Revisiting Itrifal-e-Aftimoon: A Unani Polyherbal Formulation for Cancer Management and Research

Abstract

Cancer remains a major global health challenge, with conventional therapies limited by toxicity, drug resistance, and accessibility issues. Itrifal Aftimoon, a classical Unani polyherbal formulation from the National Formulary of Unani Medicine, contains twelve botanical and mineral ingredients including Triphala (Terminalia chebula, Emblica officinalis, Terminalia belerica), Plumbago zeylanica, Cuscuta reflexa, and Cassia angustifolia. These herbs provide diverse phytochemicals gallic acid, ellagic acid, plumbagin, flavonoids, and polyphenols enabling multi-targeted anticancer mechanisms.Gupta et al. (2022) demonstrated that Itrifal-e-Aftimoon potentiates imatinib's anti-leukemic effects in chronic myeloid leukemia by modulating FAK/STAT/Akt/ERK signaling pathways. The formulation exhibits antioxidant activity via Nrf2-ARE activation, anti-inflammatory effects through NF-κB and COX-2 suppression, immunomodulation enhancing natural killer cells, and selective cytotoxicity against cancer cells while sparing normal cells. Preclinical studies show tumor growth inhibition and improved survival in animal models. Clinical observations suggest enhanced quality of life and reduced chemotherapy toxicities, though rigorous trials are limited. Toxicological studies indicate favourable safety profiles with high therapeutic margins, though drug interactions require monitoring. Future research priorities include randomized controlled trials, pharmacokinetic studies, standardization protocols, bioactive compound identification, and nanoformulation development for improved bioavailability. Integrating traditional Unani knowledge with modern pharmaceutical sciences offers opportunities for evidence-based cancer therapeutics that address current oncological challenges while providing safer, accessible treatment options globally.