From Whole-Plant Phytochemistry to Precision Oncology: A Paradigm-Shifting Systematic Review of Lycium barbarum L. (Goji Berries)

Medicinal and edible plants are promising resources for low-toxicity therapeutics and precision nutrition. Lycium barbarum L. (goji berry), a quintessential medicine–food homologous herb with 2000 years of ethnopharmacological use, has attracted global attention. However, existing studies are limited by fruit-centric bias, lack of correlation between processing methods, component properties and bioactivities, and incomplete antitumor mechanistic understanding. This systematic review establishes a holistic research paradigm that integrates whole-plant resource utilization, processing–property–bioactivity associations, multi-target pharmacology, and clinical translation. We delineate tissue-specific distributions of core bioactives (polysaccharides, phenolics, carotenoids, alkaloids) and their synergistic networks underlying antioxidant, anti-inflammatory, hypoglycemic, and immunomodulatory effects. Critically, we systematically summarize preclinical evidence for the antitumor potential of goji berries, identifying four proposed non-overlapping cell death pathways (apoptosis, cell cycle arrest, ferroptosis, autophagy) and proposed unique roles in reversing multi-drug resistance, alleviating chemoradiotherapy toxicity, and serving as biocompatible nanocarriers, all of which remain predominantly at the preclinical stage. We further propose a three-stage evidence-based roadmap to address key translational bottlenecks. This review bridges the gap between traditional ethnopharmacology and modern precision nutrition, providing a scientific foundation for the sustainable development of the global goji berry industry.