Evidence mapPaperPMID 41896285Full record

ArticleScientific reports2026

Synergistic anticancer activity of frankincense aqueous extract with sorafenib in HepG2 cells and its UHPLC-QTOF-MS/MS-based metabolomic profiling.

Wesam Ragab, Kamel Mahmoud, Seham Salah El-Din El-Hawary, Osama M Gomaa, Rasha M Allam, Abeer S Moawad, Rabab Mohammed

Abstract read
In one paragraph

Article in Scientific reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Cytotoxic Activity ofInternational journal of molecular sciences · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Wesam Ragab *Pharmacognosy Department, Faculty of Pharmacy, MUST University, 6th October City, Giza, 12566, Egypt. wesam.ragab@must.edu.eg.ORCID http://orcid.org/0000-0002-1809-8005
Kamel Mahmoud *Pharmacognosy Department, Faculty of Pharmacy, MUST University, 6th October City, Giza, 12566, Egypt.
Seham Salah El-Din El-HawaryPharmacognosy Department, Faculty of Pharmacy, Cairo University, Cairo, 11562, Egypt.
Osama M GomaaPharmacognosy Department, Faculty of Pharmacy, Cairo University, Cairo, 11562, Egypt.
Rasha M AllamPharmacology Department, Medical and Clinical Research Institute, National Research Centre, 33 El-Bohouth St., Dokki, P.O.12622, Cairo, Egypt.
Abeer S MoawadPharmacognosy Department, Faculty of Pharmacy, Beni-Suef University, Beni-Suef, 62514, Egypt.
Rabab MohammedPharmacognosy Department, Faculty of Pharmacy, Beni-Suef University, Beni-Suef, 62514, Egypt. rababmohammed@pharm.bsu.edu.eg.ORCID http://orcid.org/0000-0001-9683-4250

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Liver cancer remains a major global health challenge, with limited therapeutic options for advanced stages. Sorafenib, the standard first-line systemic therapy, provides only modest survival benefits and is frequently associated with drug resistance and adverse effects, necessitating the exploration of safer and more effective combination therapies. Frankincense, the olibanum gum resin from Boswellia sacra Flück.(Burseraceae), has long been used as a traditional medicinal remedy and is known to target multiple biological pathways, with diverse therapeutic activities. Owing to its reported multi-target anticancer, anti-inflammatory, and pro-apoptotic properties, frankincense represents a promising candidate for combination therapy aimed at enhancing sorafenib efficacy while potentially reducing required doses and associated toxicity. This study aimed to evaluate the cytotoxic activity of frankincense aqueous extract (FrAE) alone and in combination with sorafenib (SOR) against the hepatoblastoma cell line HepG2. Phytochemical analysis tentatively identified five diterpenoids and sixteen triterpenoids in FrAE. Both FrAE and SOR exhibited dose-dependent cytotoxicity, and their combination selectively enhanced cytotoxic effects, reducing the effective concentration of SOR and demonstrating strong synergism (CI = 0.298). Mechanistically, the combination induced integrated anticancer effects characterized by enhanced apoptosis and necrosis, activation of autophagic signaling, and marked inhibition of HepG2 cell migration, accompanied by cell cycle disruption across multiple phases. Molecular docking further supported these findings by demonstrating favorable binding of FrAE-derived terpenoids to key apoptotic (BCL-2, p53) and autophagic (mTOR, LC3C) regulators. Collectively, these findings suggest that the aqueous extract of frankincense enhances the anticancer efficacy of sorafenib, representing a promising adjuvant strategy for the management of liver cancer.

Indexed as

Antineoplastic AgentsFrankincenseLiver NeoplasmsMetabolomicsPlant ExtractsSorafenibApoptosisCell ProliferationChromatography, High Pressure LiquidDrug SynergismHep G2 CellsHumansTandem Mass SpectrometryAntineoplastic AgentsFrankincensePlant ExtractsSorafenibBoswelliaCompuSynFrankincenseHepG2SorafenibSynergistic cytotoxicityUHPLC-QTOF-MS/MS

Identifiers

PMID41896285
PMCPMC13039205

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.