
Figure 4
Figure 4
Natural herbal compounds and their combination with chemotherapy drugs affect the extrinsic apoptosis pathway
Figure 5
Figure 5
Overall view of the effects of herbal compounds and their combination with chemotherapy drugs on cell cycle arrest in the tumor cells
See this image and copyright information in PMC

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