Structure-Driven Mechanisms and Synergistic Approaches of Polyphyllin VII in Breast Cancer Therapy

Polyphyllin VII (PP7), a natural saponin derived from the rhizomes of Paris polyphylla (family: Melanthiaceae), possesses a unique steroidal furostane structure that contributes to its versatile pharmacological profile. It is traditionally used in Chinese medicine for treating pain, insect bites, and bleeding. PP7's unique pharmacophoric features and optimal lipophilic-hydrophilic balance underlie its diverse anticancer therapeutic actions, including cell cycle arrest, apoptosis, ferroptosis, and autophagy activation, alongside metastasis and angiogenesis inhibition. PP7 has gained attention for its potent bioactivity in breast cancer and other pathological conditions. In breast cancer, PP7 demonstrates remarkable efficacy, addressing not only tumor growth but also associated complications such as inflammation and osteoporosis. Additionally, PP7 exhibits synergistic effects with chemotherapeutic agents like cisplatin, bortezomib, and gefitinib, enhancing cancer cell apoptosis and mitigating drug resistance. Beyond its anticancer properties, PP7 also displays broad pharmacological activities, including anti-inflammatory, hepatoprotective, and antimicrobial effects. Thus, PP7 holds significant potential for therapeutic application across breast cancer patients with comorbidities. However, further research is necessary to clarify its specific role in breast cancer subtypes, ensure its safety in clinical applications, and optimize its broad-scale biosynthesis. This review highlights the structure-driven mechanisms underlying PP7 actions and its therapeutic potential as a standalone agent or adjunct in breast cancer therapy.