In vitro cytotoxicity of medicinal plants used in prostate cancer management in Africa: a systematic review

Background Prostate cancer in Africa is a significant public health problem with a consistently increasing high mortality rate. The World Health Organization (WHO) estimates that 80% of the population in Africa uses herbal medicines. However, research on the cytotoxicity related to African plant extracts against prostate cancer is still limited, which retards the development of potential anticancer agents from these plants. This review compiles data on the cytotoxicity of African medicinal plants used in the management of prostate cancer. Methods A systematic literature review search was conducted from January 2015 to June 2025 on studies on the cytotoxic activity of medicinal plants used in the management of prostate cancer in Africa. The review was based on the Preferred Reporting Items for the Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The study considered cytotoxic studies available on the search engines of ScienceDirect, Google scholar, Web of Science, SpringerLink, Scopus, PubMed, BioMed, and Scientific Electronic Library Online (SciELO). The data were analysed using SPSS statistical software. Results Twenty-eight articles on cytotoxic activity of anti-prostate cancer medicinal plants in Africa were evaluated. The studies reported 45 medicinal plants with cytotoxic activity against prostate cancer cell lines. The extract of Dichrostachys cinerea with IC50 of 8.04 μg/ml on 22RV1 exhibited the strongest cytotoxic activity. This was followed by extracts of Acacia gerrardii with IC50 of 10.45 μg/ml on DU-145, Ormenis eriolepis with IC50 of 19.31 μg/ml on LNCaP, and Momordica charantia with IC50 of 20.39 μg/ml on PC3. The cytotoxic activity of the medicinal plants is attributed to the presence of phytochemicals acting either singly or synergistically, causing cancer cell apoptosis, cell cycle arrest, inhibition of androgen receptors and inhibition of reactive oxygen species/free radicals. Conclusion The investigated medicinal plants contain bioactive compounds that exhibited cytotoxic activity against prostate cancer cell lines. The bioactive compounds found in these plants could be used in clinical trials in the development of prostate cancer therapies.