Integrative Cancer Therapies最新文献

In this study, we investigated the synergistic effect of co-administration of osimertinib and HAD-B1 using gefitinib-resistant non-small cell lung cancer cells, HCC827-GR. HAD-B1 is composed of 4 natural drugs, Panax Notoginseng Radix, Panax ginseng C. A. Meyer, Cordyceps militaris, and Boswellia carterii Birdwood, and has been reported to have therapeutic effects on patients with advanced non-small cell lung cancer in several studies. Resistance to gefitinib in HCC827 cells was acquired through MET activity. Co-treatment with osimertinib and HAD-B1 reduced the cell viability of HCC827-GR cells. In addition, phosphorylation of MET and ERK were effectively suppressed for HCC827-GR cells. And, compared to when osimertinib and HAD-B1 were administered alone, cell proliferation was significantly inhibited and apoptosis was effectively induced when osimertinib and HAD-B1 were co-administered to HCC827-GR cells. We found that the synergistic effect of osimertinib and HAD-B1 combination therapy resulted in cancer cell death and cell cycle arrest by targeting the ERK and mTOR signaling pathways. In conclusion, this study confirmed that the combination of osimertinib, a third-generation anticancer drug, and HAD-B1, a natural anticancer drug, had a potentially synergistic effect on non-small cell lung cancer resistant to EGFR-targeted anticancer drugs.

Purpose: Chemotherapy-induced peripheral neuropathy (CIPN) worsens the quality of life for people with cancer. Massage therapy involves neuromuscular modulations and can potentially reduce CIPN symptoms. We examined the immediate improvements in CIPN-related pain and neuropathy following massage therapy among patients with CIPN.

Methods: In a retrospective cohort, we assessed patients who received 1 massage therapy session for CIPN symptom relief during or after chemotherapy at a National Cancer Institute-Designated Comprehensive Cancer Center from October 2017 to September 2022. We measured the severity of pain and neuropathy before and after massage therapy with a 4-item verbal rating scale (VRS) or a 0 to 10 numerical rating scale (NRS). We converted NRS to VRS scores and examined the pre-post differences in symptom severity using the Wilcoxon rank test.

Results: Among 23 patients (median [range] age 64 [4-85] years, female 74%, White 70%), one session of massage therapy decreased the percentage of patients reporting moderate-to-severe pain from 81% at baseline to 0% (none) post-massage; percentage of patients reporting neuropathy also reduced from 77% at baseline to 12% following treatment. The pre-post differences were statistically significant for both pain (mean: -1.6, 95% confidence interval [CI] -1.9 to -1.2; P = .001) and neuropathy scores (mean: -1.2, 95%CI -1.4 to -0.9; P < .0001).

Conclusion: Among cancer patients with CIPN, one session of massage therapy was associated with immediate neuropathy and CIPN pain relief reported by patients following treatment. However, this preliminary finding requires further rigorous verifications in future randomized controlled clinical trials.

Background: Adherence in rehabilitation services includes attending appointments, regularly performing prescribed exercises, and correct exercise execution. The Exercise Adherence Rating Scale (EARS) has been adapted into several languages, but there is lack of a standardized tool for various Indian languages and cultural contexts, particularly for use with cancer survivors. With the anticipated 57.7% rise in cancer cases by 2040, this study aims to address this gap.

Aims and objectives: To cross-culturally adapt EARS to Kannada (EARS-Kn) and evaluate its validity and reliability amongst HNC survivors enrolled in the Multimodal Oncology Rehabilitation Exercise-MORE^© Program.

Methodology: Following Beaton guidelines, the EARS tool was adapted to Kannada. 34 HNC survivors engaged in the MORE^© program. Internal consistency (Cronbach's ⍺) and construct validity (Exploratory Factor Analysis, EFA) were assessed. The Receiver Operating Curve (ROC) determined cut-off scores, sensitivity and specificity of the EARS-Kn.

