Natural Products in Endometrial Cancer: Molecular Mechanisms, Preclinical Evidence, and Clinical Perspectives

Endometrial cancer (EC) is the most common gynecologic malignancy in developed countries, with increasing incidence linked to obesity and metabolic dysfunction. While early-stage EC is often curable, advanced and recurrent disease remains difficult to treat due to resistance and limited therapeutic options. Natural products derived from traditional Chinese medicine have attracted attention as complementary strategies in EC management. These compounds exhibit multi-target effects, including modulation of estrogen signaling, inhibition of proliferation, induction of apoptosis, and regulation of immune and inflammatory pathways. This review summarizes current evidence on natural products in EC, integrating preclinical findings, emerging clinical data, and mechanistic insights from molecular and systems biology approaches. Key challenges, including variability, bioavailability, and insufficient clinical validation, are discussed. Future directions emphasize the integration of natural products into precision oncology frameworks.