Betulinic acid in the treatment of tumour diseases: Application and research progress

Betulinic acid (BA) is a pentacyclic triterpene compound that can be obtained by separation, chemical synthesis and biotransformation from birch. BA has antitumour activity, and its mechanisms of action mainly include the induction of mitochondrial oxidative stress; the regulation of specificity protein transcription factors, and the inhibition of signal transducer and activator of transcription 3 and nuclear factor-κB signalling pathways. In addition, BA can increase the sensitivity of cancer cells to other chemotherapy drugs. Recent studies have shown that BA plays an anticancer role in several kinds of tumour diseases. In this article, the anticancer mechanism of BA and its application in the treatment of tumour diseases are reviewed. •BA binds to multiple targets in cancer therapy and inhibits tumour growth through diverse pathways.•Betulinic acid mediates the anticancer effect via directly binding target molecules and then affects the cellular pathways.•Betulinic acid can increase the sensitivity of cancer cells to other chemotherapy drugs.•Betulinic acid-loaded nanoliposomes may improve the water solubility and bioavailability.