**4. The molecular mechanism on liver cancer treatment by Chinese medicines and their active compounds**

inflammation and inhibiting fibrosis in the liver [15]. Shi Quan Da Bu Tang (SQDBT) is a classic TCM herbal diet formula that was documented in the "Tai Ping Imperial Grace Formulary" in Song dynasty. In TCM, SQDBT were used to regulate Qi and treat Yang deficiency. Modern scientific research show that SQDBT can relieve chronic viral liver diseases by reducing inflammatory processes and controlling serum alanine transaminase (ALT) levels, thus it may prevent liver cancer development [16]. Other TCM herbal extracts or isolates such as the Salvia Miltiorrhiza extracts, Schisandra chinensis extracts, silymarin, glycyrrhizin, baicalein and baicalin may prevent liver cancer by relieving chronic liver diseases associated hepatic steatosis

**3.2. Chinese medicines and their active compounds for inhibiting liver cancer development**

Invigorating Qi and strengthening the spleen; relieving Qi stagnancy in liver, clearing heat and detoxifying, activating blood circulation to dissipate blood stasis, supplementing Qi and nourishing yin are the main principles in treating primary liver cancer with TCM. Inhibiting tumor growth, suppressing metastasis and preventing recurrence with TCM is the key to restrain liver cancer development. According to a large‐scale cohort study in Taiwan, Jia Wei Xiao Yao San (JWXYS) and Chai Hu Shu Gan Tang (CHSGT) are the most common TCM prescriptions for liver cancer treatment. These TCM formulae can significantly inhibit tumor development and improve survival in patients with primary liver cancer [22]. JWXYS are used for invigorating the spleen and nourishing blood, it is effective for relieving Qi stagnancy in liver. Besides its antihepatoma effects, JWXYS can also inhibit colon cancer and breast cancer [23, 24]. CHSGT are also used for dispersing the Qi stagnancy in liver. Different from the JWXYS that focuses on invigorating the spleen, CHSGT is mainly applied for activating Qi movement and relieving pain. Both of these formulae have been safely used in liver cancer treatment for patients in China, Taiwan and Hong Kong, with few side effects being reported. Some pharmacological studies also revealed that a lot of CMs extracts or isolates could inhibit liver cancer growth or metastasis both *in vitro* and *in vivo*. This includes but not limited to Coptidis Rhizome extracts, Radix Bupleuri extracts, Radix Salvia Miltiorrhiza extracts, silymarin,

**3.3. Chinese medicines and their active compounds for improving the quality of life and**

As most of the liver cancer patients are diagnosed with late‐stage cancer, only 20% patients may have the chance to receive curative treatment. In this case, improving the quality of life and reducing the side effects of conventional therapy are very important for liver cancer patients. The common side‐effects of conventional therapies, such as nausea, vomiting, fever, abdominal pain, loss of appetite, alopecia and myelosuppression may lead to noncompliance of treatment and thus affect treatment outcomes and reduce the quality of life. According to a series of randomized clinical trials, CMs are effective in extending survival time, improving quality of life, and reducing side effects of conventional therapies for liver cancer patients [29]. For example, Ophiopogonis Radix and Galli Gigerii Endothelium Corneum (Ji Nei Jing) are most commonly used CMs for appetite improvement; Astragali Radix is widely used for

**reducing the side effects of conventional therapy in liver cancer patients**

and fibrosis [17–21].

52 Anti-cancer Drugs - Nature, Synthesis and Cell

berberine, Wogonin, bufalin and curcumin [25–28].
