Targeting tumor angiogenesis with traditional Chinese medicine:mechanisms,challenges,and future directionsOA

Tumor growth depends on neoangiogenesis,and current anti-angiogenic therapies face limitations owing to side effects and drug resistance.Traditional Chinese medicines(TCM)have shown potential to inhibit tumor angiogenesis owing to their multi-component and multi-target properties.This review focuses on the mechanisms of action of TCM monomers(e.g.,curcumin,tanshinone IIA,and ginsenoside)through the modulation of key pathways,such as HIF-1α,VEGF/VEGFRs,and Notch signaling,and explores their modulatory effects on the tumor microenvironment(e.g.,tumor-associated macrophage polarization).Despite the low toxicity and multi-targeting advantages of TCM,their clinical translation is still limited by low bioavailability and standardization difficulties.In this review,we further analyze the role of modern approaches,such as nanocarriers(liposomes,polymer nanoparticles,metal-coordinated nanomaterials,and plant exosome-like vesicles),in overcoming these bottlenecks and propose a strategy of combining TCM with chemotherapy,radiotherapy,and immunotherapy to overcome drug resistance and enhance therapeutic efficacy.By integrating traditional wisdom with cutting-edge technologies,anti-angiogenesis research in TCM is expected to contribute to the development of safer and more effective individualised cancer treatment.