Curcumin in Endometrial Cancer Therapy: A Qualitative Systematic Review of Molecular Targets, Preclinical Evidence, and Translational Challenges Publisher



Esmaeli M ; Dehabadi MD ; Pourentezari M ; Vostakolaei MA
Source: Indian Journal of Gynecologic Oncology Published:2026

Abstract

Background: Endometrial cancer (EC) is the most common gynecologic malignancy in high-income countries, with rising incidence driven by obesity, metabolic disorders, and aging. While molecular classifications have improved diagnostic precision, therapeutic outcomes for advanced and recurrent EC remain unsatisfactory. Objective: This qualitative systematic review evaluates the molecular mechanisms, therapeutic efficacy, and delivery strategies of curcumin and its formulations in preclinical and clinical models of endometrial cancer. Due to the limited number of included studies (n = 9) and their methodological heterogeneity, a narrative synthesis was performed rather than a quantitative meta-analysis. Methods: A comprehensive search of PubMed, Scopus, Web of Science, Embase, and Google Scholar was conducted for studies published from January 2015 to July 2025. Eligible studies included original in vitro, in vivo, or clinical investigations assessing curcumin’s effects on EC-related outcomes. Data were extracted on molecular targets, anticancer mechanisms, delivery platforms, and study limitations. Results: Nine studies met inclusion criteria, encompassing seven preclinical and two clinical investigations. Curcumin demonstrated multitargeted modulation of key signaling pathways including PI3K/Akt/mTOR, NF-κB, ERK/c-Jun, and Wnt/β-catenin, resulting in suppressed proliferation, migration, and invasion, along with enhanced apoptosis in EC models. Advanced delivery systems—such as liposomes, phytosomes, and nanohydrogels—improved curcumin’s bioavailability and therapeutic impact. Clinical evidence is extremely limited, comprising only two human studies with small sample sizes and short durations. These studies report modest immunomodulatory effects and anecdotal improvements in treatment tolerability, but no definitive conclusions regarding clinical efficacy can be drawn. Conclusion: Curcumin exhibits promising antitumor activity against endometrial cancer in preclinical models. However, clinical validation is hindered by limited human trials, lack of formulation standardization, and insufficient pharmacodynamic endpoints. Future well-designed randomized controlled trials are essential to clarify its role in EC management and support its integration into translational oncology. © The Author(s) under exclusive licence to Association of Gynecologic Oncologists of India 2026.