Chinese Herbal Medicine and Chemotherapy in the Treatment of Hepatocellular Carcinoma: A Meta-analysis of Randomized Controlled Trials

Shu, Xiao-juan; McCulloch, Michael; Xiao, Hang; Broffman, Michael; Gao, Jin

doi:10.1177/1534735405279927

Cited by 71 publications

(51 citation statements)

References 16 publications

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“…Though operative resection is still the most effective treatment (1), only 20% of patients are suitable for surgery. Therefore, optimal comprehensive therapy, combining different nonsurgical therapies such as chemotherapy, biological therapy and traditional Chinese medicine, has become the main trend (2). Moreover, development of effective therapies capable of discriminating between tumor and normal tissue are receiving considerable attention in the field of anticancer studies (3).…”

Section: Introductionmentioning

confidence: 99%

Pinus massoniana bark extract selectively induces apoptosis in human hepatoma cells, possibly through caspase-dependent pathways

Liu²,

Feng³

et al. 2010

Int J Mol Med

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Abstract. Pinus massoniana bark extract (PMBE) is a mixture of flavonoids, whose antioxidant and apoptosisinducing properties have been confirmed in vitro. In this study, the apoptotic effect and mechanism of PMBE in HepG2 human hepatoma cells were evaluated. PMBE exerted dose-and time-dependent cell growth inhibition on HepG2 cells, and selectively induced apoptosis without impact on normal liver L-02 cells. Apoptosis induced by PMBE in HepG2 cells was also confirmed by annexin-V/PI staining, transmission electron microscopy and sub-G1 phase accumulation. Moreover, PMBE also slightly blocked the cell cycle in the G2/M and S phases in HepG2 cells. The investigation of the mechanism by which PMBE induced apoptosis in HepG2 cells indicated that activation of extrinsic and intrinsic caspase, inhibition of NF-κB activation and decrease of the antiapoptotic protein Bcl-2 and the intact Bid protein were involved. Furthermore, the antitumor activity of PBME was demonstrated in vivo by a 42.88-69.94% reduction rate of tumor weight in H22 tumor-implanted mice. Taken together, these data indicate that PMBE selectively induces apoptosis in HepG2 cells through caspase-dependent pathways, and inhibits tumor growth in vivo, making it a potential candidate for anticancer therapeutics.

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Section: Introductionmentioning

confidence: 99%

Pinus massoniana bark extract selectively induces apoptosis in human hepatoma cells, possibly through caspase-dependent pathways

Liu²,

Feng³

et al. 2010

Int J Mol Med

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“…Chinese herbal medicines are now attracting great attention in the world, which also show promising effects in treatment of cancers, including HCC [4] . Paeonol (Pae, 2-hydroxy-4-methoxyacetophenone, Figure 1), is a natural product extracted from the root of Paeonia Suffruticosa Andrew [5] .…”

Section: Introductionmentioning

confidence: 99%

Antiproliferation and apoptosis induction of paeonol in HepG₂cells

Xu¹

2007

WJG

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“…Recent meta-analyses confirmed the utility of Chinese herbs both to enhance control of particular cancers (particularly viral-induced cancers such as hepatocellular carcinoma and nasopharyngeal cancers) and to reduce side effects of chemotherapy 27,28 . Laboratory studies suggest that some herbs increase the effectiveness of conventional chemotherapy.…”

Section: Tumour Physiologymentioning

confidence: 99%

Chinese Medicine and Biomodulation in Cancer Patients—Part Two

Sagar

Wong

2008

Current Oncology

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Traditional Chinese Medicine (TCM) is a whole system containing therapeutic interventions that individually induce biomodulation at the physiologic, chemical, and molecular levels. The theory of TCM proposes a synergy between specific interventions selected as part of a care plan based on TCM diagnostic theory. Combining TCM with the modern practice of oncology seems, in conjunction with biomedical interventions (surgery, radiotherapy, chemotherapy, and pharmaceuticals), to have potential advantages through the synergy of biomodulation. Biomodulation approaches are broadly categorized as modification of tumour response and reduction of adverse effects; modulation of immunity; prevention of cancer progression; and enhancement of symptom control. Although the database of preclinical studies is rapidly expanding, good-quality clinical trials are notably scarce.Laboratory studies suggest that some herbs increase the effectiveness of conventional chemotherapy without increasing toxicity. A healthy immune system is necessary for control of malignant disease, and the immune suppression associated with cancer contributes to its progression. Many Chinese herbs contain glycoproteins and polysaccharides (among them, constituents of Coriolus versicolor, Ganoderma lucidum, Grifola frondosa, Astragalus membranaceus, Panax ginseng, and various other medicinal mushrooms) that can modulate metastatic potential and the innate immune system. Phytochemicals such as specific polysaccharides have been shown to boost the innate immune system, especially through interaction with Tolllike receptors in mucosa-associated lymphoid tissue. This intervention can potentially improve the effectiveness of new anticancer vaccines. An increase in virusassociated cancers presents a major public health problem that requires novel therapeutic strategies. A number of herbal therapies have both antiviral activity and the ability to promote immunity, possibly inhibiting the initiation and promotion of virus-associated cancers.The mechanisms learned from basic science should be applied to clinical trials both of specific interventions and of whole-system care plans that safely combine the TCM approach with the conventional biomedical model. In Western medicine, the combination of TCM herbs with drug therapies is controversial, given lack of knowledge concerning whether a drug is favourably enhanced or whether adverse effects occur. Using initial data from the preclinical studies, future clinical research needs to evaluate the combinations, some of which are showing favourable synergy.

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Chinese Herbal Medicine and Chemotherapy in the Treatment of Hepatocellular Carcinoma: A Meta-analysis of Randomized Controlled Trials

Abstract: These findings provide promising evidence that combining Chinese herbal medicine with chemotherapy may benefit patients with HCC. Because of the low quality of these studies, these findings should be confirmed through conducting high-quality, rigorously controlled trials.

Cited by 71 publications

References 16 publications

Pinus massoniana bark extract selectively induces apoptosis in human hepatoma cells, possibly through caspase-dependent pathways

Pinus massoniana bark extract selectively induces apoptosis in human hepatoma cells, possibly through caspase-dependent pathways

Antiproliferation and apoptosis induction of paeonol in HepG₂cells

Chinese Medicine and Biomodulation in Cancer Patients—Part Two

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Chinese Herbal Medicine and Chemotherapy in the Treatment of Hepatocellular Carcinoma: A Meta-analysis of Randomized Controlled Trials

Abstract: These findings provide promising evidence that combining Chinese herbal medicine with chemotherapy may benefit patients with HCC. Because of the low quality of these studies, these findings should be confirmed through conducting high-quality, rigorously controlled trials.

Cited by 71 publications

References 16 publications

Pinus massoniana bark extract selectively induces apoptosis in human hepatoma cells, possibly through caspase-dependent pathways

Pinus massoniana bark extract selectively induces apoptosis in human hepatoma cells, possibly through caspase-dependent pathways

Antiproliferation and apoptosis induction of paeonol in HepG2cells

Chinese Medicine and Biomodulation in Cancer Patients—Part Two

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Antiproliferation and apoptosis induction of paeonol in HepG₂cells