Ovarian cancer remains a leading cause of gynecologic cancer-related mortality, primarily driven by the development of multidrug resistance. Plant-derived natural products have gained attention as promising adjuncts to conventional treatments due to their multifaceted mechanisms and low systemic toxicity. This review summarizes recent advances in plant-derived compounds that counteract ovarian cancer resistance and explores their underlying molecular mechanisms. A comprehensive literature search was performed in the PubMed and Web of Science databases to identify English-language articles published up to September 2025. The search terms included “ovarian cancer”, “drug resistance”, “aging”, “plant nanotechnology”, “Chinese herbal medicine”, and “natural products”, which were combined using Boolean operators “AND/OR”. Studies were eligible for inclusion if they addressed the pharmacological effects, molecular mechanisms, and therapeutic potential of plant-derived compounds in overcoming drug resistance in ovarian cancer. Basic research studies, in vitro and in vivo experiments, preclinical investigations, and relevant reviews were included, whereas duplicate articles were excluded. Various resistance mechanisms, including altered drug transport, enhanced DNA repair, immunosuppressive microenvironment remodeling, and senescence-associated phenotypes, are modulated by flavonoids, alkaloids, saponins, terpenes, and polysaccharides. These compounds target critical signaling pathways, such as PI3K/Akt/mTOR, STAT3, NF-κB, and VEGFR2/FAK. Advances in nanoparticle delivery and senescence regulation further enhance their therapeutic efficacy. The integration of natural products with standard therapies may offer a viable strategy to overcome chemoresistance in ovarian cancer, highlighting the need for further translational and clinical investigations.
Ao et al. (Sun,) studied this question.
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