CANCER CHEMOPREVENTION (R AGARWAL, CV RAO AND S YU, SECTION EDITORS) Emerging Insights into Anticancer Chemopreventive Activities of Nutraceutical Moringa oleifera: Molecular Mechanisms, Signal Transduction and In Vivo Efficacy Maniti Sodvadiya 1 & Harsh Patel 2 & Adarsh Mishra 1 & Sujit Nair 2 # Springer Nature Switzerland AG 2020 Abstract The health-beneficial effects of various phytochemicals and nutraceuticals have been known historically especially in ancient systems of medicine such as Indian Ayurvedic Medicine, Traditional Chinese Medicine and African Traditional Medicine for combating cancer, inflammation, cardiovascular and metabolic diseases. Moringa oleifera Lam., commonly known as the ‘drumstick’ tree, is a cruciferous tree belonging to the Moringaceae family, which shows antiinflammatory, anticancer and nutraceutical properties. The isothiocyanates present in the leaves or leaf extracts have been shown to modulate critical signal transduction pathways involved in cancer. The leaves are also widely used for their nutraceutical benefits in building body fitness and improving overall health. We discuss the phytochemistry, molecular mechanisms for anticancer chemopreventive activity as well as anticancer nanotheranostic formulations of Moringa. Relatively few preclinical and clinical studies have been conducted so far to scientifically establish the anticancer potential of Moringa and these are discussed here. Importantly, the available literature is encouraging and supports the use of Moringa in cancer chemoprevention. Future work needs to focus on appropri- ately designed clinical trials in cancer patients to systematically evaluate the clinical anticancer potential of Moringa. Taken together, scientific investigation of Moringa isothiocyanates alone, or Moringa leaf powder as a nutraceutical and/or functional food, can open new avenues in discovery research for translating the anticancer benefits of Moringa from bench-to-bedside for cancer prevention. Keywords Moringa oleifera . Cancer . Inflammation . Signal transduction . Chemoprevention . Moringa isothiocyanate . Moringin . Moringenine Introduction The health-beneficial effects of various phytochemicals and nutraceuticals have been known historically especially in an- cient systems of medicine such as Traditional Chinese Medicine (TCM) and Ayurveda in India for combating cancer, inflammation, cardiovascular and metabolic diseases [1]. A healthy nutraceutical-enriched diet also helps to prevent or reduce the risk for cancer [2]. The National Cancer Institute (NCI) SEER report [3] for the year 2018 suggests 1,735,350 newer cases of cancer while 609,640 deaths due to it. The regional WHO office of Europe states 3.7 million newer can- cer cases each year with stomach, breast, liver, lung and colon cancer to be the major cases of deaths due to cancer with around 20% of deaths due to it [4]. The development of resis- tance to anticancer drugs is the major drawback associated with the use of chemotherapeutic agents. The reasons attrib- uted for this are presence of one or more transporters that eliminate drugs from the cells, lack of sensitivity to drug- induced apoptosis and induction of detoxification pathways [5]. Epigenetic and genetic changes within cancer cells lead to both extrinsic as well as intrinsic resistance to chemothera- py. Moreover, tumour stroma components like tumour- associated macrophages (TAM) and fibroblasts also make cancerous tumours resistant to therapy [6]. This article is part of the Topical Collection on Cancer Chemoprevention * Sujit Nair sujit108@gmail.com 1 Shobhaben Pratapbhai Patel School of Pharmacy & Technology Management, SVKM’ s NMIMS University, V. L. Mehta Road, Vile Parle (West), Mumbai 400056, India 2 SVKM’ s Dr. Bhanuben Nanavati College of Pharmacy, University of Mumbai, V. L. Mehta Road, Vile Parle (West), Mumbai 400056, India Current Pharmacology Reports https://doi.org/10.1007/s40495-020-00210-z