Traditional Chinese Medicine Prolongs Progression-Free Survival and Enhances Therapeutic Effects in Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitor (EGFR-TKI)Treated Non-Small-Cell Lung Cancer (NSCLC) Patients Harboring EGFR Mutations

Abstract

BackgroundLung cancer is the most common cause of cancer-associated deaths worldwide. This study aimed to investigate the efficacy and safety of Traditional Chinese Medicine combining EGFR-TKIs in treatment of NSCLC patients harboring EGFR mutations.Material/MethodsThis study involved 153 advanced-stage NSCLC patients harboring EGFR mutations. Patients were divided into a Control group (administered EGFR-TKI, n=61) and an Experimental group (administered Traditional Chinese Medicine combining EGFR and TKI, n=92). Progression-free survival (PFS) was evaluated for exon 19 deletion and/or 21 deletion patients. Disease control rate (DCR) was assessed to observe therapeutic effects. Adverse effects, including rashes, diarrhea, ALT/AST increase, dental ulcers, and onychia lateralis, were also evaluated.ResultsTCM combining EGFR-TKI (90.11%) demonstrated no DCR improvement compared to single EGFR-TKI (83.33%) (p>0.05). Median PFS (mPFS) of TCM combining EGFR-TKI (13 months) was significantly longer compared to that in the single EGFR-TKI group (8.8 months) (p=0.001). For 19DEL mutant NSCLC, the mPFS (11 months) in TCM combining EGFR-TKI was significantly longer compared to single EGFR-TKI (8.5 months) (p=0.007). The mPFS of L858 mutant NSCLC patients in EGFR-TKI combining CTM (14 months) was significantly longer compared to single EGFR-TKI (9.5 months) (p=0.015). TCM combining EGFR-TKI was more inclined to prolong mPFS of NSCLC with exon 21 deletion. TCM combining EGFR-TKI illustrated no additional adverse effects in NSCLC patients (p=0.956).ConclusionsApplication of Traditional Chinese Medicine prolonged progression-free survival and enhanced therapeutic effect in NSCLC patients harboring EGFR mutations receiving EGFR-TKI treatment. Meanwhile, adjunctive Chinese medicine combining EGFR-TKI in NSCLC with EGFR mutations caused no adverse effects.

Research Status and Molecular Mechanism of the Traditional Chinese Medicine and Antitumor Therapy Combined Strategy Based on Tumor Microenvironment

“…There are many pieces of research on Chinese medicine monomers and their active ingredients (31). Many researches have shown that TCM combined with antitumor therapy can achieve significant tumor suppression effects, reduce drug resistance, and improve adverse reactions and patient quality of life (32)(33)(34)(35)(36). In recent years, targeting the immune checkpoints CTLA-4, PD-1, and PD-L1 has led to breakthroughs in a variety of cancer types (37)(38)(39).…”

Ze-Qi-Tang Formula Induces Granulocytic Myeloid-Derived Suppressor Cell Apoptosis via STAT3/S100A9/Bcl-2/Caspase-3 Signaling to Prolong the Survival of Mice with Orthotopic Lung Cancer

“…In our previous study, we have revealed that the TCM formula ZQT played a direct role in tumor inhibition by inducing intrinsic apoptosis and blocking the cell cycle in a subcutaneous lung cancer model established in immune-deficient mice. However, more and more evidence show that TCM is capable of regulating TME [ 7 , 8 ]. Therefore, we explored whether ZQT had a significant regulatory effect on TME of the orthotopic lung cancer mouse model established with immune competent mice.…”

“…At present, accumulating researches indicate that TCM therapy can obviously improve the quality of life of NSCLC patients, significantly prolong their survival, and apparently alleviate the clinical symptoms of the patients. In addition, TCM is less toxic and has fewer side effects [ 7 , 8 ]. Therefore, TCM, as a popular and promising anticancer agent, has been gaining more and more attention.…”

Clinical application and mechanism of traditional Chinese medicine in treatment of lung cancer

“…This combination maximizes the duration of the EGFR-TKI treatment for lung cancer patients. [ 38 – 40 ]…”