Berberine, an active ingredient in several plants, shows good effects in managing high blood sugar and excess body weight, plus lower risk of colorectal cancer.

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This section does not replicate the other information on this topic but provides additional details or context most relevant to professionals.

Preclinical evidence for improving treatment outcomes

All the evidence of berberine’s effects on treatment outcomes so far is preclinical. The strongest evidence to date shows improved survival in animals treated with berberine, which has been reported only in lung cancer and multiple myeloma.   

Cancer as a whole

Bladder cancer

Brain and nervous system cancers

Brain cancer:

Neuroblastoma:

  • Anticancer effects on neuroblastoma cells treated with berberine10Choi MS, Yuk DY et al. Berberine inhibits human neuroblastoma cell growth through induction of p53-dependent apoptosis. Anticancer Research. 2008 Nov-Dec;28(6A):3777-84.

Neuroepithelial cancer:

Breast cancer

Colorectal cancer

Gastrointestinal cancer

Colorectal cancer and pancreatic cancer are listed separately.

Gallbladder cancer:

  • Berberine inhibited growth of cholangiocarcinoma cells in a dose-dependent manner23Obchoei S, Detarya M et al. Low dose berberine suppresses cholangiocarcinoma cell progression as a multi-kinase inhibitor. Asian Pacific Journal of Cancer Prevention. 2022;23(10):3379-3386. 

Liver cancer:

Stomach cancer:

Gynecological cancer

Ovarian cancer is listed separately.

Cervical cancer:

Endometrial cancer:

  • Smaller tumor volume among animals with endometrial carcinoma treated with berberine in a meta-analysis of 2 preclinical studies36Xu J, Long Y et al. Anticancer effect of berberine based on experimental animal models of various cancers: a systematic review and meta-analysis. BMC Cancer. 2019;19(1):589. 
  • Berberine inhibited the proliferation and metastasis of endometrial cancer cells and promoted apoptosis37Liang H, Liu Y, Fu L, Li L, Gong N. Berberine inhibits the development of endometrial cancer through circ_ZNF608/miR-377-3p/COX2 axis. Autoimmunity. 2022;55(7):485-495.

Head, neck, and oral cancer

Leukemia

Lung cancer

Lymphoma

  • Anticancer activity in diffuse large B-cell lymphoma cells treated with berberine56Ren S, Cai Y et al. Berberine exerts anti-tumor activity in diffuse large B-cell lymphoma by modulating c-myc/CD47 axis. Biochemical Pharmacology. 2021;188:114576.

Melanoma

Mesothelioma

Multiple myeloma

  • Anticancer activity and longer survival of mice bearing multiple myeloma xenografts treated with berberine60Gu C, Yin Z et al. Identification of berberine as a novel drug for the treatment of multiple myeloma via targeting UHRF1. BMC Biology. 2020;18(1):33.
  • Anticancer activity in multiple myeloma cells treated with berberine61Hu HY, Li KP et al. Set9, NF-κB, and microRNA-21 mediate berberine-induced apoptosis of human multiple myeloma cells. Acta Pharmacological Sinica. 2013 Jan;34(1):157-66. 
  • Less cell proliferation and synergism with bortezomib in multiple myeloma cells treated with berberine62Li C, Su R et al. Discovery of the oncogenic MDM2, a direct binding target of berberine and a potential therapeutic, in multiple myeloma. Functional & Integrative Genomics. 2022;22(5):1031-1041. 

