The Anticancer Potential of Nelumbo Nucifera Leaves in Breast Cancer: A Systematic Review of Molecular and Experimental Studies

Abstract

Breast cancer is one of the most prevalent malignancies globally, and resistance to standard therapies such as tamoxifen and trastuzumab poses significant treatment challenges. Lotus (Nelumbo nucifera) leaves contain bioactive compounds, including kaempferol, quercetin, and neferine, which exhibit promising anticancer properties through multi-target mechanisms. This review aims to synthesize preclinical evidence on the anticancer potential of lotus leaves and compare their effectiveness and molecular pathways with other herbal extracts tested in breast cancer models. A narrative review of studies published between 2015 and 2024 was performed using PubMed and ResearchGate databases. Eligible studies included in vitro, in vivo, or silico models evaluating lotus leaves or related herbal extracts against breast cancer. The selection process adhered to the PRISMA 2020 guidelines. Lotus leaf extracts demonstrated approximately 85% inhibition of migration and metastasis in breast cancer models via multiple pathways, including TGF-β/SMAD, ERK, PI3K/Akt, and apoptotic signaling. These effects were validated in xenograft and metastatic models and, in some cases, surpassed the efficacy of standard agents. Comparatively, Nymphaea mexicana achieved the highest inhibition (~88%) but lacked detailed mechanistic data, while lotus seedpod extract (80%) showed activity against radioresistant models via DNA repair inhibition. Lotus leaves exhibit potent and broad-spectrum anticancer activity through multi-pathway mechanisms, positioning them as promising candidates for integrative breast cancer therapy. Further research should prioritize standardized extract preparation, dose–response studies, and clinical validation to translate preclinical findings into therapeutic applications