细胞外基质（ECM）在肿瘤微环境（TME）的构建中起着至关重要且动态的作用，成为癌症研究和治疗的焦点。多种细胞信号在ECM重塑中的作用导致癌症的无限增殖、转移、免疫逃逸和药物抗性。针对ECM重塑的三位一体靶向可能成为癌症早期、中期和晚期的新策略，克服药物抗性。目前，近60％的替代抗癌药物来源于植物的天然产物、活性成分或结构类似物。根据ECM的特点，本文提出了癌症全过程的三个阶段管理方案，包括在癌症早期阶段预防癌症发展（阶段I）；阻止癌症中期阶段肿瘤的转移（阶段II）；为晚期癌症使用免疫疗法提供新方法（阶段III）；并以靶向ECM组分的天然产物的使用为创新策略提供了抗癌作用的新视角。在此，我们关注ECM重塑的三位一体以及ECM、癌相关成纤维细胞（CAFs）和肿瘤相关巨噬细胞（TAMs）之间的相互作用，并整理了天然产物对肿瘤进展中ECM和相关靶点的干预效果，为开发针对肿瘤转移和复发的新药提供了参考。版权所有 © 2023 Liang, Liu, Zhao, Luo, He, Li, Tang, Tang and Chen.

Extracellular matrix (ECM) plays a pivotal and dynamic role in the construction of tumor microenvironment (TME), becoming the focus in cancer research and treatment. Multiple cell signaling in ECM remodeling contribute to uncontrolled proliferation, metastasis, immune evasion and drug resistance of cancer. Targeting trilogy of ECM remodeling could be a new strategy during the early-, middle-, advanced-stages of cancer and overcoming drug resistance. Currently nearly 60% of the alternative anticancer drugs are derived from natural products or active ingredients or structural analogs isolated from plants. According to the characteristics of ECM, this manuscript proposes three phases of whole-process management of cancer, including prevention of cancer development in the early stage of cancer (Phase I); prevent the metastasis of tumor in the middle stage of cancer (Phase II); provide a novel method in the use of immunotherapy for advanced cancer (Phase III), and present novel insights on the contribution of natural products use as innovative strategies to exert anticancer effects by targeting components in ECM. Herein, we focus on trilogy of ECM remodeling and the interaction among ECM, cancer-associated fibroblasts (CAFs) and tumor-associated macrophages (TAMs), and sort out the intervention effects of natural products on the ECM and related targets in the tumor progression, provide a reference for the development of new drugs against tumor metastasis and recurrence.Copyright © 2023 Liang, Liu, Zhao, Luo, He, Li, Tang, Tang and Chen.