Effectiveness and Safety of Oral Chinese Patent Medicines Combined with Chemotherapy for Gastric Cancer: A Bayesian Network Meta-Analysis

Abstract

Objectives. This network meta-analysis (NMA) was designed to assess the comparative effectiveness and safety of oral Chinese patent medicines combined with chemotherapy for gastric cancer on the National Basic Medical Insurance Drugs List of China. Methods. A comprehensive literature search was performed in seven electronic databases from their inception to February 25, 2020, aiming to collect all related randomized controlled trials (RCTs) to evaluate the effectiveness and safety of oral Chinese patent medicines as an adjuvant for gastric cancer. Two researchers independently screened the literature, extracted data, and assessed the risk of bias of included studies using the Cochrane Risk of Bias Scale. NMA was then performed by using STATA 16.0 software and ADDIS 1.16.8 software. Results. Finally, 30 RCTs were included, involving seven kinds of oral Chinese patent medicines, with a total of 2602 patients. For improvement of clinical efficacy, Bazhen granule combined with chemotherapy was ranked first for effectiveness, followed by the Cinobufacin capsule combined with chemotherapy and Xiao’aiping tablet combined with chemotherapy. Meanwhile, Bazhen granules combined with chemotherapy also were ranked first in reducing gastrointestinal reactions. In terms of improving performance status, the Xiao’aiping tablet was the best and significantly better than other oral Chinese patent medicines. Besides, the Zhenqi Fuzheng granule combined with chemotherapy was best for reducing the incidence of leucopenia. Conclusions. Since only one RCT of Bazhen granule was included in this study for analysis, its statistical efficiency is low. Therefore, this study recommends that the Cinobufacin capsule combined with chemotherapy should be a priority in improving clinical efficacy. In terms of improving patients’ quality of life, Xiao’aiping tablet is the best choice. Safety was best for Zhenqi Fuzheng granule and Bazhen granule combined with chemotherapy. Limited by the quantity, quality, and possible bias of included studies, the above conclusions need to be further verified by more high-quality RCTs.

Chinese Medicine as an Adjunctive Treatment for Gastric Cancer: Methodological Investigation of meta-Analyses and Evidence Map

“…After removing 26 duplicates, 92 titles and abstracts were further screened. Finally, 20 systematic reviews with MAs ( Xie et al, 2013 ; Yang et al, 2013 ; Li et al, 2014 ; Wang et al, 2014 ; Yao et al, 2014 ; Li et al, 2015 ; Wang et al, 2015 ; Zhang et al, 2017 ; Zhang D. et al, 2018 ; Zhang X. et al, 2018 ; Chen et al, 2018 ; Lee et al, 2018 ; Wu et al, 2018 ; Sun et al, 2019 ; Wu et al, 2019 ; Lu X. et al, 2020 ; Chen et al, 2020 ; Li et al, 2020 ; Wu et al, 2020 ; Cheng et al, 2021 ) in English that focused on CM for gastric cancer were included (no different MA was identified from the reference lists). The selection flow used in this research is displayed in Figure 1 .…”

“…According to Zhang et al ( Zhang et al, 2017 ), a comparison between ten CM injections combined with FOLFOX and FOLFOX alone revealed that the combinations of astragalus, FFKS, KangAi, lentinan, HuaChanSu, and SQFZ with FOLFOX improved the objective response rate. Lu et al ( Lu X. et al, 2020 ) demonstrated that when seven oral Chinese patent medicines (e.g., BaZhen granule, Cinobufacin capsule, and XiaoAiPing tablet) combined with chemotherapy were compared to chemotherapy alone, the BaZhen granule combined with chemotherapy ranked first in terms of objective response rate. However, a network MA conducted by Zhang et al ( Zhang D. et al, 2018 ) showed no obvious difference between 11 CM injections (e.g., AiDi, KangAi, HuaChanSu, and FFKS) combined with XELOX compared to XELOX alone in terms of objective response rate.…”

“…In 2018, Zhang et al ( Zhang D. et al, 2018 ) performed another network MA and found that among the nine CM injections combined with XELOX, the SQFZ, HuaChanSu, KangAi, and BJOE injections could enhance the performance status compared to XELOX alone. A network MA published by Lu et al ( Lu X. et al, 2020 ) showed that the XiaoAiPing tablet in combination with chemotherapy significantly built up the performance status and ranked best among six oral Chinese patent medicines combined with chemotherapy when compared to chemotherapy alone.…”

Metabolomics Analysis Reveals Interaction of Base-Line Chemotherapy and Shiyiwei Shenqi Tablets in Breast Cancer Treatment

“…For example, previous studies have shown that a TCM named Yiqi Jianpi Hewei could alleviate the occurrence rate of chemotherapy induced constipation in breast cancer patients (Wu et al, 2019;Li et al, 2020). The SST has been used to restore the immune function of chemotherapeutic or post-operational period gastric cancer patients (Lu et al, 2020). However, the mechanisms of pharmacodynamics and drug-drug interaction remain unclear.…”

Oral Chinese Patent Medicine Combined With Oxaliplatin-Based Chemotherapy Regimen for the Treatment of Colorectal Cancer: A Network Meta-Analysis

“…Compared with Chinese herbal medicine and Chinese herbal injection, OCPM has the advantages of convenient management and accurate dosage, which have been generally accepted and widely used in Chinese clinical practice. 6 Some studies have provided evidence that the combination of OCPM and chemotherapy can obtain a better clinical efficacy in the treatment of CRC. 7 , 8 However, there is a lack of head-to-head comparisons between different OCPM, and its relative advantages have not been well understood.…”