Astragalus Polysaccharides and Astragaloside IV Modulate Immunity and Tumor Metabolism in Preclinical Cancer ModelsAstragalus compounds may help the immune system fight cancer cells

This systematic review examines the mechanistic and therapeutic potential of Astragalus polysaccharides (APS) and Astragaloside IV (AS-IV) in cancer. The authors synthesize preclinical evidence on immune modulation, metabolic interventions, and anti-tumor responses. No clinical trial data are included.

For cellular immunity, the review reports that APS facilitates dendritic cell maturation and attenuates T-cell exhaustion, while AS-IV promotes an immunostimulatory M1 macrophage polarization. For tumor bioenergetics, the authors describe inhibition of aerobic glycolysis and lipid metabolism, which may alleviate resource competition within the tumor microenvironment. For anti-tumor responses, co-delivery of these agents via advanced nanoplatforms or in combination with immune checkpoint inhibitors is reported to significantly enhance anti-tumor responses.

No effect sizes, absolute numbers, p-values, or confidence intervals are reported for any outcome. Safety data, including adverse events, serious adverse events, discontinuations, and tolerability, are not reported. The authors explicitly note that the evidence is preclinical only. Funding sources and conflicts of interest are not reported.

The authors suggest a potential transition from empirical adjuvants to rationally designed precision immunotherapies. However, given the absence of clinical data and quantitative synthesis, these findings should be interpreted as hypothesis-generating. They do not support clinical use of APS or AS-IV in cancer outside of research settings.