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Elemene refers to a group of natural sesquiterpene compounds extracted primarily from the rhizome of Curcuma wenyujin and Curcuma zedoaria. The main active component is β-elemene (beta-elemene), which exhibits broad-spectrum antitumor activity and is used clinically in China as an injectable or oral emulsion for cancer therapy. Elemene acts through multiple mechanisms including cell cycle arrest via modulation of cyclin-dependent kinases, induction of apoptosis by affecting proteins such as survivin, caspase family members, and Bcl-2 family proteins, inhibition of tumor angiogenesis and metastasis through regulation of VEGF and matrix metalloproteinases, reversal of multidrug resistance in cancer cells, modulation of key signaling pathways such as Wnt/β-catenin, Notch, PI3K/Akt/mTOR, MAPK/ERK pathways, STAT3 transcription factor regulation. It has also been shown to enhance immune function and improve the efficacy while reducing side effects when combined with chemotherapy regimens. Approved by the Chinese regulatory authority for use in gliomas and brain metastases as well as adjuvant treatment for esophageal and gastric cancers.
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