<i>Astragalus</i>-Based Chinese Herbs and Platinum-Based Chemotherapy for Advanced Non–Small-Cell Lung Cancer: Meta-Analysis of Randomized Trials

McCulloch, Michael; See, Caylie; Shu, Xiao-juan; Broffman, Michael; Kramer, Alan M.; Wang, Fan; Gao, Jin; Lieb, Whitney; Shieh, Kane; Colford, John M.

doi:10.1200/jco.2005.03.6392

Cited by 230 publications

(148 citation statements)

References 22 publications

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“…A metaanalysis of another immune-enhancing botanical, Astragalus, reported an enhancement of the efficacy of platinum-based chemotherapy for lung cancer 31 and PSK (Coriolus versicolor) for the enhancement of tegafur for colorectal cancer 108 .…”

Section: Herbsmentioning

confidence: 99%

“…Survival of these cells and longterm immune "memory" development in patients with malignancy are necessary for improving the clinical benefits of cancer immunotherapies. Polysaccharides derived from Chinese herbs and mushrooms are emerging agents that seem to enhance cytotoxic drugs, radiotherapy, surgery, and the newer targeted therapies and vaccines 31,105,153 . Rigorous authentication and quality control of these phytoceuticals are necessary before clinical studies begin 43 .…”

Section: Herbsmentioning

confidence: 99%

“…For example, red ginseng acidic polysaccharide increases the cytotoxicity of paclitaxel 29 , and Phellinus linteus enhances the cytotoxicity of doxorubicin 30 . A meta-analysis of Astragalusbased Chinese herbs and platinum-based chemotherapy for advanced non-small-cell lung cancer indicates a promising therapeutic gain 31 .…”

Section: Tumour Physiologymentioning

confidence: 99%

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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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Section: Herbsmentioning

confidence: 99%

Section: Herbsmentioning

confidence: 99%

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Chinese Medicine and Biomodulation in Cancer Patients—Part Two

Sagar

Wong

2008

Current Oncology

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“…A meta-analysis by McCullough and colleagues 8 found that Astragalus-based Chinese herbal medicine can increase the effectiveness of platinum-based chemotherapy. However, an updated comprehensive review of tcm in the treatment of advanced nsclc has yet to be performed.…”

Section: Introductionmentioning

confidence: 99%

Astragalus-Containing Traditional Chinese Medicine, with and without Prescription Based on Syndrome Differentiation, Combined with Chemotherapy for Advanced Non-Small-Cell Lung Cancer: A Systemic Review and Meta-Analysis

Wang

Jiao

et al. 2016

Current Oncology

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Objective Traditional Chinese Medicine (tcm) is used in China as part of the treatment for non-small-cell lung cancer (nsclc) and often includes prescription of herbal therapy based on syndrome differentiation. Studies of various Astragalus-based Chinese medicines combined with platinum-based chemotherapy in the treatment of lung cancer are popular in East Asia, particularly in China. The aim of the present study was to perform a systematic review and meta-analysis comparing platinum-based chemotherapy alone with platinum-based chemotherapy plus Astragalus-based Chinese botanicals, with and without prescription based on syndrome differentiation, as first-line treatment for advanced nsclc. MethodsWe searched the Chinese Biomedical Literature database, the China National Knowledge Internet, the VIP Chinese Science and Technology Periodicals Database, PubMed, embase, the Cochrane databases, and abstracts presented at meetings of the American Society of Clinical Oncology, the World Conference on Lung Cancer, the European Society for Medical Oncology, and the Chinese Society of Clinical Oncology for all eligible studies. Endpoints were overall survival; 1-year, 2-year, and 3-year survival rates; performance status; overall response rate; and grade 3 or 4 adverse events. Subgroup analyses based on herbal formulae individualized using syndrome differentiation or on oral or injection patent medicines were performed using the Stata software application (version 11.0: StataCorp LP, College Station, TX, U.S.A.) and a fixed-effects or random-effects model in case of heterogeneity. Results are expressed as a hazard ratio (hr) or relative risk (rr), with corresponding 95% confidence intervals (cis).Results Seventeen randomized studies with scores on the Jadad quality scale of 2 or more, representing 1552 patients, met the inclusion criteria. Compared with platinum-based chemotherapy alone, the addition of Astragalus-based tcm to chemotherapy was associated with significantly increased overall survival (hr: 0.61; 95% ci: 0.42 to 0.89; p = 0.011); 1-year (rr: 0.73; 95% ci: 0.65 to 0.82; p < 0.001), 2-year (rr: 0.3344; 95% ci: 0.237 to 0.4773; p < 0.001), and 3-year survival rates (rr: 0.30; 95% ci: 0.17 to 0.53; p < 0.001); performance status (rr: 0.43; 95% ci: 0.34 to 0.55; p < 0.001); and tumour overall response rate (rr: 0.7982; 95% ci: 0.715 to 0.89; p < 0.001). Subgroup analyses indicated that Astragalus herbal formulae given based on syndrome differentiation were more effective than Astragalus-based oral and injection patent medicines. Side effects-including anemia, neutropenia, thrombocytopenia, fatigue, poor appetite, nausea, and vomiting-were significantly more frequent with platinumbased chemotherapy alone than when platinum-based chemotherapy was combined with Astragalus-based tcm.

