Investigation of traditional Chinese medicine for cancer treatment: Signaling pathways and anti-tumor microenvironment

Abstract

Traditional Chinese Medicines (TCMs) have performed great efficacy in carcinoma treatment. Due to bidireactional and multitargeting capability and the small side effects of TCM, it has been used in cancer treatment in China and has been studied a lot in other countries. In the early research, two possible anti-tumor mechanisms of TCM have been proposed, first is directly affecting cancer cells by regulating the signaling pathway, the second is indirectly affecting cancer cells by regulating the immune system and tumor microenvironment. Herein we want to discuss systematically how these anti-tumor mechanisms of TCM work together to influence carcinoma treatment. This review will include several kinds of active extracts of TCM, such as ginsenoside, baicalein, baicalin, astraglan, berberine and ferulic, and several pathways influenced by TCM in the pathogenesis of cancer, such as Fas/FasL pathway, PI3K/Akt pathway, TGF-/Smad pathway and the regulation of tumor microenvironment, such as repolarization of tumor-associated macrophages (TAMs) and PD1/PD-L1 interactions.