Integrative Cancer Therapies最新文献

Background: Chemotherapy-induced peripheral neuropathy (CIPN) is a serious clinical problem with no widely applicable solutions. Modified Wen Luo Tong (mWLT) was designed specifically for paclitaxel-related CIPN, yet its efficacy and mechanisms remain unclear. This study aimed to investigate its therapeutic effects and potential mechanisms via network pharmacology and animal experimental validation.

Methods: Paclitaxel-induced CIPN rat models were treated with mWLT pediluvium. The effect of mWLT was estimated by behavior test. The components and targets of 5 herbs in mWLT were screened from TCMSP and TCMIP databases. CIPN-related targets were retrieved from Genecards and DisGeNET. Networks of gene ontology and pathway associations related to intersection targets were constructed and visualized. A pharmacological network encompassing the intersecting genes and active components was mapped out. A protein-protein interaction network was established for these intersecting targets and visualized using Cytoscape software. Finally, the findings derived from network pharmacology were validated through a series of in vivo experiments, including ELISA, Western Blot, immunohistochemistry and RT-qPCR. Molecular docking was used to predict binding sites between small molecules of mWLT and CX3CR1.

Results: mWLT ameliorates mechanical withdrawal threshold of CIPN model rats. Three hundred and three targets of mWLT against CIPN were identified through intersection analysis, and 8 hub targets such as IL6, TNF and STAT3 were pinpointed. Enrichment analysis of intersection targets highlighted cellular response to cytokine stimulus, JAK-STAT3 pathway and NF-κB pathway. Thus, we speculated that mWLT may exert its effects by acting on IL6 and TNF, subsequently regulating IL6-JAK-STAT3 and TNFα-NF-κB signaling pathway, ultimately mitigating CIPN. Experimental validation demonstrated that mWLT significantly decreased the levels of IL-6, IL-1β and TNF-α in both spinal cord and plasma. Additionally, mWLT downregulated the phosphorylation of JAK, STAT3 and NF-κB in spinal cord. Further analyses using Immunohistochemistry, Western Blot and ELISA confirmed that mWLT reduced the protein expression of CX3CL1. RT-qPCR results revealed downregulation of Cx3cl1 and Cx3cr1 mRNA level in spinal cord and dorsal root ganglia. Molecular docking predicts 4 potential of compounds derived from mWLT to treat CIPN targeting CX3CR1.

Conclusion: mWLT exerts therapeutic effects in the treatment of CIPN by inhibiting CX3CL1/CX3CR1 axis and modulating JAK-STAT3 and NF-κB pathway.

Despite advances in HER2-targeted therapies and CSC-directed agents, resistance remains a major barrier in breast cancer. Synthesize evidence for exercise as a precision strategy to disrupt HER2/CD44-driven resistance circuits. Preclinical and clinical data demonstrate that physical activity: (1) downregulates HER2/PI3K signaling via myokine-mediated pathways (IL-6/SPARC), (2) reduces CD44 through NK-dependent immune surveillance, and (3) synergizes with biologics to overcome cardiotoxicity and chemoresistance. Molecular subtype-specific exercise prescriptions are defined. Exercise reprograms the tumor-immune microenvironment to target therapy-resistant pathways, establishing a paradigm for exercise as adjuvant precision medicine.

Cancer survivors experience a range of side effects during and after treatment. There is a need for a rigorous synthesis of the most recent and best available evidence on the role of nutritional supplements for supportive care in cancer, to inform shared decision-making. We searched 5 databases for umbrella reviews, meta-analyses and systematic reviews on nutritional supplements for supportive cancer care, excluding studies on pain, anxiety and depression, which are covered in recent guidelines. We found 52 reviews that reported on 250 RCTs on 18 supplements for 16 indications. Almost all reviews were of low/critically low quality (assessed using A MeaSurement Tool to Assess systematic Reviews version 2). There was moderate-certainty evidence for benefit from the following supplements: amino acids and oral proteolytic enzymes for severity of radiation-induced dermatitis, N-acetyl cysteine for prevention of chemotherapy-induced peripheral neuropathy (CIPN) in individuals with gastrointestinal cancers. There was low to very low certainty evidence that glutamine, zinc, probiotics and melatonin may be effective for oral mucositis; Vitamin E, omega-3 fatty acids, glutamine and other amino acids may be effective for preventing CIPN. Serious adverse events were reported for high-dose Vitamin A, and dose-related adverse events were reported with zinc and Vitamin E. However, the majority of nutritional supplements were associated with only minor adverse events. Due to the low to very low certainty of the majority of evidence, firm clinical recommendations cannot be made. Further research to conclusively evaluate benefit and harm, including potential impact on efficacy of standard treatments, should be conducted.

