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Ginsenosides from Panax ginseng: Their mechanisms, microbiome determinants, and translational strategies in therapeutic activity against cancer

Year: 2026
Type: article
Abstract: Meyer and their microbiota-derived metabolites have been explored as adjuncts in oncology, with pleiotropic activities across tumor-intrinsic and microenvironmental pathways. This review focuses on representative metabolites (Rg3, Rh2 and compound K) and summarizes mechanistic evidence for apoptosis and cell-cycle control, metabolic reprogramming (Warburg-type glycolysis), and epigenetic regulation (miRNA/lncRNA-linked programs), together with immunomodulatory effects in the tumor microenvironment. A central translational constraint is pharmacokinetics and the "microbiota gatekeeping" effect: many parent ginsenosides show limited oral absorption and require microbiota-mediated deglycosylation, resulting in delayed and variable systemic exposure across individuals. To address this bottleneck, we discuss pragmatic translational directions including bioconversion/pre-transformation to enrich active metabolites, biomimetic delivery platforms such as ginseng-derived exosome-like nanoparticles to improve exposure and tissue uptake, and mechanism-guided combinations (e.g., with immune checkpoint blockade). Finally, we outline how biomarker-informed stratification and AI/ML-enabled, hypothesis-generating optimization of delivery/formulation may support more predictable clinical development.
Language: English
Open Access status: diamond
OpenAlex ID: W7147635681
FWCI: 3.684
Cites: 148
Cited by: 2
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