Results: The EARS-Kn demonstrated a Cronbach's-⍺ value of .93. The EFA revealed a one-factor solution with eigenvalues exceeding one and 70.1% loading. The area under the curve (AUC) was 0.908. A cut-off score of 17 was established, with 95.83% sensitivity and 80% specificity.

Conclusion: The EARS-Kn version showed strong validity and reliability among Kannada-speaking HNC survivors, indicating its potential to enhance the understanding of exercise adherence among them. Future studies could explore the EARS-Kn version among diverse populations prescribed various rehabilitation regimes. Studies could also further investigate psychometric properties of the EARS in different Indian languages among cancer survivors, which would help improve survivorship outcomes.

Screening for pulmonary nodules (PN) using low-dose CT has proven effective in reducing lung cancer (LC) mortality. However, current treatments relying on follow-up and surgical excision fail to fully address clinical needs. Pathological angiogenesis plays a pivotal role in supplying oxygen necessary for the progression of PN to LC. The interplay between hypoxia and angiogenesis establishes a vicious cycle, rendering anti-angiogenesis therapy alone insufficient to prevent PN to LC transformation. In traditional Chinese medicine (TCM), PN is referred to as "Feiji," which is mainly attributed to Qi and blood deficiency, correspondingly, the most commonly prescribed medicines are Astragalus membranaceus (Fisch.) Bge. var. mongholicus (Bge.) Hsiao (huang qi) (AR) and Angelica sinensis (Oliv.) Diels (dang gui) (ARS). Modern pharmacological studies have demonstrated that AR and ARS possess immune-enhancing, anti-tumor, anti-inflammatory, and anti-angiogenic properties. However, the precise mechanisms through which AR and ARS exert anti-angiogenic effects to delay PN progression to LC remain inadequately understood. This review explores the critical roles of hypoxia and angiogenesis in the transition from PN to LC. It emphasizes that, compared to therapies targeting angiogenic growth factors alone, AR, ARS, and their compound-based prescriptions offer additional benefits. These include ameliorating hypoxia by restoring blood composition, enhancing vascular structure, accelerating circulation, promoting vascular normalization, and blocking or inhibiting various pro-angiogenic expressions and receptor interactions. Collectively, these actions inhibit angiogenesis and delay the PN-to-LC transformation. Finally, this review summarizes recent advancements in related research, identifies existing limitations and gaps in knowledge, and proposes potential strategies and recommendations to address these challenges.

Introduction: As pharmacological strategies remain limited for relieving fatigue and associated cognitive symptoms, integrative modalities such as traditional Chinese medicine (TCM) could be explored as therapeutic strategies in cancer survivors. Here, we evaluate and report the efficacy and safety of a TCM concoction, modified Xiang Bei Yang Rong Tang (XBYRT), on quality of life (QOL), cancer-related fatigue (CRF), and cognitive symptoms, compared to placebo.

Methods: In a single-centered, randomized, double-blinded, placebo-controlled pilot trial conducted from 2019 to 2022, fatigued cancer survivors ≥21 years old were recruited to receive the XBYRT intervention or placebo (5% diluted) once daily for the duration of 8 weeks. Patient-reported outcomes for QOL, CRF, cognition, blood samples for biomarker testing, and adverse events were collected at baseline (T0), 4 weeks (T1), 8 weeks (T2), and 10 weeks (T3) after baseline. Linear regression was performed to evaluate differences between groups at T2 and T3.

Results: A total of 1502 patients were screened, with 672 patients considered eligible. Of the eligible, 15 XBYRT and 13 placebo subjects with similar mean ages (58.5 vs 58.4) were recruited. Both groups were predominantly Chinese (93% vs 62%), breast cancer patients (87% vs 62%), and diagnosed with stage 2 cancer (60% vs 46%). Although no significant difference was found in QOL between groups, the XBYRT group exhibited improved emotional fatigue at T3 (P = .045) and higher BDNF levels at T2 (P = .047) and T3 (P = .029). After baseline adjustment, XBYRT was associated with better perceived cognitive impairment at T2 (P = .011) and T3 (P = .017), as well as overall perceived cognitive function at T3 (P = .028). XBYRT is well tolerated, with grade 3 adverse events reported in three XBYRT (20%) and two placebo (15%) subjects.

