Astaxanthin (AXT), a carotenoid primarily derived from marine organisms such as shrimp, krill and the microalga Haematococcus pluvialis, has gained significant attention for its potent antioxidant, anti‑inflammatory and anti‑proliferative properties. The present comprehensive review explored the role of AXT in cancer prevention and treatment, emphasizing its cytotoxic mechanisms and modulation of key molecular pathways involved in cancer progression. AXT has demonstrated efficacy across a variety of cancer types, including nervous system, breast and gastrointestinal cancers, through its ability to induce apoptosis, inhibit metastasis and disrupt cell growth. The present review detailed both in vitro and in vivo studies highlighting the effectiveness of AXT in sensitizing cancer cells to chemotherapy, thereby enhancing therapeutic outcomes and potentially reducing treatment‑related side effects. The incorporation of AXT in nanoparticle‑based delivery systems has further improved its bioavailability and targeted action, showcasing its potential in advanced cancer therapies. However, despite promising experimental results, more comprehensive in vivo studies and clinical trials are necessary to validate the efficacy and safety of AXT in human populations. Such research would help standardize dosing, confirm interactions with conventional treatments and support the integration of AXT into clinical oncology as a natural, complementary approach to existing cancer treatments.

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