Meta-Analysis of 5-Fluorouracil-Based Chemotherapy Combined With Traditional Chinese Medicines for Colorectal Cancer Treatment

Chen, Peng; Ni, Wei; Xie, Tian; Sui, Xinbing

doi:10.1177/1534735419828824

Cited by 14 publications

(12 citation statements)

References 20 publications

(19 reference statements)

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“…For CRC, 5-Fu and oxaliplatin are the main chemotherapy drugs used by oncologists for the treatment of CRC. [ 25 ] Due to the general toxicity of the drugs, chemotherapy results in some side effects. Some cancer patients cannot adhere to the effective chemotherapy cycle, the side effects of chemotherapy affect the treatment effect and the QOL.…”

Section: Discussionmentioning

confidence: 99%

The efficacy of Chinese herbal medicine as an adjunctive therapy for colorectal cancer

Guo

Wang

et al. 2020

Medicine

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Background: Colorectal cancer (CRC) is a public health problem and the world's leading cancer killer. It is a disease with high incidence and mortality. Although chemotherapy has achieved some success in the treatment of CRC, drug resistance and tumor metastasis caused by chemotherapy are still the main causes of death in patients with CRC. Notably, many side effects associated with chemotherapy, such as nausea, vomiting, and peripheral neurotoxicity, are major challenges in the treatment of patients with CRC. Chinese herbal medicine (CHM) has been widely used as an adjunctive therapy for CRC, but its efficacy and safety are still uncertain. The aim of this systematic review is to assess the efficacy and safety of CHM for the treatment of CRC. Methods: A comprehensive retrieval will be performed in the following electronic databases: PubMed, Cochrane Library, EMBASE, Web of Science, CNKI, SinoMed, VIP, and Wan Fang Data. The methodologic quality of randomized controlled trials will be assessed using the Cochrane risk assessment tool. Review Manager 5.3 software will be used for data synthesis and analysis. Funnel plot analysis and Egger test will be used to assess publication bias. The Grading of Recommendations Assessment, Development and Evaluation standard will be used to generate summary of finding table. Results: The results of this systematic review will be used to summarize and evaluate the evidence from randomized controlled clinical trials of CHM as adjuvant therapy for CRC. Conclusion: This review will provide a detailed summary of the evidence to assess the efficacy and safety of CHM for CRC. OSF Registration: DOI 10.17605/OSF.IO/X2SKJ

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Section: Discussionmentioning

confidence: 99%

The efficacy of Chinese herbal medicine as an adjunctive therapy for colorectal cancer

Guo

Wang

et al. 2020

Medicine

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“…Active compounds of HQ were screened under the criteria of oral bioavailability (OB) ≥30% and drug-likeness (DL) ≥0. 18.…”

Section: Retrieval Of Chemical Ingredientsmentioning

confidence: 99%

“…A series of recent retrospective experimental studies have shown that conventional chemotherapeutics based on FOLFOX 4, 5-FU, and oxaliplatin can be used in combination with HQ and other Chinese herbal medicines to treat mid- to advanced-stage CRC. It can improve the quality of life of patients showing that increases the tumor response rate (TRR) and reduce the incidence of severe neutropenia, nausea, vomiting, and neurotoxicity associated with chemotherapy, showing that HQ has a good antitumor activity in the treatment of CRC ( 9 , 18 , 19 ). Nevertheless, the ingredients and targets of HQ in CRC need to be further explored.…”

Section: Introductionmentioning

confidence: 99%

A network pharmacology approach for investigating the multi-target mechanisms of Huangqi in the treatment of colorectal cancer

