Sulforaphane in Cancer Prevention and Therapy: A State-of-the-Art Review of Epidemiological Evidence, Molecular Mechanisms, and Translational Challenges
Abstract
1. Introduction
2. Literature Search Strategy and Study Selection
3. Chemistry, Metabolism, and Bioavailability
3.1. Glucoraphanin-to-SFN Conversion
3.2. Human Metabolism and the Mercapturic Acid Pathway
3.3. Determinants of SFN Bioavailability in Humans
4. Molecular Mechanisms of SFN
4.1. Nrf2–ARE Activation
4.2. Epigenetic Modulation
4.3. Cell Death and Anticancer Signaling
4.4. Additional Antitumor Mechanisms of SFN
5. Preclinical and Clinical Evidence
5.1. Preclinical Summary
5.1.1. Prostate Cancer
5.1.2. Breast Cancer
5.1.3. Colorectal Cancer
5.2. Clinical Studies
6. Challenges, Translational Barriers, and Future Perspectives
6.1. Bioavailability-Related Variability and Translational Barriers
6.2. Biomarker-Guided and Mechanism-Driven Clinical Trial Design
6.3. Advanced Delivery Systems and Combination Strategies
6.4. Long-Term Safety Considerations for Chronic SFN Administration
7. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
| AKT | Protein kinase B |
| AMPK | AMP-activated protein kinase |
| AP-1 | Activator protein 1 |
| ARE | Antioxidant response element |
| CKMT2-AS1 | Creatine kinase, mitochondrial 2 antisense RNA 1 |
| DNMT | DNA methyltransferase |
| GPX4 | Glutathione peroxidase 4 |
| G2/M | G2/M phase of the cell cycle |
| HDAC | Histone deacetylase |
| HO-1 | Heme oxygenase 1 |
| IL-1β | Interleukin-1 beta |
| IL-6 | Interleukin-6 |
| Keap1 | Kelch-like ECH-associated protein 1 |
| MAPK | Mitogen-activated protein kinase |
| mTOR | Mechanistic target of rapamycin |
| NADPH | Nicotinamide adenine dinucleotide phosphate |
| NF-κB | Nuclear factor kappa-light-chain-enhancer of activated B cells |
| NQO1 | NAD(P)H quinone dehydrogenase 1 |
| Nrf2 | Nuclear factor erythroid 2–related factor 2 |
| PI3K | Phosphoinositide 3-kinase |
| ROS | Reactive oxygen species |
| SFN | Sulforaphane |
| STAT3 | Signal transducer and activator of transcription 3 |
| TRAMP | Transgenic adenocarcinoma of mouse prostate |
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| Cancer Type | Models (In Vitro/In Vivo) | Key Findings | Major Mechanisms | Refs. |
|---|---|---|---|---|
| Prostate cancer | LNCaP, 22Rv1 cells (in vitro) | ↓: ACC1, FASN, CPT1A, SREBP1 | ↓: fatty-acid synthesis pathway | [70] |
| TRAMP mice (in vivo) | ↓: total free fatty acids, total phospholipids, acetyl-CoA, ATP, neutral lipid droplets | ↓: fatty-acid metabolism ↑: Nrf2-mediated cytoprotective signaling | [70] | |
| PC-3 CSC-like cells (in vitro) | ↓: tumor sphere formation, PCSC markers (CD44, ALDH1, Oct4, Nanog) | ↓: Wnt/β-catenin & Hedgehog pathways ↑: apoptosis | [71] | |
| Breast cancer | MDA-MB-231 (in vitro) | ↓: RAF family proteins (ARAF, BRAF, and CRAF), MEK, p-ERK | ↓: metastasis signaling | [68] |
| MDA-MB-231, ZR-75-1 cells (in vitro) | ↓: Cyclin B1, CDC2, CDC25C ↑: MPM-2 activity, CDK5R1, CDK5 | ↓: proliferation ↑: apoptosis, mitotic arrest (G2/M) | [72] | |
| MDA-MB-231-Luc-D3H1 CSC-like cells (in vitro) | ↓: mammosphere formation (1, 2, 3), CSC population (CD44+/CD24−/CD49f+), CSC-associated stemness signaling (CR1, CR3, WNT3, NOTCH4, FOXD3) | ↓: stemness pathway, self-renewal capacity | [73] | |
| MDA-MB-231-Luc-D3H1 xenograft (in vivo) | ↓: tumor volume, Cripto-1 protein expression (CR1/CR3; IHC trend) | ↓: CSC-driven tumor growth | [73] | |
| Colorectal cancer | HCT116 cells (in vitro) | ↓: cell viability, SLC7A11 ↑: ROS, MDA, intracellular iron | ↑: SIRT3–AMPK–mTOR axis–mediated ferroptosis | [62] |
| HT-29 cells (in vitro) | ↓: IL-6 mRNA, IL-6 secretion, IL-6 promoter activity, ROS, p-p38 MAPK, p-STAT3, p-c-Jun/AP-1, invasion, migration | ↓: ROS–p38 MAPK–AP-1/STAT3 inflammatory signaling | [63] | |
| HT-29, SW480 cells (in vitro) | ↓: cell viability, colony formation, EdU proliferation, migration (wound healing & transwell) ↑: ROS, G0/G1 arrest, apoptosis, p-ERK/ERK ratio, Nrf2, UGT1A | ↑: ERK–Nrf2–UGT1A metabolic detoxification pathway | [74] | |
| Lung cancer | A549, H460 CD133+ cells (in vitro) | ↓: cell viability, tumorsphere formation, SHH signaling (Shh, Smo, Gli1), PHC3 | ↓: Sonic Hedgehog signaling and PHC3-associated self-renewal | [75] |
