Advancement of Astragali Radix in anti-tumor: Active components and combination therapy

Natural products continue to serve as indispensable sources for anti-tumor drug discovery, accounting for approximately 40% of United States Food and Drug Administration (U.S. FDA) FDA-approved anti-tumor agents despite advancements in biologic therapies. Among these natural products, Astragali Radix (AR, Huangqi in Chinese) has emerged as a particularly promising candidate for tumor treatment due to its well-documented anti-tumor properties. Contemporary research has identified three principal bioactive compounds responsible for these therapeutic effects: Astragalus polysaccharides, total Astragalus flavonoids, and astragalosides. These compounds demonstrate multimodal anti-tumor activity against five major malignancies, including lung, breast, liver, colorectal, and cervical cancers, through coordinated modulation of critical cellular processes including apoptosis induction, cell cycle arrest, and metastasis suppression. Critical studies have revealed that AR-based combination therapies can synergistically enhance conventional treatments (chemotherapy/radiotherapy). This is achieved by simultaneously addressing two critical challenges in tumor treatment: Reducing treatment-related toxicity and overcoming multidrug resistance through chemosensitization effects in vivo. This review synthesizes current knowledge on AR's anti-tumor components, their molecular mechanisms, and therapeutic targets. It emphasizes the synergistic benefits of integrating AR with existing tumor treatments and proposes future research directions to advance its clinical translation. By bridging traditional herbal knowledge with modern scientific rigor, this work aims to accelerate the development of AR-based therapies as safer, more effective options for cancer patients.