Inhibition or induction of gastrointestinal tumors by ferroptosis and intervention by herbal extracts (Review)

Ferroptosis is a regulated form of iron-dependent cell death characterized by lipid peroxidation and oxidative stress. Increasing evidence indicates that ferroptosis plays an important role in gastrointestinal (GI) tumors, including esophageal, gastric, hepatic and colorectal cancer. Depending on the cellular context, ferroptosis may suppress tumor growth or contribute to therapy resistance. The present review summarizes the molecular mechanisms underlying ferroptosis in GI cancer, with a focus on iron metabolism, lipid peroxidation and the solute carrier family 7 member 11-reduced glutathione-glutathione peroxidase 4 axis antioxidant system. Common regulatory patterns and tumor-specific characteristics are discussed. In addition, the potential of herbal extracts to induce ferroptosis in GI tumors is reviewed, and current limitations in clinical translation are addressed. Clarifying the regulatory determinants of ferroptosis may improve therapeutic stratification in GI cancer.