Lessons From Astaxanthin Therapy to Combat Oral Premalignant and Malignant Lesions: A Narrative Review

Background and Aims: Oral cancer is one of the most common head and neck malignancies and remains associated with high morbidity, mortality, and treatment-related toxicity. Despite advances in surgery, radiotherapy, and chemotherapy, there is still a need for safer adjunctive therapies with better therapeutic potential. Results: Astaxanthin, a natural lipophilic carotenoid, has gained attention because of its antioxidant, anti-inflammatory, and anticancer activities. The available evidence suggests that astaxanthin may suppress oral premalignant and malignant progression by inhibiting inflammation, oxidative stress, proliferation, invasion, angiogenesis, and survival signaling pathways, while promoting apoptosis and reactivating tumor suppressor mechanisms. Preclinical studies also indicate that astaxanthin-based formulations may improve delivery efficiency and enhance antitumor effects in oral cancer models. Conclusion: Overall, astaxanthin appears to be a promising natural candidate for oral cancer prevention and treatment. However, most findings are based on preclinical studies, and further well-designed clinical investigations are required to confirm its efficacy and safety.