Ovarian cancer

  • Less chemotherapy-exacerbated ovarian cancer metastasis in cells treated with berberine63Zhao Y, Yang X et al. Berberine inhibits chemotherapy-exacerbated ovarian cancer stem cell-like characteristics and metastasis through GLI1. European Journal of Pharmacology. 2021;895:173887.
  • Anticancer activity in ovarian cancer cells treated with berberine, whether with or without cisplatin64Liu L, Fan J et al. Berberine in combination with cisplatin induces necroptosis and apoptosis in ovarian cancer cells. Biological Research. 2019 Jul 18;52(1):37. 
  • Less proliferation, migration and invasion of ovarian cancer cells treated with berberine65Li J, Zhang S, Wu L, Pei M, Jiang Y. Berberine inhibited metastasis through miR-145/MMP16 axis in vitro. Journal of Ovarian Research. 2021;14(1):4.
  • Less motility and invasiveness of ovarian cancer cells treated with berberine66Chuang TC, Wu K et al. Dual down-regulation of EGFR and ErbB2 by berberine contributes to suppression of migration and invasion of human ovarian cancer cells. Environmental Toxicology. 2021;36(5):737-747.

Pancreatic cancer

Prostate cancer

Sarcoma

Berberine combined with other therapies

Berberine and benzoic acid

  • Anticancer activity in hepatocarcinoma cells treated with extracts of Berberis lycium royle, major compounds of which include berberine and benzoic acid72Mustafa K, Mohamed H et al. In vitro anticancer potential of Berberis lycium royle extracts against human hepatocarcinoma (HepG2) cells. Biomedical Research International. 2020;2020:8256809.

Berberine and costunolide

  • Anticancer effects in hepatoma cells treated with berberine and costunolide73Si H, Genna B et al. DaHuangWan targets EGF signaling to inhibit the proliferation of hepatoma cells. PLoS One. 2020;15(4):e0231466.

Berberine and curcumin

  • Stronger anticancer activity in breast cancer cells treated with berberine and curcumin in addition to 5-fluorouracil compared to 5-fluorouracil alone74Ziasarabi P, Sahebkar A, Ghasemi F. Evaluation of the effects of nanomicellar curcumin, berberine, and their combination with 5-fluorouracil on breast cancer cells. Advances in Experimental Medicine and Biology. 2021;1328:21-35. 

Berberine and d-limonene

  • Anticancer effects among gastric carcinoma cells treated with berberine and d-limonene75Zhang XZ, Wang L, Liu DW, Tang GY, Zhang HY. Synergistic inhibitory effect of berberine and d-limonene on human gastric carcinoma cell line MGC803. Journal of Medicinal Food. 2014 Sep;17(9):955-62.

Berberine and emodin

Berberine and evodiamine

Berberine and exercise

Berberine and galangin

Berberine and gefinitib

Berberine and lapatinib

Berberine and palmatine

  • Anticancer effects in rhabdomyosarcoma cells treated with berberine and palmatine84Shinji S, Nakamura S, Nihashi Y, Umezawa K, Takaya T. Berberine and palmatine inhibit the growth of human rhabdomyosarcoma cells. Bioscience, Biotechnology, and Biochemistry. 2020;84(1):63-75.

Berberine photodynamic therapy

  • Berberine photosensitized cervical cancer cells to enhance the response to photodynamic therapy85Oliveira PM, Lopes TZ, Tedesco AC, Rahal P, Calmon MF. Effect of berberine associated with photodynamic therapy in cell lines. Photodiagnosis and Photodynamic Therapy. 2020;32:102045.
  • Berberine photodynamic therapy sensitized melanoma cells to cisplatin86Wang X, Gong Q et al. Berberine-photodynamic therapy sensitizes melanoma cells to cisplatin-induced apoptosis through ROS-mediated P38 MAPK pathways. Toxicology and Applied Pharmacology. 2021;418:115484.
  • Anticancer activity in renal carcinoma cells treated with berberine associated photodynamic therapy87Lopes TZ, de Moraes FR et al. Berberine associated photodynamic therapy promotes autophagy and apoptosis via ROS generation in renal carcinoma cells [published correction appears in Biomedicine & Pharmacotherapy. 2020 May;125:110038] [published correction appears in Biomedicine & Pharmacotherapy. 2021 Apr;136:111175]. Biomedicine & Pharmacotherapy. 2020;123:109794.
  • Anticancer activity in cervical carcinoma cells treated with berberine and photodynamic therapy88Floriano BF, Carvalho T et al. Effect of berberine nanoemulsion photodynamic therapy on cervical carcinoma cell line. Photodiagnosis and Photodynamic Therapy. 2021;33:102174.