Conclusion: In this pilot study, XBYRT as an integrative therapy is safe and generates encouraging improvements in cognitive and fatigue symptoms. Difficulties with recruitment limited the generalizability of trial findings, thus findings should be verified through a larger, multi-centered trial.

Background: Cancer pain is a prevalent and persistent issue, and while there have been some observations of the possible benefits of acupuncture in managing cancer pain, there is still debate regarding its safety and effectiveness. This study aims to compare the efficacy and safety of different acupuncture modalities in the treatment of cancer pain through a network meta-analysis.

Methods: Between the time each database was created and June 3, 2024, eight databases were queried: PubMed, Cochrane, Embase, Web of Science, CNKI, Wanfang, VIP, and China Biomedicine. Randomized controlled trials investigating the use of various acupuncture and moxibustion techniques in the treatment of cancer pain were identified. Publication bias and quality of randomized controlled trials were assessed using the Cochrane Risk of Bias tool and the Jadad scale, and network meta-analyses were performed using Stata 15 and R 4.3.2.

Results: We incorporated 111 studies encompassing 9549 individuals diagnosed with cancer, examining 29 distinct therapies. Network meta-analysis showed that, compared to Usual Medicine, Acupuncture + Usual Medicine + Traditional Chinese medicine (MD = -1.83, 95% CI: -2.86 to -0.80) could reduce NRS scores, Acupuncture + Traditional Chinese medicine (OR = 30.86, 95% CI: 3.75-254.20) could improve cancer pain relief, Moxibustion + Usual Medicine (MD = 2.12, 95% CI: 0.43-3.80) could effectively improve KPS score, Acupuncture + Application of Chinese medicine (OR = 0.16, 95% CI: 0.04-0.66) is associated with a lower incidence of constipation, Electro-Acupuncture + Usual Medicine (OR = 0.11, 95% CI: 0.03-0.45) shows a lower incidence of nausea and vomiting, Acupuncture + Moxibustion + Usual Medicine (OR = 0.29, 95% CI: 0.09-0.90) is associated with a lower incidence of dizziness.

Conclusion: Acupuncture + Traditional Chinese medicine is the best intervention for different acupuncture methods in the treatment of cancer pain, and Moxibustion + Usual Medicine is the best intervention to improve the quality of life of patients.

Background: Over the last decade, the anticancer effects of Rhus verniciflua Stokes (RVS) have been reported in various preclinical or clinical studies. However, the effects of RVS on immuno-oncology, especially on the functional properties of T cells and their phenotypes, remain unclear. Here, we planned to investigate the impact of RVS on immuno-oncology, specifically focusing on its effects on T cells.

Methods: Peripheral blood mononuclear cells (PBMCs) from breast cancer patients were isolated to obtain cytokine-induced killer cell populations with >85% CD3+ T cells. The anticancer activity of these T cells was evaluated by introducing red fluorescent protein (RFP) into HLA-A02:01 type-matched breast cancer cell lines (MCF7 and MDA-MB-231) and analyzing the results using flow cytometry. The effect of RVS extracts on T cell phenotype was assessed using markers such as CTLA-4 and PD-1, as well as mRNA expression levels of key genes (IFN-γ, TNF-α, and IL-2).

Results: RVS treatment significantly enhanced the anticancer activity of T cells against breast cancer cells. Specifically, T cells treated with 100 µg/mL of RVS showed a 20.6% increase in cytotoxicity against MCF-7 cells and a 36.2% increase against MDA-MB231 cells compared to the control. Additionally, RVS treatment led to a significant reduction in PD-1 expression on T cells.

Conclusion: Our findings demonstrate that RVS treatment enhances T cell function against breast cancer cells by reducing PD-1 expression. These results suggest that components of RVS may serve as potential candidates for restoring exhausted T cells in cancer therapy.