An Overview of Natural Plant Products in the Treatment of Hepatocellular Carcinoma

Abstract

Liver cancer is the fifth most commonly diagnosed cancer and the second leading cause of cancer related deaths worldwide. Among the liver cancers, hepatocellular carcinoma has been reported to be responsible for 85-90% of primary liver cancer and it is the second most common cause of cancer mortality with 700,000 deaths documented annually. The major risk factors of HCC include chronic infections with the hepatitis B (HBV) or hepatitis C (HCV) virus, chronic liver diseases, alcoholism as well as dietary carcinogens, such as aflatoxins. Highest incidence rates are estimated to occur in Asia and Africa. The effectiveness of current man-made agents in treating chronic liver disease is not satisfactory and they have uninvited side effects. Herbal medicines are extensively used all over the world; however there is still a vast gap in accepting them by the scientific community. Plants are rich in secondary metabolites and phytochemicals obtained from both, dietary and non-dietary sources. Natural plant products are potent therapeutic as well as chemo preventive agents for numerous chronic diseases like cardiovascular, metabolic, neurodegenerative and neoplastic diseases. Dietary phytochemicals such as curcumin, resveratrol, quercetin, silibinin, N-trans-feruloyloctopamine, lycopene, emodin, caffeine, urolithin A and Phloretin have been found to be useful for the treatment of HCC and other diseases and report estimate that 60% of the anticancer medication in current use has been obtained from natural sources. Thus, derivatives from plants have played an essential role in cancer prevention due to their pleiotropic abilities to scavenge free radicals, inhibit cell growth and induce apoptosis.

Antitumor Effects of Quercetin in Hepatocarcinoma In Vitro and In Vivo Models: A Systematic Review

“…Regardless of its effectiveness, liver cancer cells are able to develop sorafenib resistance after sustained administration [17], where several TKIs (regorafenib and cabozantinib) and monoclonal antibodies (nivolumab, pembrolizumab and ramucirumab) have been recently approved [16]. Considering toxicity and adverse reactions caused by these chemotherapeutic agents, some investigations have focused on the study of antitumor effects of natural compounds against HCC, such as resveratrol, curcumin and melatonin [18][19][20].…”

Resveratrol inhibited the progression of human hepatocellular carcinoma by inducing autophagy via regulating p53 and the phosphoinositide�3‑kinase/protein kinase�B pathway

“…Over recent decades, natural products have served significant roles in the development of anticancer agents (5,6). Resveratrol (trans-3,4',5-trihydroxystilbene) was originally isolated from the roots of white hellebore at 1940 (7).…”

Autophagy: A Potential Therapeutic Target of Polyphenols in Hepatocellular Carcinoma

“…Several anticancer drugs, such as vinblastine, teniposide, camptothecin, docetaxel, etoposide, and paclitaxel, have been either identified in natural sources or synthesized by modification of molecules having natural origins [6,7]. Numerous natural products, including phytochemicals of dietary and non-dietary origin, have been shown to modulate various signaling pathways linked to hepatocarcinogenesis in vitro and in vivo, which could be valuable for the prevention and treatment of HCC [8][9][10][11][12][13][14][15][16].…”

“…Based on the analysis of the available literature presented here, polyphenols could be considered as potent autophagy modulators for HCC therapy. Although numerous in vitro and in vivo studies have reported the beneficial roles of polyphenols in treating HCC [8][9][10][11][12][13][14][15][16], there are hardly any clinical trials to realize the full potential of preclinical studies. For this purpose, it is worthwhile to explore polyphenols alone or in combination with approved drugs for the treatment of human HCC.…”