Mechanism of Xu Li’s Experiential Prescription for the Treatment of EGFR‐Positive NSCLC

Xu, Bin; Zhang, Haitao; Wang, Yuchao; Huang, Shuran; Xu, Lina

doi:10.1155/2020/8787153

Cited by 3 publications

(3 citation statements)

References 33 publications

(28 reference statements)

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“…Xu Li’s experiential prescription (XLEP) has been applied in the treatment of NSCLC, which is mainly composed of Radix adenophorae , Radix Glehniae , Radix Asparagi , Radix Ophiopogonis , Schisandra , Privet fruit , Astragalus , Zedoary . Xu et al 189 discovered that XLEP could promote M2-like macrophage polarization to M1-like macrophages and increase the M1-like /M2-like macrophage ratio in EGFR-positive NSCLC cells. This effect was mediated by the downregulation of mTOR, IL-10, TGF-β, and CCL22 and the upregulation of IL-6, CCL2, CCL3, and TNF-α, thereby delaying resistance to the EGFR-TKI inhibitor gefitinib.…”

Section: Targeting M2-like Tams To Overcome Tumor Resistancementioning

confidence: 99%

Targeting M2-like tumor-associated macrophages is a potential therapeutic approach to overcome antitumor drug resistance

Wang,

Chen

et al. 2024

npj Precis. Onc.

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Tumor drug resistance emerges from the interaction of two critical factors: tumor cellular heterogeneity and the immunosuppressive nature of the tumor microenvironment (TME). Tumor-associated macrophages (TAMs) constitute essential components of the TME. M2-like TAMs are essential in facilitating tumor metastasis as well as augmenting the drug resistance of tumors. This review encapsulates the mechanisms that M2-like TAMs use to promote tumor drug resistance. We also describe the emerging therapeutic strategies that are currently targeting M2-like TAMs in combination with other antitumor drugs, with some still undergoing clinical trial evaluation. Furthermore, we summarize and analyze various existing approaches for developing novel drugs that target M2-like TAMs to overcome tumor resistance, highlighting how targeting M2-like TAMs can effectively stop tumor growth, metastasis, and overcome tumor drug resistance.

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Section: Targeting M2-like Tams To Overcome Tumor Resistancementioning

confidence: 99%

Targeting M2-like tumor-associated macrophages is a potential therapeutic approach to overcome antitumor drug resistance

Wang,

Chen

et al. 2024

npj Precis. Onc.

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“… 22 As an auxiliary and complementary medicine in China, traditional herbal medicine is prevalently used in clinical practice. 23 , 24 Traditional herbal medicine has the advantages of alleviating clinical symptoms, enhancing autoimmunity and helping to manage the quality of life of patients. 25 - 27 Previous studies have reported that herbal extracts and prescriptions through multi-targeting inhibit tumor proliferation, induce tumor apoptosis, and alleviate drug resistance.…”

Section: Introductionmentioning

confidence: 99%

Traditional Herbal Medicine: A Potential Therapeutic Approach for Adjuvant Treatment of Non-small Cell Lung Cancer in the Future

Huang

et al. 2022

Integr Cancer Ther

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Lung carcinoma is the primary reason for cancer-associated mortality, and it exhibits the highest mortality and incidence in developed and developing countries. Non-small cell lung cancer (NSCLC) and SCLC are the 2 main types of lung cancer, with NSCLC contributing to 85% of all lung carcinoma cases. Conventional treatment mainly involves surgery, chemoradiotherapy, and immunotherapy, but has a dismal prognosis for many patients. Therefore, identifying an effective adjuvant therapy is urgent. Historically, traditional herbal medicine has been an essential part of complementary and alternative medicine, due to its numerous targets, few side effects and substantial therapeutic benefits. In China and other East Asian countries, traditional herbal medicine is increasingly popular, and is highly accepted by patients as a clinical adjuvant therapy. Numerous studies have reported that herbal extracts and prescription medications are effective at combating tumors. It emphasizes that, by mainly regulating the P13K/AKT signaling pathway, the Wnt signaling pathway, and the NF-κB signaling pathway, herbal medicine induces apoptosis and inhibits the proliferation and migration of tumor cells. The present review discusses the anti-NSCLC mechanisms of herbal medicines and provides options for future adjuvant therapy in patients with NSCLC.

