Advancements in the therapeutic potential of sesquiterpenoids for the treatment of hepatocellular carcinoma (Review).

Sesquiterpenoids are widely distributed in plants, animals, marine organisms and microorganisms, particularly in Asteraceae plants, and they exhibit various biological activities, including anti‑tumor, anti‑bacterial, anti‑inflammatory, antiviral and antioxidant properties. They also have the effects of protecting the liver, protecting the nerves, preventing and treating diabetes and improving immunosuppressive function. Hepatocellular carcinoma (HCC) is the main type of primary liver cancer and the third leading cause of cancer‑related death worldwide. There is accumulating evidence that HCC is an increasingly serious threat to human health and the incidence of primary liver cancer is also still increasing. For the present review, literature on sesquiterpenoids in the treatment of liver cancer from 2003 to 2024 was searched through electronic databases. A total of 46 sesquiterpenoids were identified for HCC treatment. It was found that sesquiterpenoids play a therapeutic role in HCC by inhibiting proliferation, inducing apoptosis, inhibiting invasion and metastasis of HCC cells, regulating the body's immune function and decreasing the resistance of tumor cells. Sesquiterpenoids are promising drugs, which may create more opportunities for the treatment of liver cancer. However, research on how sesquiterpenoids act on HCC is not systematic and most reports are also limited to mixtures, while there is only a small number of reports of new sesquiterpene monomers for treating HCC. Therefore, it is necessary to further discover new components and study their biological activities, and to gradually conduct in‑depth in vivo studies and clinical application in the future. The present study reviewed the research progress of sesquiterpene‑rich natural products in the treatment of HCC in the past two decades.