| Rank |
Pathway / Target Axis |
Direction |
Primary Effect |
Notes / Cancer Relevance |
Ref |
| 1 |
Wnt / β-catenin signaling |
↓ Wnt/β-catenin (↓ β-catenin nuclear program) |
Growth & stemness suppression |
Piperine suppresses canonical Wnt signaling and shows anti-cancer effects in colorectal cancer cells |
(ref) |
| 2 |
PI3K → AKT survival signaling |
↓ PI3K/AKT signaling |
Reduced survival / increased apoptosis |
Gastric cancer study concludes piperine inhibits proliferation and induces apoptosis through inhibition of PI3K/Akt signaling |
(ref) |
| 3 |
AKT → mTOR axis |
↓ Akt/mTOR |
Anti-growth + anti-migration |
Piperine downregulates Akt/mTOR signaling with associated inhibition of migration and MMP-9 expression |
(ref) |
| 4 |
NF-κB transcriptional program |
↓ NF-κB activation |
Reduced inflammatory / pro-survival gene expression |
Piperine is reported as a potent inhibitor of NF-κB and related transcription factor activity in melanoma cells |
(ref) |
| 5 |
STAT3 → Snail EMT axis |
↓ STAT3 / ↓ Snail → ↓ EMT |
Anti-migration / anti-invasion |
Piperine inhibits colorectal cancer migration/invasion through a STAT3/Snail-mediated EMT mechanism |
(ref) |
| 6 |
Multidrug resistance transporter ABCB1 (P-gp) |
↓ P-gp-mediated efflux (chemosensitization) |
Improved chemo response (MDR reversal) |
Demonstrates piperine has chemosensitizing activity in P-gp–mediated MDR models (piperine characterized as P-gp substrate/modulator) |
(ref) |
| 7 |
ROS / oxidative stress |
↑ ROS |
Upstream stress trigger |
Piperine induces oxidative stress in cancer cells (ROS increase shown) and links it to growth inhibition/apoptosis |
(ref) |
| 8 |
Intrinsic apoptosis (caspase activation) |
↑ apoptosis |
Programmed cell death |
HeLa study: piperine induces apoptosis in a dose-dependent manner with apoptosis markers reported |
(ref) |
| 9 |
Autophagy-dependent cell death (ROS–Akt/mTOR coupling) |
↑ autophagy-dependent death (with ↓ Akt/mTOR) |
Stress-lethal program |
Colon cancer study: piperine induces autophagy-dependent cell death by increasing ROS and inhibiting Akt/mTOR signaling |
(ref) |
| 10 |
Cell-cycle progression |
↑ cell-cycle arrest (context-dependent) |
Proliferation blockade |
Rectal cancer cell study: piperine impairs cell-cycle progression and produces cytostatic/cytotoxic effects |
(ref) |
| 11 |
Migration / invasion (MMP-9 axis) |
↓ migration / ↓ MMP-9 |
Anti-metastatic phenotype |
Piperine suppresses migration with MMP-9 downregulation and Akt/mTOR inhibition |
(ref) |
| 12 |
In vivo chemosensitization (doxorubicin) |
↑ doxorubicin sensitivity |
Enhanced therapeutic efficacy |
Study evaluates piperine as an adjuvant to enhance doxorubicin sensitivity in triple-negative breast cancer models |
(ref) |