Potential of Indonesian Herbal as an Anti-Cancer Therapy: A Systemic Review of in vitro Studies

INTRODUCTION: In the world, the second most common cause of mortality is cancer, and its prevalence is increasing in both developing and developed states. Cancer therapy has severe side effects for people with cancer. The selection of natural ingredients in the form of herbal plants is expected to provide therapeutic effectiveness with low side effects. A total of 6000 plant species are utilized as herbal medicines in Indonesia by the local population for various ailments. OBJECTIVE: To describe the potential of Indonesian herbal plant products as a cancer therapy in vitro. METHODS: This systematic review is based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA-SR) guidelines. The selection of articles published in the last 5 years (2018–2023) from Pubmed, Ebsco, Garuda portal, ScienceDirect, Cochrane, and Webscience was carried out in January 2023 with the keyword “Indonesian herbal” AND/OR “Anti-cancer” AND/OR “In Vitro”. Risk of bias assessment using OHAT tools. RESULTS: A total of 1,816,511 articles then through inclusion, exclusion criteria screening, and the risk of bias were obtained 23 (twenty-three) low risk of bias articles. Some herbal plant products such as Soursop (Annona muricata L.), Nyamplung (Calophyllum spp.), Benalu Cengkeh/Clove Benalu (Dendrophthoe pentandra), Rumput Mutiara/Pearl Grass (Hedyotis corymbosa L.), Rasamala (Altingia excelsa), Sarang Semut/Anthill plant (Myrmecodia pendans), Basil (Ocimum sanctum Linn.), and Tepus (Zingiber griffithii) showed different potentials for activity as an in vitro anti-cancer therapy. The three Indonesian herbal plants that are most studied in vitro as anti-cancer are Soursop, Rasamala, and Benalu Cengkeh/Clove Benalu. CONCLUSION: The most widely studied Indonesian herbal plant in vitro as an anti-cancer is Soursop, while the anti-cancer activity that is widely reported is by inhibiting cell proliferation through intrinsic pathways.