How Traditional Chinese Medicine Works: Biological Mechanisms and Clinical Evidence for Hepatocellular Carcinoma Treatment

Xueying Jia,1,* Yu Wang,2,* Wenjuan Chen,1 Zicong Huang,1 Shuo Xu,1 Anar Bai,1 Chen Xue,3 Penghui Li1 1Department of Gastrointestinal Surgery, The First Affiliated Hospital, College of Clinical Medicine, Henan University of Science and Technology, Luoyang, Henan, People’s Republic of China; 2School of Basic Medical Sciences and Forensic Medicine, Hangzhou Medical College, Hangzhou, Zhejiang, People’s Republic of China; 3State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, National Medical Center for Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, People’s Republic of China*These authors contributed equally to this workCorrespondence: Penghui Li, Department of Gastrointestinal Surgery, The First Affiliated Hospital, College of Clinical Medicine, Henan University of Science and Technology, No. 24 Jinghua Road, Jianxi District, Luoyang, Henan, People’s Republic of China, Email [email protected] Chen Xue, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, National Medical Center for Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, No. 79 Qingchun Road, Shangcheng District, Hangzhou, Zhejiang, People’s Republic of China, Email [email protected]: Hepatocellular carcinoma (HCC) is a malignant tumor with a high mortality rate globally, ranking among the top cancers in incidence and posing a serious human health threat. In recent years, with research advancement in traditional medicine, traditional Chinese medicine (TCM) has attracted increasing interest for its potential role in the management of hepatocellular carcinoma (HCC). As a comprehensive review, this article critically synthesizes the biological mechanisms and clinical application evidence of TCM extracts and classic formulas in HCC treatment, systematically detailing the important roles and specific mechanisms of TCM in inhibiting tumor growth, inducing apoptosis, enhancing immunity, and suppressing angiogenesis. This review aims to synthesize and analyze existing findings to provide a consolidated theoretical basis and identify potential research gaps. Furthermore, it seeks to explore new therapeutic concepts by bridging TCM theory with modern pharmacological approaches, thereby promoting the development of integrated strategies in oncology. Ultimately, we aim to contribute to the improvement of patient survival rates and quality of life. However, while preclinical evidence is promising, the clinical evidence base requires further strengthening through larger-scale, rigorously designed trials to validate efficacy and establish standardized protocols.Keywords: traditional Chinese medicine, liver cancer, formulas, biological mechanisms, clinical evidence