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“…CHM contains several active compounds that interact with target proteins involved in EGFR-TKI resistance (Bing et al, 2018), in addition to enhancing the inhibition effect of EGFR-TKIs in gefitinibresistant NSCLC cells by activating PI3-K/Akt-mediated suppress of MUC1 expression (Li et al, 2016). CHM has also been reported to increase the ratio of M1/M2 macrophages by inhibiting autophagy, and suppress the proliferation of EGFR-TKI-resistant cancer cells (Xu et al, 2020). Several clinical trials and systematic reviews report that CHM is effective in delaying EGFR-TKI resistance and alleviating AE (.…”

Section: Introductionmentioning

confidence: 99%

Chinese Herbal Medicine Combined With First-Generation EGFR-TKIs in Treatment of Advanced Non-Small Cell Lung Cancer With EGFR Sensitizing Mutation: A Systematic Review and Meta-Analysis

Sun

Jiao

et al. 2021

Front. Pharmacol.

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Background: Non-small cell lung cancer (NSCLC) is the leading cause of cancer-related deaths worldwide. First-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (EGFR-TKIs) significantly improve prognosis of advanced NSCLC patients harboring EGFR sensitizing mutation. However, acquired resistance to EGFR-TKIs limits the good outcomes. Chinese herbal medicine (CHM) has been used for NSCLC patients receiving EGFR-TKIs for more than 10°years as an adjuvant treatment.Methods: Studies were searched from China BioMedical Literature, Chinese National Knowledge Infrastructure, Cqvip Database, Wanfang Database, MEDLINE (PubMed), EMBASE (Ovid), Google Scholar, and Cochrane Library from inception to March, 2021. Randomized controlled clinical trials (RCT) comparing EGFR-TKIs + CHM (TKIs + CHM) versus EGFR-TKIs with/without placebo (TKIs ± placebo) in participants with advanced NSCLC harboring EGFR sensitizing mutation were included in this study. Two authors screened all references, assessed the risk of bias and extracted data independently. Data were summarized using hazard ratio (HR) and risk ratios (RR), with 95% confidence intervals (CI) for binary outcomes. Meta-analysis was performed using random effects model. Overall quality of evidence was assessed using GRADE.Results: A total of 9 RCTs (1137 participants, 581 in the TKIs + CHM group and 556 in the TKIs ± placebo group) were included in this review. Only first-generation EGFR-TKIs were included. Most trials included used oral CHM preparations to tonify Qi and/or Yin. Treatment lasted from enrollment until disease progression (PD) or intolerable adverse events (AE). Combination of CHM with EGFR-TKIs improved median progression-free survival (mPFS) (HR,0.59; 95% CI, 0.52–0.68; P < 0.00001) and objective response rate (ORR) (RR, 1.23; 95% CI, 1.13–1.34; P < 0.00001) compared with used of EGFR-TKIs ± placebo. CHM reduced AE associated with EGFR-TKIs such as cutaneous toxicity (RR, 0.58; 95% CI, 0.46–0.73; P < 0.00001) and diarrhea (RR, 0.43; 95% CI, 0.30–0.60; P < 0.00001).Conclusion: Combination therapy of CHM and EGFR-TKIs significantly delays acquired resistance while improving ORR to EGFR-TKIs. Furthermore, CHM reduces AE induced by EGFR-TKIs. More international multi-centered, double-blinded, placebo-controlled, well-designed clinical trials are needed in future research.

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Mechanism of Xu Li’s Experiential Prescription for the Treatment of EGFR‐Positive NSCLC

Cited by 3 publications

References 33 publications

Targeting M2-like tumor-associated macrophages is a potential therapeutic approach to overcome antitumor drug resistance

Targeting M2-like tumor-associated macrophages is a potential therapeutic approach to overcome antitumor drug resistance

Traditional Herbal Medicine: A Potential Therapeutic Approach for Adjuvant Treatment of Non-small Cell Lung Cancer in the Future

Chinese Herbal Medicine Combined With First-Generation EGFR-TKIs in Treatment of Advanced Non-Small Cell Lung Cancer With EGFR Sensitizing Mutation: A Systematic Review and Meta-Analysis

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