Mojtaba Tarin, Mahsa Akbari Oryani, Hossein Javid, Alireza Hashemzadeh, Mehdi Karimi-Shahri
The combination of herbal medicines and chemotherapeutic agents via nanocarriers establishes a promising framework for cancer treatment. However, realizing their potential requires rigorous clinical validation, standardized pharmacokinetic modeling, and scalable manufacturing protocols to move beyond preclinical limitations.
INTRODUCTION: The ongoing battle against cancer highlights the limitations of conventional treatments, underscoring the pressing need for therapies that mitigate systemic toxicity and multidrug resistance (MDR). Co-administering herbal medications with chemotherapeutics via nanodelivery systems offers a promising approach to addressing these oncology challenges.
METHODS: A narrative review was conducted using PubMed, Scopus, and Web of Science to identify relevant literature published between 2010 and 2026. Search terms included "herbal medicine," "chemotherapy," "nanoparticles," and "co-delivery" using standard Boolean operators (AND, OR). A total of 845 studies were initially screened, from which 137 were selected based on strict inclusion and exclusion criteria. Studies were critically selected based on their evaluation of in vivo efficacy, nanocarrier design, and mechanisms of synergy.
RESULTS: Phytochemicals such as curcumin, ginsenosides, and quercetin exhibit significant synergistic potential when combined with agents like doxorubicin and paclitaxel. Critical analysis reveals that while nanocarriers (e.g., liposomes, polymeric nanoparticles) improve bioavailability and selectively target tumors via the enhanced permeability and retention (EPR) effect, comparative metrics like loading efficiency and in vivo toxicity vary widely. The current data remain predominantly preclinical.
DISCUSSION: Despite promising pharmacodynamics, clinical translation is hindered by formulation instability, a lack of standardized herbal extracts, and complex pharmacokinetic interactions, including cytochrome P450 (CYP450) modulation.
CONCLUSION: The combination of herbal medicines and chemotherapeutic agents via nanocarriers establishes a promising framework for cancer treatment. However, realizing their potential requires rigorous clinical validation, standardized pharmacokinetic modeling, and scalable manufacturing protocols to move beyond preclinical limitations.