Therapeutic potential of escin and its nanoparticle formulations in cancer -a systematic review and meta-analysis of preclinical study

Introduction The present study aimed to perform a systematic review and meta-analysis to evaluate the potential therapeutic effects and underlying mechanisms of Escin and its nanoparticle formulations in cancer based on preclinical studies. Methods English databases including PubMed, Web of Science and Embase were used to search all relevant articles from their inception to July 13, 2026. The risk of bias of the included studies was assessed using the SYRCLE animal experiment risk assessment tool, while Review Manager (RevMan) software (Version 5.4) and Stata SE 12 software were employed for all statistical computations. Egger’s test was used to assess potential publication bias. Results The initial search produced a total of 279 potentially pertinent studies, and 34 studies met the inclusion criteria. The meta-analysis findings demonstrated Escin significantly inhibited cancer cell growth in vitro. Compared with the control group, Escin substantively reduced cell viability (SMD = ‐4.73, 95% CI = [‐5.81, ‐3.65]), induced cell cycle arrest (SMD = -7.29, 95% CI = [‐10.45, ‐4.14]), increased cell apoptosis (SMD =4.88, 95% CI = [3.41, 6.36]), and inhibited cell colony formation (SMD = -8.15, 95% CI = [‐14.04, ‐2.26]), cell adhesion (SMD = ‐11.17, 95% CI = [‐17.80, ‐4.55]), and migration (SMD = ‐3.19, 95% CI = [‐4.80, ‐1.57]). In tumor‐bearing animals, Escin treatment reduced tumor weight (SMD =‐2.49, 95% CI = [‐3.27, ‐1.70]), tumor volume (SMD = ‐2.05, 95% CI = [‐2.87, ‐1.23]), and tumor number (SMD = ‐1.83, 95% CI = [‐2.84, ‐0.82]). Besides, Escin nanoformulations also significantly reduced cell viability (SMD = ‐3.12, 95% CI = [‐5.15, ‐1.09]). Discussion Overall, this meta-analysis provided quantitative preclinical evidence supporting the potential anti‐tumor effects of Escin and its nanoformulations. However, given the heterogeneity and limited number of included studies, especially for nanoformulations, these findings should be interpreted cautiously. Further well‐designed preclinical studies are warranted to facilitate clinical translation. Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO/ .