癌细胞中反应性氧化物（ROS）产生和ROS调节通路的失控导致反应性氧化物的异常积累，对癌症进展具有双刃作用，既支持转化/增殖和促进肿瘤发生，又引起细胞死亡。癌细胞可以通过调节反应性氧化物的水平来容忍其存在，使其能够激活促癌信号通路，而不通过调节抗氧化防御系统诱导细胞死亡。因此，靶向反应性氧化物是癌症治疗的有希望方法。人参皂苷及其衍生物和相关的药物载体，通过调节氧化应激介导的细胞和分子靶点，调节多条信号通路，诱导凋亡；调节细胞周期阻滞和自噬、侵袭和转移；增强不同癌症类型的耐药细胞对化疗药物的敏感性，取决于反应性氧化物的类型、水平和来源，以及癌症的类型和阶段。我们的综述聚焦于反应性氧化物的促癌和抗癌效应，并总结了靶向反应性氧化物带来抗癌效应的各种人参皂苷的机制和最新进展，为进一步设计抗癌研究或进行更多临床前和临床研究提供了新思路。 © 2023 Li, Cao, Sun and Wang.

Dysregulation of reactive oxygen species (ROS) production and ROS-regulated pathways in cancer cells leads to abnormal accumulation of reactive oxygen species, displaying a double-edged role in cancer progression, either supporting transformation/proliferation and stimulating tumorigenesis or inducing cell death. Cancer cells can accommodate reactive oxygen species by regulating them at levels that allow the activation of pro-cancer signaling pathways without inducing cell death via modulation of the antioxidant defense system. Therefore, targeting reactive oxygen species is a promising approach for cancer treatment. Ginsenosides, their derivatives, and related drug carriers are well-positioned to modulate multiple signaling pathways by regulating oxidative stress-mediated cellular and molecular targets to induce apoptosis; regulate cell cycle arrest and autophagy, invasion, and metastasis; and enhance the sensitivity of drug-resistant cells to chemotherapeutic agents of different cancers depending on the type, level, and source of reactive oxygen species, and the type and stage of the cancer. Our review focuses on the pro- and anticancer effects of reactive oxygen species, and summarizes the mechanisms and recent advances in different ginsenosides that bring about anticancer effects by targeting reactive oxygen species, providing new ideas for designing further anticancer studies or conducting more preclinical and clinical studies.Copyright © 2023 Li, Cao, Sun and Wang.