Research status and challenges of anti-tumor effects of natural saponins and their combination therapy

Cancer is a leading global cause of death, and traditional chemotherapy is plagued by severe side effects, making the development of high-efficacy and low-toxicity antitumor agents an urgent need. Saponins, natural bioactive compounds, exhibit prominent antitumor potential. This review systematically retrieved relevant literature from 2015 to 2025 via Web of Science, PubMed and other databases, summarizing the antitumor effects and mechanisms of saponins, their synergistic value in combination with chemotherapy, as well as existing saponin-based drugs, translational challenges and corresponding solutions. Saponin monomers exert distinct antitumor efficacy, and their rational combination with chemotherapy yields notable advantages. Structural modification and dosage form optimization can effectively mitigate the inherent limitations of saponins. In conclusion, natural saponins hold great translational potential for antitumor therapy, and combination regimens represent a promising research focus in oncology treatment.