Radix Astragali (RA) is widely used in traditional Chinese medicine (TCM), and astragaloside IV (AS‑IV) is the most critical component of RA. Previous studies have demonstrated that AS‑IV exerts effects on the myocardium, nervous system and endocrine system, among others. In the present review article, data from studies conducted over the past 20 years were collated, which have evaluated the effects of AS‑IV on tumors. The mechanisms of action of AS‑IV on malignant cells both in vivo and in vitro were summarized and it was demonstrated that AS‑IV plays a vital role, particularly in inhibiting tumor growth and metastasis, promoting the apoptosis of tumor cells, enhancing immune function and preventing drug resistance. Moreover, AS‑IV controls several epithelial‑mesenchymal transformation (EMT)‑related and autophagy‑related pathways, such as the phosphoinositide‑3‑kinase (PI3K)/protein kinase B (AKT), Wnt/β‑catenin, mitogen‑activated protein kinase (MAPK)/extracellular regulated protein kinase (ERK) and transforming growth factor‑β (TGF‑β)/SMAD signaling pathways, which are commonly affected in the majority of tumors. The present review provides new perspectives on the functions of AS‑IV and its role as an adjuvant treatment in cancer chemotherapy.
Keywords: astragaloside IV; epithelial‑mesenchymal transformation; cancer; molecular mechanisms; chemosensitivity.