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“…However, chemotherapy is reported to be associated with a series of adverse reaction, e.g., bone marrow suppression, gastrointestinal toxicity, immunosuppression, etc (Yamamoto and Iwase, 2012). It was reported that Chinese herbal medicine (CHM) may increase effectiveness of platinum based chemotherapy in this setting (McCulloch, M., et al,2006). Javanica oil emulsionsemulsion (Yadanzi®) is a product with Brucea Jen petroleum ether extracts as raw materials, and purified soybean lecithin as emulsifier.…”

Section: Introductionmentioning

confidence: 99%

Phase II Study on Javanica Oil Emulsion Injection (Yadanzi^®) Combined with Chemotherapy in Treating Patients with Advanced Lung Adenocarcinoma

Huang²,

Cao³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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Purpose: To investigate the efficacy and safety of Javanica oil emulsion injection (Yadanzi®) combined with pemetrexed and platinum (PP) for treating patients with advanced lung cancer. Patients and Methods: From June 2011 to June 2013, we recruited 58 patients with advanced lung cancer, and divided them into two groups. Twenty eight patients received Yadanzi® (from ZheJiang Jiuxu Pharmaceutical Co., Ltd.) together with PP chemotherapy (combined group), while the others were given only PP chemotherapy (control group). After two cycles of treatment, efficacy and safety of treatment were evaluated. Results: The overall response rate [(CR+PR+SD)/(CR+PR+SD+PD)] of the combined group was higher than that of control group (89.7% vs. 86.2%, p>0.05). Regarding rate of life improvement, it was 82.8% in combined group, and 51.7% in the control group (p<0.05). In terms of side effects, leukopenia in combined group was less frequent than that in control group (p<0.05). More patients in the control group were found to suffer liver toxicity. Conclusions: Javanica oil emulsion injection combined with chemotherapy could be considered as a safe and effective regimen in treating patients with advanced lung adenocarcinoma. It can improve the quality of life and reduce the possibility of leukopenia. Further clinical trials with a large sample size should be conducted to confirm whether addition of Yadanzi® to chemotherapy could increase the response rate, reduce toxicity, enhance tolerability and improve quality of life for patients with advanced lung cancer.

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Astragalus-Based Chinese Herbs and Platinum-Based Chemotherapy for Advanced Non–Small-Cell Lung Cancer: Meta-Analysis of Randomized Trials

Abstract: Astragalus-based Chinese herbal medicine may increase effectiveness of platinum-based chemotherapy when combined with chemotherapy. These results require confirmation with rigorously controlled trials.

Cited by 230 publications

References 22 publications

Chinese Medicine and Biomodulation in Cancer Patients—Part Two

Chinese Medicine and Biomodulation in Cancer Patients—Part Two

Astragalus-Containing Traditional Chinese Medicine, with and without Prescription Based on Syndrome Differentiation, Combined with Chemotherapy for Advanced Non-Small-Cell Lung Cancer: A Systemic Review and Meta-Analysis

Phase II Study on Javanica Oil Emulsion Injection (Yadanzi^®) Combined with Chemotherapy in Treating Patients with Advanced Lung Adenocarcinoma

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Astragalus-Based Chinese Herbs and Platinum-Based Chemotherapy for Advanced Non–Small-Cell Lung Cancer: Meta-Analysis of Randomized Trials

Abstract: Astragalus-based Chinese herbal medicine may increase effectiveness of platinum-based chemotherapy when combined with chemotherapy. These results require confirmation with rigorously controlled trials.

Cited by 230 publications

References 22 publications

Chinese Medicine and Biomodulation in Cancer Patients—Part Two

Chinese Medicine and Biomodulation in Cancer Patients—Part Two

Astragalus-Containing Traditional Chinese Medicine, with and without Prescription Based on Syndrome Differentiation, Combined with Chemotherapy for Advanced Non-Small-Cell Lung Cancer: A Systemic Review and Meta-Analysis

Phase II Study on Javanica Oil Emulsion Injection (Yadanzi®) Combined with Chemotherapy in Treating Patients with Advanced Lung Adenocarcinoma

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Product

Resources

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Phase II Study on Javanica Oil Emulsion Injection (Yadanzi^®) Combined with Chemotherapy in Treating Patients with Advanced Lung Adenocarcinoma