Frontiers in pharmacology · 2026
TCM herb pairs regulate breast cancer TME heterogeneous mechanisms in immune, vascular, and stromal compartments.
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Liu Lu, Zhang Yuxuan, Feng Jing, Yang Hua, Fan Chunling, Ding Xiaoxia, Min Qiong, Dai Xiaoyan, Lei Xudong, Shen Wei
Аннотация
BACKGROUND: Breast cancer is the most prevalent malignancy in women, and its complex tumor microenvironment (TME) characterized by immunosuppression, aberrant angiogenesis and stromal fibrosis is a critical cause of therapeutic failure. Traditional Chinese Medicine (TCM) herb pairs, with multi-target, multi-component and multi-dimensional modes of action, show unique advantages in modulating the breast cancer TME.
CORE FINDINGS: This study systematically reviewed the regulatory mechanisms of 20 core anti-breast cancer herb pairs on the TME. Heat-clearing and detoxifying herb pairs (e.g., Hedyotis diffusa-Scutellaria barbata) principally reshape the immune microenvironment by activating CD8+ T cells and promoting M2-to-M1 polarization of tumor-associated macrophages (TAMs). Blood-activating and stasis-resolving herb pairs (e.g., Sparganium stoloniferum-Curcuma zedoaria) inhibit tumor angiogenesis via targeting VEGF/VEGFR2 and ITGA5/CCN1 pathways. Qi-tonifying and pathogen-eliminating herb pairs (e.g., Astragalus membranaceus-C. zedoaria) ameliorate stromal fibrosis by suppressing cancer-associated fibroblast (CAF) activation and modulating the TGF-β/Smad pathway.
CONCLUSION: TCM herb pairs have substantial value in systematically remodeling the breast cancer TME and advancing integrative oncology. Nano-enabled delivery systems serve as a critical technical solution to overcome the intrinsic pharmacokinetic defects of herbal bioactive components and accelerate their clinical translation. The clinical translation pathway based on "syndrome differentiation-guided herb pair selection-precision TME modulation-synergistic efficacy enhancement" is expected to provide more precise, safe and effective therapeutic options for breast cancer patients.
CORE FINDINGS: This study systematically reviewed the regulatory mechanisms of 20 core anti-breast cancer herb pairs on the TME. Heat-clearing and detoxifying herb pairs (e.g., Hedyotis diffusa-Scutellaria barbata) principally reshape the immune microenvironment by activating CD8+ T cells and promoting M2-to-M1 polarization of tumor-associated macrophages (TAMs). Blood-activating and stasis-resolving herb pairs (e.g., Sparganium stoloniferum-Curcuma zedoaria) inhibit tumor angiogenesis via targeting VEGF/VEGFR2 and ITGA5/CCN1 pathways. Qi-tonifying and pathogen-eliminating herb pairs (e.g., Astragalus membranaceus-C. zedoaria) ameliorate stromal fibrosis by suppressing cancer-associated fibroblast (CAF) activation and modulating the TGF-β/Smad pathway.
CONCLUSION: TCM herb pairs have substantial value in systematically remodeling the breast cancer TME and advancing integrative oncology. Nano-enabled delivery systems serve as a critical technical solution to overcome the intrinsic pharmacokinetic defects of herbal bioactive components and accelerate their clinical translation. The clinical translation pathway based on "syndrome differentiation-guided herb pair selection-precision TME modulation-synergistic efficacy enhancement" is expected to provide more precise, safe and effective therapeutic options for breast cancer patients.