Background: The prevalence of brain metastases (BM) in lung cancer patients is notably high and is associated with poor prognoses. The efficacy of standard treatment regimens in improving intracranial progression-free survival (IPFS) for lung cancer BM is markedly limited. While traditional Chinese medicine (TCM) has been effective in enhancing the quality of life and prognosis of lung cancer patients, its efficacy in treating BM remains unreported.

Case presentation: Here, we present a case of a middle-aged female with lung cancer BM, whose condition was assessed as progressive post-standard treatment including two local surgeries (both involving resection of cerebellar space-occupying lesions), stereotactic radiotherapy, chemotherapy and EGFR-TKIs. Subsequently, she underwent treatment with the traditional Chinese herbal formula gubenxiaoyi (GBXY). The patient was treated with GBXY for a total duration of 55 months. After treatment, a significant reduction of about 50% in intracranial lesions was observed, accompanied by an extension of both Intracranial Progression-Free Survival (IPFS) and Cognitive Deterioration-Free Survival (CDFS) exceeding 50 months.

Conclusion: These results demonstrate that in patients with lung cancer brain metastases (BM) unresponsive to standard treatments, GBXY not only has the potential to effectively prolong IPFS and decelerate cognitive decline, but may also contribute to a reduction in intracranial tumor burden. This suggests that GBXY could be a promising therapeutic option that warrants further investigation.

Chemotherapy-induced peripheral neuropathy (CIPN) has a markedly deleterious impact on a patient's quality of life. It manifests as pain, paresthesia, numbness, and weakness, particularly in the context of cisplatin (CDDP), a widely utilised chemotherapeutic agent renowned for its pronounced peripheral nerve toxicity. Trichosanthes kirilowii Maxim. (Cucurbitaceae, TK) and cucurbitacin D(CucD), its bioactive compound, have been demonstrated to possess anti-tumour, anti-inflammatory, and antioxidant properties. However, their potential to alleviate CIPN has not been fully exploredyet. The present study evaluated effectiveness of TK and CucD in mitigating CDDP-induced neuropathic pain using both cellular and animal models. CDDP, TK extracts (TKD and TKE), and CucD dose-dependently reduced viability and apoptosis of PC12 cells. Conversely, pre-treatment with TKD, TKE, and CucD exhibited significant protective effects against CDDP-induced cytotoxicity, preserving cell viability and morphology while enhancing neurite outgrowth. In vivo, administration of CDDP resulted in the development of mechanical allodynia and thermalhyperalgesia in rats. However, treatment with TKD and TKE led to a notable improvement in pain threshold and a reduction in hyperalgesia, while CucD demonstrated less pronounced effects. Although body weight was reduced in the CDDP-treated group, it was not significantly mitigated bytreatments. In conclusion, results of this study indicate that TKD, TKE, and CucD have the potential to alleviate CDDP-induced neuropathic pain by protecting against cell damage, promoting neuriteregeneration, and improving pain responses in animal models. Further investigation into TK and CucD as therapeutic options for managing CIPN is warranted.

Background: 25% to 30% of primary stage IV pulmonary adenocarcinomas (PUAD-IV) die within 3 months. Many ≥3 months survivors at long follow-up are alive with disease (AWD). Platinum-based chemotherapy (PBC), tyrosine kinase inhibitors- targeted therapy (TKI-TT), and Chinese herbal medicines (oral CHM) improve prognosis. In China, moxibustion treatment (Moxa) is also used, without prognostic proof.

Methods: Prospective observational Moxa evaluation in 412 first-onset consecutive PUAD-IV performance score 0 to 1 patients with 3 to 120 months follow-up. All received oral CHM with PBC, TKI-TT, or PBC + TKI-TT. Moxa was given as indicated at the start of the treatment (and eventually adapted in the follow-up period by de novo development) of well-established TCM syndromes and symptoms. Survival was analyzed using Kaplan-Meier and Cox regression. Propensity score analysis (PSA) with matching and inverse probability of treatment weighting (IPTW) were used to adjust for baseline covariate imbalances.

