Research Progress of Traditional Chinese Medicine in Regulating Ferroptosis Related to Digestive System Tumors

Ferroptosis is a novel type of cell death that depends on iron ions and lipid peroxidation. An increasing number of studies have shown that ferroptosis can inhibit the progression of digestive system tumors, enhance the sensitivity of tumor cells to drugs, and reduce drug resistance. Traditional Chinese medicine (TCM) has been widely utilized in the field of tumor treatment, and has recently achieved remarkable research results in regulating the ferroptosis of tumor cells. This review systematically expounds on the specific molecular mechanisms through which TCM regulates ferroptosis in digestive system tumors (including hepatocellular carcinoma, gastric cancer, colorectal cancer, and pancreatic cancer). It covers various intervention strategies, including TCM small molecules like terpenoids, flavonoids, phenols, saponins, and alkaloids, nanoparticles loaded with active ingredients like novel nanoparticle-encapsulated berberine and NPBer, compound formulas such as Banxia Xiexin Decoction and Compound Gegen Decoction, and external treatments such as acupuncture. Studies have indicated that TCM, through its multi-target and multi-pathway action mechanism, affects pathways such as iron metabolism, lipid metabolism, and anti-oxidant defense to thereby promote ferroptosis and consequently inhibit tumor growth and metastasis. This provides new strategies and scientific evidence for the treatment of digestive system tumors. The purpose of this paper is to provide innovative ideas and theoretical support for the further exploration of TCM in the field of tumor treatment.