Effect of Annona muricata (Soursop) on Patients with Cancer: A Systematic Review

Introduction: Annona muricata is among the most commonly used herbal remedies by cancer patients.Most previous systematic reviews on Annona muricata have reported studies performed in-vitro and in-vivo.However, no systematic review has been conducted solely to compile studies on humans with cancer.Objective: We aimed to summarise the effects of Annona muricata and explore its potential mechanisms of action and safety for cancer patients.Method: A systematic search was performed in the following electronic databases from inception until February 2022: MEDLINE, Cochrane library, EMBASE, ClinicalTrials.gov,WHO Trials Portal, Google scholar, and grey literature reports.The papers were then reviewed and assessed for eligibility based on the inclusion and exclusion criteria.Results: From the 475 abstracts, 11 were extracted for a full review, with five included in the final analysis.All studies included had a high or critical risk of bias, along with varying outcome measures; thus, caution is required when interpreting the results.Annona muricata has shown to inhibit cancer cell growth, enhance caspase activity, and provide antiinflammatory effects.It was found to be safe, with minimal side effects in cancer patients.Annona muricata does not interfere with bone marrow, liver, and kidney function and may even improve nutritional status.Conclusion: Annona muricata could offer potential anticancer benefits while being safe for cancer patients.However, the absence of high-quality studies and incomplete evidence pose challenges in drawing a conclusive statement.More research is required to validate the efficacy and safety of Annona muricata, enabling more definitive evidence-based recommendations.