Results: Of 412 patients, 117 received no Moxa, 239 had 1 to 4 treatments, and 56 received >4 treatments alongside conventional treatments. Tumor-Node-Metastasis (TNM) stage IVB and male sex increased dead of disease (DOD)-risk, while TKI-TT, ≥4 Chemotherapy cycles, and Moxa improved survival (P < .05). Median survival (MST): Reference group (PBC + CHM) 20.0 months; Moxa 32.0; TKI-TT 33.0; TKI-TT+1-4 Moxa 33.0; TKI-TT+>4 Moxa 40.0 months (all P < .05). Cox regression indicated a dosage-dependent Moxa effect (P = .0004). Restricted Mean Survival Time (RMST) at 36 months favored >4 Moxa+TKI-TT over TKI-TT (+6.2 months, P = .01). PSA confirmed results were not due to baseline covariate imbalance.

Conclusions: Moxibustion may dosage-dependently improve survival in PUAD-IV, both in TKI- and non-TKI-treated patients. Randomized clinical trials (RCT) are needed to confirm this.

Background: Glioblastoma multiforme (GBM) is an aggressive brain tumor with limited treatment options and poor prognosis. Emerging evidence suggests that integrative oncology approaches may provide survival benefits when combined with conventional treatments. This study examines whether an integrative oncology treatment plan incorporating modulated electro-hyperthermia (mEHT) improves survival in GBM patients.

Methods: This retrospective cohort study analyzed data from GBM patients treated at the Integrated Health Clinic (IHC) between 2010 and 2024. Survival outcomes were compared between IHC patients receiving adjuvant integrative naturopathic therapies and a matched control group from the National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) database. Kaplan-Meier survival estimates, and Cox proportional hazard models were conducted to assess survival differences. Secondary analyses evaluated the impact of treatment timing (≤120 days vs >120 days post-diagnosis) and age on survival.

Results: The integrative treatment cohort demonstrated a lower hazard of mortality than the SEER group (HR = .72, 95% CI: .53-1.00, P-value = .05). The treatment benefit was greater among IHC patients who started treatment within 120 days of diagnosis (HR = .52, 95% CI: .33-.83, P-value = .006) and those under age 50 (HR = .51, 95% CI: .31-.85, P-value = .009).

Conclusions: The findings suggest that an integrative naturopathic approach incorporating mEHT may improve survival outcomes in GBM patients. Patients initiating integrative treatment earlier experienced a greater survival benefit, as did patients under 50 years of age. Further studies, ideally prospective randomized controlled trials, are warranted to validate these findings.

Background: Colorectal cancer (CRC) imposes a heavy disease burden. Besides physical morbidity, some patients might still experience long-term psychological distress. Our previous study demonstrated that physical symptoms and psychological distress of CRC improved following traditional Chinese medicine (TCM) combined online group psychotherapy. However, the multidimensional nature of these experiences warrants deeper exploration of patients' lived perspectives.

Methods: We designed a single-arm phase I clinical trial, in which 40 CRC patients (aged between 18 and 75) who have received radical surgery (stage I-III) were recruited. This 6-week intervention of TCM combined online group psychotherapy included 90 minutes' communication on various topics for each week. The video of each online group psychotherapy session was saved, and the 38 patient's' speech was analyzed by thematic analysis in the qualitative study.

Results: We identified 4 themes and 13 subthemes. The patients mainly displayed foundational outlook transformation and tangible lifestyle reformation. The physical symptoms and psychological symptoms also had a certain degree of relief. In addition, patients also showed an increased demand for medical advice and health care information, which indicates that they were more concerned about their health condition, and the needs of patients were responded to in treatment, resulting in corresponding benefits.

Conclusion: During TCM combined online group psychotherapy interventions-including education, skill-building, TCM lifestyle coaching, and peer-exchange platforms-patients developed sustained self-health management practices, improving psychological resilience and physical symptoms. This holistic, tailored and culturally sensitive approach fostered long-term recovery and independence of CRC survivors.