Research on Buyang Yiwei Decoction in the Treatment of Gastric Cancer Based on PI3K/AKT Signaling Pathway: A Review

Gastric cancer is a digestive tract malignant tumor with high incidence and high mortality rate in the world, and patients with advanced gastric cancer often face clinical difficulties such as drug resistance and significant toxic and side effects. Traditional Chinese medicine shows unique advantages of multi-target and multi-pathway regulation in the comprehensive treatment of gastric cancer. Buyang Yiwei Decoction is a classic prescription for replenishing qi and nourishing blood, and combining tonification with dispersion. Clinical studies have confirmed that Buyang Yiwei Decoction combined with chemotherapy can significantly improve the performance status of patients with advanced gastric cancer, decrease the levels of tumor markers, and alleviate chemotherapy-induced organ damage/toxicities. In this paper, we systematically combed the key biological processes of the PI3K/AKT signaling pathway in the occurrence and development of gastric cancer. Our study found that the core active ingredients of Buyang Yiwei Decoction have been shown to inhibit the abnormal activation of the PI3K/AKT pathway, down-regulate the key phosphorylated proteins in this pathway, regulate downstream effector molecules, and thereby exert the molecular mechanism of inhibiting gastric cancer cell proliferation, inducing apoptosis, suppressing invasion and metastasis, and reversing chemotherapy resistance. However, current studies on the holistic mechanism of Buyang Yiwei Decoction remain insufficient; the evidence for clinical translation is weak; and the precision of its therapeutic targets needs to be improved. The next step is to further elucidate the multi-component synergistic mechanisms by which Buyang Yiwei Decoction regulates the PI3K/AKT pathway through an integrated approach combining network pharmacology, animal model validation, and multi-center clinical research. It is also essential to clarify its precise therapeutic value in targeting specific pathological processes. This will provide a more targeted, mechanism-elucidated, and higher-level evidence-based scientific foundation for its clinical application as an adjunctive strategy in the precision treatment of gastric cancer.