Revaluation of Xihuang Pill on tumor treatment: from ancient literatures to modern studies

Xihuang Pill (XHP), an old prescription since the 18th century to treat various diseases, including breast cancer, is used widely for tumor therapy alone or in combination with chemotherapy and/or radiotherapy. XHP is composed of Niu Huang (Calculus bovis), She Xiang (Moschus), Ru Xiang (Olibanum), and Mo Yao (Myrrha). XHP was recorded to have effects on treating breast cancer, intestinal cancer, lymphomas, ovarian cancer. Modern studies indicate that XHP can inhibit tumor cells proliferation, migration, angiogenesis and regulate tumor microenvironment. In this review, we firstly introduced the application of XHP on tumor therapy in ancient literatures. Then, the antitumor studies of XHP in both clinical and basic aspects were summarized and we also discussed the antitumor material basis and mechanisms of Calculus Bovis, Moschus, Olibanum and Myrrha. In addition, with the development of time, the dosage form of XHP, source and dose of herbs and processing methods of Olibanum and Myrrha have been changed and we also evaluated the advantage and disadvantage of these changes of XHP. Taken together, XHP has various antitumor active ingredients, which is multi-target. Moreover, beneficial technology improvement has been made in modern XHP compared to the ancient prescription. Here, we aimed to put forward a new method to revaluating XHP on its application from ancient literatures to modern studies and from pharmacy to medicine.