Traditional Chinese Medicine Applications in Hepatocellular Carcinoma Treatment

Traditional Chinese Medicine (TCM) has a long-standing history in managing liver diseases and has emerged as a complementary approach in hepatocellular carcinoma (HCC) treatment. Research spans herbal formulas, purified compounds and fungal extracts, focusing on apoptosis induction, inhibition of proliferative signalling, modulation of the tumour microenvironment and enhancement of conventional therapies. Key interventions include polysaccharide-rich extracts from Trametes robiniophila (Huaier), compound injections such as PHY906 (KD018), and small molecules such as icaritin and salvianolic acid B. These agents have been shown to regulate immune cell infiltration, influence macrophage polarization, downregulate the PI3K/AKT/mTOR pathway and synergise with sorafenib and immune checkpoint inhibitors to improve therapeutic outcomes and reduce systemic toxicity. Given the global burden of HCC, particularly in regions with high viral hepatitis prevalence, integrating evidence-based TCM represents a promising avenue to address unmet clinical needs.

Research from Nature Portfolio

Foundational studies have demonstrated that a four-herb formulation potentiates the efficacy of sorafenib in hepatocellular carcinoma xenograft models. The combination enhances tumour cell apoptosis via upregulation of Fas ligand signalling, promotes infiltration of M1-polarised macrophages into the tumour microenvironment and shifts chemokine profiles to support antitumour immunity. Concurrent modulation of autophagy regulators contributes further to growth inhibition, underscoring the potential of TCM formulations to augment standard kinase inhibitor therapy.

Traditional Chinese Medicine Applications in Hepatocellular Carcinoma Treatment publication trend

The graph below shows the total number of articles in traditional chinese medicine applications in hepatocellular carcinoma treatment across all publications each year (not limited to Nature Index journals).

Technical terms

Hepatocellular carcinoma (HCC): A primary malignancy of the liver arising from hepatocytes.

Tumour microenvironment: The cellular and molecular milieu surrounding tumour cells, including immune and stromal cells.

Apoptosis: Programmed cell death characterised by cell shrinkage and DNA fragmentation.

Macrophage polarization: Functional differentiation of macrophages into pro-inflammatory (M1) or anti-inflammatory (M2) states.

PI3K/AKT/mTOR pathway: Intracellular signalling cascade regulating cell growth, proliferation and survival.

Immune checkpoint: Regulatory pathway that modulates immune activation, such as PD-1/PD-L1 interactions.

T-cell infiltration: Migration of T lymphocytes into tumour tissue, which can mediate antitumour effects.

References

1. Traditional Chinese medicine for the treatment of cancers of hepatobiliary system: from clinical evidence to drug discovery. Molecular Cancer (2024).
2. Immunoregulatory effects of Huaier (Trametes robiniophila Murr) and relevant clinical applications. Frontiers in Immunology (2023).
3. Huqi formula suppresses hepatocellular carcinoma growth by modulating the PI3K/AKT/mTOR pathway and promoting T cell infiltration. Chinese Medicine (2025).
4. PHY906(KD018), an adjuvant based on a 1800-year-old Chinese medicine, enhanced the anti-tumor activity of Sorafenib by changing the tumor microenvironment. Scientific Reports (2015).
5. First-in-class immune-modulating small molecule Icaritin in advanced hepatocellular carcinoma: preliminary results of safety, durable survival and immune biomarkers. BMC Cancer (2019).