**4.4. Chinese medicines and their active compounds for inhibiting angiogenesis in liver cancer treatment**

Angiogenesis is a physiological process during which new blood vessels are produced and developed based on the original vessels. As angiogenesis plays a crucial role in tumor growth and metastasis, the novel antitumor therapies targeting angiogenesis may provide new hopes for cancer treatment. Livistona Chinensis seeds (EELC) have been used for centuries in TCM for cancer treatment. HCC xenograft mice model confirmed that EELC can inhibit tumor angiogenesis through the Notch‐signaling pathway [40]. After EELC treatment, *in vivo* results showed remarkable decrease in intratumoral microvessel density (MVD) in the HCC xenograft mice tumors. In addition, the angiogenesis‐related proteins such as the VEGF‐A and VEGFR‐ 2 were significantly decreased after EELC treatment. The mechanism study demonstrated that the antiangiogenesis effect was related with the inhibition of the Notch pathway as the expression of Notch, Dll4 and Jagged1 were down regulated according to the real‐time polymerase chain reaction (RT‐PCR) results.

Yang Zheng Xiao Ji (YZXJ) is a commercial TCM product for supplementary treatment of advanced liver cancer. Some clinical trials indicated that YZXJ may improve the curative effect of interventional chemotherapy for advanced liver cancer patients. *In vitro* studies showed that YZXJ can inhibit the matrigel‐based sandwich tubule formation and cell migration. Western blot results confirmed that inhibition of the activation of focal adhesion kinase may at least in part confer the YZXJ‐induced inhibition of cell migration and tube formation [41]. These results indicated that YZXJ could be a potential antihepatoma TCM product via suppressing tumor angiogenesis.

Asparagus polysaccharide, the bioactive derivate from Asparagus, is a common TCM herbal diet that may exhibit anticancer activity according to previous researches. One study has explored the adjunctive effects of asparagus polysaccharide in liver cancer chemotherapy [42]. Their results showed that asparagus polysaccharide significantly suppressed liver cancer growth in combination with transcatheter arterial chemoembolization (TACE) therapy in orthotopic HCC rat model. Tumor angiogenesis may be the major target for asparagine gelatinous in liver cancer treatment. Several angiogenesis markers such as CD34 and VEGF significantly decreased after asparagine gelatinous treatment. The expression of MVD markers also remarkably reduced in asparagus polysaccharide treated liver tumors. These results suggested that asparagus polysaccharide with TACE could apparently inhibit the tumor angiogenesis *in vivo*; asparagus polysaccharide might be a potential adjunvant therapy for TACE in treating liver cancer.
