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**OSW-1** is a natural steroidal saponin primarily isolated from the bulbs of *Ornithogalum saundersiae*. It exhibits extremely potent and selective anticancer activity, in vitro and in vivo, across diverse cancer types such as glioma, colorectal, breast, prostate, ovarian, leukemia, and hepatocellular carcinoma. OSW-1 triggers programmed cell death through both apoptosis and necroptosis, exhibiting significantly higher cytotoxicity for cancer cells compared to nonmalignant cells. Its mechanisms of action include inhibition of *oxysterol-binding protein* (OSBP) and OSBP-related protein 4 (ORP4), disruption of intracellular lipid trafficking, induction of endoplasmic reticulum stress, mitochondrial membrane damage, modulation of the p53/PUMA pathway, cytosolic calcium influx, and inhibition of the PI3K/AKT pathway. The induced forms of cell death are highly immunogenic, potentiating antitumor immunity and synergizing with immunotherapy. OSW-1 also demonstrates significant inhibition of tumor growth, colony formation, and migration, with low systemic toxicity observed in animal models[1][2][3][4][5][11].
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