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Synergistic Interactions Between Medicinal Plant Bioactive and Standard Chemotherapy in Gastric Cancer: Preclinical
Emilia Daliana Muntean1,2, Daniela-Cornelia Lazăr1, Ana-Maria Pah3
1University Clinic of Internal Medicine IV, Faculty of Medicine, "Victor Babeş" University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timisoara, Romania.
Abstract:
Gastric cancer remains a highly heterogeneous malignancy in which chemotherapy response is limited by intrinsic and acquired resistance, cumulative toxicity, and the restricted predictive value of conventional preclinical models. This review critically synthesizes evidence on selected medicinal plants and their bioactive phytocompounds as adjuncts to standard chemotherapy for gastric cancer, with an emphasis on mechanistic plausibility, preclinical synergy, and translational barriers. Across the reviewed literature, phytocompounds from Curcuma longa, Scutellaria baicalensis, Camellia sinensis, Syzygium aromaticum, Glycyrrhiza glabra, Allium sativum, Marsdenia tenacissima, and Rhus verniciflua showed anticancer or chemopreventive activity through multitarget effects on apoptosis, proliferation, invasion, inflammation, oxidative stress, and resistance-associated signaling. The most convincing chemosensitizing evidence involved curcumin, wogonin, baicalein, EGCG, which enhanced the activity of fluoropyrimidines, platinum agents, paclitaxel, doxorubicin, or related antitumor regimens in selected gastric cancer models. However, the evidence base remains heterogeneous and is constrained by variable extract standardization, incomplete dose reporting, poor bioavailability, insufficient pharmacokinetic/pharmacodynamic integration, and underuse of clinically relevant model systems. Overall, medicinal plant bioactives remain promising adjunct candidates in gastric cancer. Still, meaningful translation will require chemically defined interventions, rigorous synergy analysis, interaction-aware study design, and validation in advanced preclinical and clinical settings.
Insights
Medicinal plants show promise as adjuncts to gastric cancer chemotherapy, enhancing drug efficacy through multitarget effects. However, challenges in standardization and bioavailability hinder clinical translation.
Area of Science:
- Oncology
- Pharmacology
- Natural Products Chemistry
Background:
- Gastric cancer exhibits significant heterogeneity, leading to limited chemotherapy response due to resistance and toxicity.
- Conventional preclinical models have restricted predictive value for chemotherapy efficacy.
- Medicinal plants and their bioactive compounds are explored as potential adjuncts to standard chemotherapy.
Purpose of the Study:
- To review and synthesize evidence on medicinal plants and phytocompounds as adjuncts for gastric cancer treatment.
- To evaluate mechanistic plausibility, preclinical synergy, and translational barriers of these natural compounds.
- To identify promising phytocompounds and their targets in gastric cancer therapy.
Main Methods:
- Systematic review of scientific literature on medicinal plants and their bioactive constituents.
- Analysis of preclinical studies investigating synergy between phytocompounds and standard chemotherapeutic agents.
- Evaluation of mechanistic data related to apoptosis, proliferation, invasion, inflammation, oxidative stress, and drug resistance.
Main Results:
- Phytocompounds from *Curcuma longa*, *Scutellaria baicalensis*, *Camellia sinensis*, and others demonstrated anticancer/chemopreventive effects.
- Curcumin, wogonin, baicalein, and EGCG showed the most convincing evidence of chemosensitization, enhancing conventional chemotherapy.
- Multitarget effects observed include modulation of apoptosis, proliferation, invasion, inflammation, oxidative stress, and resistance signaling.
Conclusions:
- Medicinal plant bioactives are promising adjunct candidates for gastric cancer therapy.
- Significant translational barriers exist, including variable standardization, poor bioavailability, and insufficient pharmacokinetic/pharmacodynamic data.
- Future research requires chemically defined interventions, rigorous synergy analysis, and validation in advanced preclinical and clinical settings.
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