Background: Triterpenes are a large group of secondary metabolites mainly produced by plants with a variety of biological activities, including potential antitumor effects. Hepatocellular carcinoma (HCC) is a very common primary liver disease spread worldwide. The treatment can consist of surgical intervention, radiotherapy, immunotherapy and chemotherapeutic drugs. These drugs mainly include tyrosine multikinase inhibitors, although their use is limited by the underlying liver disease and displays side effects. For that reason, the utility of natural compounds such as triterpenes to treat HCC is an interesting line of research. No clinical studies are reported in humans so far.

Objective: The aim of the present work is to review the knowledge about the effects of triterpenes as a possible coadjuvant tool to treat HCC.

Results: In vitro and xenograft models have pointed out the cytotoxic and anti-proliferative effects as well as improvements in tumor growth and development of many triterpenes. In addition, they have also shown to be chemosensitizing agents when co-administered with chemotherapeutic agents. The mechanisms of action are diverse and involve the participation of mitogen-activated protein kinases, including JNK, p38 MAPK and ERK, and the survival-associated PI3K / Akt signaling pathway. However, no clinical studies are still reported in humans.

Conclusion: Triterpenes could become a future strategy to address HCC or at least improve results when administered in combination with chemotherapeutic agents.

背景：三萜类是一大类次生代谢产物，主要由具有多种生物活性（包括潜在的抗肿瘤作用）的植物产生。肝细胞癌（HCC）是一种非常普遍的原发性肝病，在世界范围内广泛传播。治疗可以包括外科手术，放射疗法，免疫疗法和化学治疗药物。这些药物主要包括酪氨酸多激酶抑制剂，尽管它们的使用受到潜在的肝脏疾病的限制并显示出副作用。由于这个原因，诸如三萜的天然化合物用于治疗HCC的实用性是一个有趣的研究领域。迄今为止，尚未在人类中报告临床研究。

目的：本工作的目的是回顾有关三萜类化合物作为治疗HCC可能的辅助药物的作用的知识。

结果：体外和异种移植模型已指出许多三萜的细胞毒性和抗增殖作用以及肿瘤生长和发育的改善。另外，当与化学治疗剂共同使用时，它们也显示出化学增敏剂。作用机制是多种多样的，涉及丝裂原激活的蛋白激酶（包括JNK，p38 MAPK和ERK）的参与，以及与生存相关的PI3K / Akt信号通路。但是，尚无关于人类的临床研究报道。

结论：三萜类与化疗药联合使用可能成为解决HCC或至少改善结果的未来策略。