From cell lines to animal models: "plant- derived chemotherapeutics unlocking new frontiers against oral squamous cell carcinoma"-a comprehensive systematic review.

Abstract

Background and aim: Despite progress in traditional treatment methods, the overall survival rate for oral squamous cell carcinoma (OSCC) remains limited. Consequently, it is essential to investigate alternative therapeutic strategies to enhance patient outcomes. This review highlights the potential role of plant extracts as chemo preventive agents in oral cancer treatment.

Methods: A systematic review was conducted following PRISMA guidelines, involving an extensive literature search from databases such as PubMed, Scopus, Embase, Web of science, Cochrane and CINAHL which included studies from 2010 to 2024 that explored the anticancer potential of medicinal plants for OSCC treatment. Data extraction focused on plant species, parts used, extract type, active components, dosage, and cancer cell lines or animal models used. Risk of bias was assessed using the OHAT tool for animal studies and the ROBINS-I tool for in vitro studies.

Results: A total of 12 in vitro and animal studies were included, examining plants such as Allium sativum (garlic), Crocus sativus (saffron), Curcuma longa (turmeric), Scutellariabaicalensis (Baikal skullcap), etc., These studies demonstrated that bioactive components like allicin, curcumin, and baicalin significantly inhibited OSCC cell proliferation and induced apoptosis. However, there was substantial variability in the dose concentrations required, ranging from 1 µg/mL for garlic extract to 50 mg/mL for saffron nanoparticles. The risk of bias assessment indicated that four studies had a moderate risk, while one had a low risk of bias, indicating methodological rigor.

Conclusion: Plant extracts such as Curcuma longa and Vitis vinifera present a promising, less toxic alternative for OSCC treatment, with the potential to be integrated into conventional chemotherapeutic regimens. While in-vitro and animal studies are encouraging, further clinical trials among humans are necessary to confirm their efficacy and safety in clinical settings.