Berberine and resveratrol

Berberine and vincristine

Preclinical evidence for managing side effects

Animal studies have found that berberine reduces neuropathy from paclitaxel,91Rezaee R, Monemi A, SadeghiBonjar MA, Hashemzaei M. Berberine alleviates paclitaxel-induced neuropathy. Journal of Pharmacopuncture. 2019 Jun;22(2):90-94; Singh J, Saha L et al. Study of nuclear factor-2 erythroid related factor-2 activator, berberine, in paclitaxel induced peripheral neuropathy pain model in rats. Journal of Pharmacy and Pharmacology. 2019 May;71(5):797-805. although whether by reducing paclitaxel’s effect or not was not clear. Also see evidence that berberine reduces the effectiveness of these drugs in gastric cancer in Safety and precautions ›

Berberine derivatives and formulations

“There are significant barriers to the absorption of berberine. Microemulsions, liposomes, micelles, and other nanoparticles have been used as part of the nanoparticle drug delivery system in recent years to boost the bioavailability of berberine.”92Samadi P, Sarvarian P, Gholipour E, et al. Berberine: a novel therapeutic strategy for cancer. IUBMB Life. 2020;72(10):2065-2079. We report here that research using berberine derivatives and formulations is finding better treatment effects than with berberine and that they may be a promising new treatment in the future.

We have not found that these derivatives and formulations are currently available outside research studies, nor could we find berberine derivatives for cancer treatment mentioned in any of the clinical practice guidelines or programs that we consulted. 

Preclinical evidence for derivatives and formulations improving treatment outcomes

Brain and nervous system cancer
  • Salt modifications enhanced the anticancer effects of berberine in glioblastoma astrocytoma cells93Xu F, Liu M et al. Improvement of anticancer effect of berberine by salt formation modifications. Phytomedicine. 2022;104:154314.
  • Better anticancer effects in glioma cells and better solubility and stability of glucose-coated berberine nanoparticles compared to berberine water nanoparticles94Wang S, An J et al. Glucose-coated berberine nanodrug for glioma therapy through mitochondrial pathway. International Journal of Nanomedicine. 2020;15:7951-7965.
Breast cancer
  • Stronger anticancer activity in breast cancer cells treated with berberine derivatives compared to berberine95Wang ZC, Wang J et al. Synthesis and anticancer activity of novel 9,13-disubstituted berberine derivatives. Bioorganic & Medicinal Chemistry Letters. 2020;30(2):126821.
  • Anticancer activity in breast cancer stem cells and mice treated with targeting berberine liposomes96Ma X, Zhou J et al. Modulation of drug-resistant membrane and apoptosis proteins of breast cancer stem cells by targeting berberine liposomes. Biomaterials. 2013 Jun;34(18):4452-65. 
Colorectal cancer
Liver cancer
Lung cancer
Melanoma and other skin cancer
  • Salt modifications enhanced the anticancer effects of berberine in melanoma cancer cells and animals with melanoma110Xu F, Liu M et al. Improvement of anticancer effect of berberine by salt formation modifications. Phytomedicine. 2022;104:154314.
  • Less cell migration and invasion in in skin cancer cells treated with 13-butoxyberberine bromide compared to berberine111Laomethakorn P, Tayeh M, Samosorn S, Tananyuthawongse C, Watanapokasin R. 13-butoxyberberine bromide inhibits migration and invasion in skin cancer A431 cells. Molecules. 2023;28(3):991. 
Prostate cancer
  • Stronger anticancer activity in prostate cancer cells treated with berberine derivatives compared to berberine112Wang ZC, Wang J et al. Synthesis and anticancer activity of novel 9,13-disubstituted berberine derivatives. Bioorganic & Medicinal Chemistry Letters. 2020;30(2):126821.
Berberine derivatives and formulations in combination with other therapies

Berberine with 10-HCPT microsphere

Berberine derivative nanoparticle formulation combined with photodynamic and photothermal therapies

  • Anticancer activity in breast cancer cells and animals with breast cancer treated with ABH, a berberine derivative nanoparticle formulation combined with photodynamic and photothermal therapies114Li RT, Chen M et al. AIE-based gold nanostar-berberine dimer nanocomposites for PDT and PTT combination therapy toward breast cancer. Nanoscale. 2022;14(27):9818-9831.

