a systematic review of the cytotoxic effects of morphine on cancer cells

Background: to date, numerous studies have delved into the cytotoxic effects of morphine on cancer cells. the present research undertook a systematic review of the cytotoxic effects of morphine on cancer cells to attain a more precise estimation.methods: the research articles were sourced from pubmed, scopus, and google scholar databases spanning from 1999 to november 20, 2024. the selection criteria were established in accordance with the guidelines of prisma (preferred reporting items for systematic reviews and meta-analyses).results: the results of this study show that morphine reduces survival and increases the apoptosis of lung, uterine, ovarian, liver, breast, stomach, pancreas, neuroblastoma, and mouth cancer cells. the mechanisms underlying this cytotoxicity may involve the modulation of apoptosis pathways, cell cycle arrest, the production of free radicals, increased expression of apoptotic genes, and inhibition of cell proliferation. these effects were observed in a dose-dependent manner, with higher concentrations of morphine often leading to increased cytotoxicity in cancer cells. in contrast, morphine increases survival and decreases the apoptosis of breast, lung, bladder, endothelial, and pancreatic cancer cells.conclusion: morphine can induce apoptosis and inhibit cell proliferation in some cancer cells. meanwhile, it may promote cancer progression through inflammation, immune suppression, and metastasis in other cells. however, further studies are needed to clarify its mechanisms and evaluate its safe therapeutic use in cancer.