| Pancreatic cancer | Mia PaCa-2 cells (in vitro) | ↓: cell viability, p-NF-κB p65, NF-κB p65, NF-κB p50, c-Myc, BCL-2 ↑: p-GSK-3β, β-catenin, cleaved caspase-3 and PARP | ↑: apoptosis via modulation of the GSK-3β/β-catenin pathway | [76] |
| Bladder cancer | T24, UMUC3 cells (in vitro) | ↓: pseudopodia formation (lamellipodia, filopodia, invadopodia), cell migration and invasion, CTTN (cortactin), WASL, ACTR2/ARP2, ATP production, ECAR, OCR | ↓: actin nucleation–driven pseudopodia formation (CTTN–WASL–ARP2/3, AKT1-ATP axis) | [77] |
| T24-luc tail-vein metastasis model (in vivo) | ↓: lung metastatic burden, metastatic tumor growth, Actr2s/Arp2 and CTTN expression in metastatic lung tissue | ↓: pseudopodia-dependent metastatic colonization | [77] |
| Cancer Type | Phase | Study Design | Key Baseline Characteristics | Main Outcomes | Clinical Trial ID | Refs. |
|---|---|---|---|---|---|---|
| Prostate cancer | Phase 2 | Single-arm interventional study | n = 20; biochemical recurrence; SFN-rich broccoli sprout extract | ≥50% PSA decline achieved in 1 of 20 patients | NCT01228084 | [78,79] |
| Not applicable | Interventional biopsy window study | n = 98; men scheduled for prostate biopsy; SFN-rich broccoli sprout extract capsules | Increase in urinary SFN metabolites | NCT01265953 | [80,81] | |
| Breast cancer | Phase 2 | Randomized, placebo-controlled presurgical window study | n = 54; presurgical breast cancer; SFN-yielding broccoli sprout preparation | HDAC activity decreased in breast tissue | NCT00843167 | [82,83,84] |
| Phase 2 | Interventional breast tissue biomarker study | n = 34; women scheduled for breast biopsy; SFN-rich broccoli sprout preparation | Cancer-related biomarkers showed changes in breast tissue | NCT00982319 | [85] | |
| Lung cancer risk (former smokers) | Phase 2 | Randomized, placebo-controlled lung tissue biomarker study | n = 43; former smokers at high lung cancer risk; SFN | Modulation of bronchial dysplasia index and Ki-67 proliferation marker over 12 months | NCT03232138 | [86] |
| System | Representative Example | Stability | PK Features | Key Advantage | Key Limitation | Refs. |
|---|---|---|---|---|---|---|
| Free SFN | Pure SFN | Low | Short half-life; high inter-individual variability | Simple formulation | Instability; rapid metabolism | [37,38,41] |
| Microencapsulation | Protein-based matrix | ↑ | Delayed release; increased bioaccessibility | Improved stability | Limited human PK data | [96] |
| Enzyme-stabilized formulations | Glucoraphanin + active myrosinase | ↑↑ | Reproducible in situ SFN generation | Reduced PK variability | Enzyme dependence | [32,88] |
| Nanotechnology-based carriers | Liposomes/polymeric nanoparticles | ↑↑↑ | Prolonged exposure; enhanced uptake * | Targeted delivery potential | Limited clinical translation | [99,100] |
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Jang, J.Y.; Kim, D.; Lee, N.K.; Im, E.; Kim, N.D. Sulforaphane in Cancer Prevention and Therapy: A State-of-the-Art Review of Epidemiological Evidence, Molecular Mechanisms, and Translational Challenges. Int. J. Mol. Sci. 2026, 27, 2028. https://doi.org/10.3390/ijms27042028
Jang JY, Kim D, Lee NK, Im E, Kim ND. Sulforaphane in Cancer Prevention and Therapy: A State-of-the-Art Review of Epidemiological Evidence, Molecular Mechanisms, and Translational Challenges. International Journal of Molecular Sciences. 2026; 27(4):2028. https://doi.org/10.3390/ijms27042028
Chicago/Turabian StyleJang, Jung Yoon, Donghwan Kim, Na Kyeong Lee, Eunok Im, and Nam Deuk Kim. 2026. "Sulforaphane in Cancer Prevention and Therapy: A State-of-the-Art Review of Epidemiological Evidence, Molecular Mechanisms, and Translational Challenges" International Journal of Molecular Sciences 27, no. 4: 2028. https://doi.org/10.3390/ijms27042028
APA StyleJang, J. Y., Kim, D., Lee, N. K., Im, E., & Kim, N. D. (2026). Sulforaphane in Cancer Prevention and Therapy: A State-of-the-Art Review of Epidemiological Evidence, Molecular Mechanisms, and Translational Challenges. International Journal of Molecular Sciences, 27(4), 2028. https://doi.org/10.3390/ijms27042028

