Salidroside's Multi-Faceted Attack on Cancer: Insights from A Systematic Review of Preclinical Studies

OBJECTIVE: In recent years, salidroside (SAL) derived from Rhodiola rosea has attracted considerable research interest. SAL is regarded as a potential therapeutic agent for cancer treatment. This study aimed to investigate the antitumor effects and underlying mechanisms of SAL using in vitro and in vivo models. METHODS: A systematic review was executed in compliance with the PRISMA guidelines. A systematic literature search was conducted across the Web of Science, PubMed, Embase, and Cochrane Library, covering all original literature published before April 2025. RESULTS: Of the 1415 initially gathered studies, 47 articles met the predefined inclusion criteria for full-text review. A comprehensive assessment across 19 cancer types demonstrated that SAL exhibited multifaceted antitumor effects. These effects encompassed improvement of host physiological status, inhibition of tumor progression, alteration of tumor tissue architecture, suppression of cancer cell proliferation and cell cycle progression, and attenuation of metastatic behaviors, including migration and invasion. The antitumor mechanisms of SAL involved the induction of cellular apoptosis and ferroptosis, modulation of oxidative stress and autophagy, remodeling of the tumor immune microenvironment, inhibition of glycolysis and angiogenesis, and regulation of key signaling pathways such as MAPK, JAK2/STAT3, and PI3K/Akt. DISCUSSION: This systematic review demonstrates that SAL exerts antitumor effects in both in vivo and in vitro experimental models. Nonetheless, well-designed randomized controlled clinical trials are essential to assess SAL's clinical efficacy. CONCLUSION: SAL represents a candidate for clinical translation as an antitumor agent.