Chu¹,

Zhang²,

Zhou³

et al. 2021

Transl Cancer Res TCR

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Background: Colorectal cancer (CRC) is the third most prevalent cancer globally. In the treatment of CRC, surgical resection is commonly adopted, and neoadjuvant chemotherapy or immunotherapy is mainly administered for patients with advanced disease. However, despite the developments in the field of cancer treatment, the mortality rate of CRC has remained high. Therefore, novel treatments for CRC need to be explored. Astragalus membranaceus, commonly known in China as Huangqi (HQ), a traditional Chinese medicine, has been reported to be a potential antitumorigenic agent. This study aimed to investigate the mechanisms of action of HQ.Methods: Active ingredients and putative targets of HQ were obtained through a comprehensive search of the Traditional Chinese Medicine Systems Pharmacology database. CRC-related targets were retrieved from the GeneCards database and then overlapping targets were acquired. After visualization of the compound-disease network and protein-protein interaction (PPI) network, Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses of the overlapping genes were performed. Additionally, HCT116 cells were treated with the active components of HQ at a 20-μM concentration. Cell Counting Kit-8 was used to detect cell activity, and real-time quantitative polymerase chain reaction was carried out to detect the expression of genes downstream of the interleukin (IL)-17 signaling pathway.Results: A PPI network comprising 177 nodes and 318 edges was obtained. The GO analysis of the overlapping genes showed enrichment in response to lipopolysaccharide and oxidative process. For the KEGG analysis, the AGE-RAGE signaling pathway and inflammation-related pathways, such as the IL-17 and tumor necrosis factor (TNF) signaling pathways, were enriched. The in vitro experiments showed that HQ promoted the apoptosis of CRC cells by inhibiting the expression of the CCL2, CXCL8, CXCL10, and PTGS2 genes.Conclusions: This study systematically revealed the multitarget mechanism of HQ in CRC through a network pharmacology approach. We verified that HQ promotes CRC cell death via the IL-17 signaling pathway. This finding provides indications for further mechanistic studies and the development of HQ as a

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“…Although the response rate to 5-FU as a single antitumor medicine is typically below 20%, there are interindividual differences regarding the clinical effectiveness of 5-FU-based chemotherapy[ 12 , 13 ]. 5-FU is a synthetic pyrimidine antagonist (uracil analog) and belongs to the group of anticancer medicine known as antimetabolites[ 14 , 15 ].…”

Section: Fluorouracil-based Chemotherapy and Crcmentioning

confidence: 99%

Molecular determinants of response to 5-fluorouracil-based chemotherapy in colorectal cancer: The undisputable role of micro-ribonucleic acids

Aghabozorgi

Sarabi

Koochakkhani

et al. 2020

WJGO

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5-flurouracil (5-FU)-based chemotherapy is the main pharmacological therapy for advanced colorectal cancer (CRC). Despite significant progress in the treatment of CRC during the last decades, 5-FU drug resistance remains the most important cause of failure in CRC therapy. Resistance to 5-FU is a complex and multistep process. Different mechanisms including microsatellite instability, increased expression level of key enzyme thymidylate synthase and its polymorphism, increased level of 5-FU-activating enzymes and mutation of TP53 are proposed as the main determinants of resistance to 5-FU in CRC cells. Recently, micro-ribonucleic acids (miRNA) and their alterations were found to have a crucial role in 5-FU resistance. In this regard, the miRNA-mediated mechanisms of 5-FU drug resistance reside among the new fields of pharmacogenetics of CRC drug response that has not been completely discovered. Identification of the biological markers that are related to response to 5-FU-based chemotherapy is an emerging field of precision medicine. This approach will have an important role in defining those patients who are most likely to benefit from 5-FU-based chemotherapy in the future. Thereby, the identification of 5-FU drug resistance mechanisms is an essential step to predict and eventually overcome resistance. In the present comprehensive review, we will summarize the latest knowledge regarding the molecular determinants of response to 5-FU-based chemotherapy in CRC by emphasizing the role of miRNAs.

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Meta-Analysis of 5-Fluorouracil-Based Chemotherapy Combined With Traditional Chinese Medicines for Colorectal Cancer Treatment

Cited by 14 publications

References 20 publications

The efficacy of Chinese herbal medicine as an adjunctive therapy for colorectal cancer

The efficacy of Chinese herbal medicine as an adjunctive therapy for colorectal cancer

A network pharmacology approach for investigating the multi-target mechanisms of Huangqi in the treatment of colorectal cancer

Molecular determinants of response to 5-fluorouracil-based chemotherapy in colorectal cancer: The undisputable role of micro-ribonucleic acids

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