Berberine and doxorubicin nanodrug

Berberine with folic acid derivatives and paclitaxel liposome

  • Anticancer activity in glioma cells treated with intelligent and tumor microenvironment (TME)-responsive folic acid derivatives and mitochondria-targeting berberine derivatives co-modified liposome coated with Tween 80 loading paclitaxel to improve penetration of the blood-brain barrier116Yang C, Yang Z et al. Berberine and folic acid co-modified pH-sensitive cascade-targeted PTX-liposomes coated with Tween 80 for treating glioma. Bioorganic & Medicinal Chemistry. 2022;69:116893.

Berberine and jatrorrhizine derivatives

Liposomal berberine and mitoxantrone 

Berberine and phytantriol nanoparticles

Helpful link for professionals

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Keep reading about berberine

Author

Nancy Hepp, MS

Lead Researcher
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Ms. Hepp is a researcher and communicator who has been writing and editing educational content on varied health topics for more than 20 years. She serves as lead researcher and writer for CancerChoices and also served as the first program manager. Her graduate work in research and cognitive psychology, her master’s degree in instructional design, and her certificate in web design have all guided her in writing and presenting information for a wide variety of audiences and uses. Nancy’s service as faculty development coordinator in the Department of Family Medicine at Wright State University also provided experience in medical research, plus insights into medical education and medical care from the professional’s perspective.

Nancy Hepp, MS Lead Researcher

Reviewer

Laura Pole, MSN, RN, OCNS

Senior Clinical Consultant
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Laura Pole is senior clinical consultant for CancerChoices. Laura is an oncology clinical nurse specialist who has been providing integrative oncology clinical care, navigation, consultation, and education services for over 40 years. She is the co-creator and co-coordinator of the Integrative Oncology Navigation Training at Smith Center for Healing and the Arts in Washington, DC. Laura also manages the “Media Watch Cancer News That You Can Use” listserv for Smith Center/Commonweal. In her role as a palliative care educator and consultant, Laura has served as statewide Respecting Choices Faculty for the Virginia POST (Physician Orders for Scope of Treatment) Collaborative as well as provided statewide professional education on palliative and end-of-life care for the Virginia Association for Hospices and Palliative Care.

For CancerChoices, Laura curates content and research, networks with clinical and organizational partners, brings awareness and education of integrative oncology at professional and patient conferences and programs, and translates research into information relevant to the patient experience as well as clinical practice.

Laura sees her work with CancerChoices as a perfect alignment of all her passions, knowledge and skills in integrative oncology care. She is honored to serve you.

Laura Pole, MSN, RN, OCNS Senior Clinical Consultant

Last update: May 8, 2024

Last full literature review: February 2023

We are grateful for research assistance from Adriana Rocio Gutierrez Galvis.

CancerChoices provides information about integrativein cancer care, a patient-centered approach combining the best of conventional care, self care, and evidence-informed complementary care in an integrated plan cancer care. We review complementaryin cancer care, complementary care involves the use of therapies intended to enhance or add to standard conventional treatments; examples include supplements, mind-body approaches such as yoga or psychosocialtherapy, and acupuncture therapies and self carelifestyle actions and behaviors that may impact cancer outcomes; examples include eating health-promoting foods, limiting alcohol, increasing physical activity, and managing stress practices to help patients and professionals explore and integrate the best combination of conventionalthe cancer care offered by conventionally trained physicians and most hospitals; examples are chemotherapy, surgery, and radiotherapy and complementary therapies and practices for each person.

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