Integrative Cancer Therapies最新文献

Solanum lycopersicum L. Moench (Tomato) is a rich source of bioactive compounds. This study investigated the anticancer potential of S. lycopersicum roots methanol extract (TMESLR) and their nanocrystals (TMESLR-NCs) against breast (MCF-7), hepatocellular (HepG2), and colon (Caco-2) cancer cell lines, for the first time. TMESLR exhibited significant cytotoxicity against all 3 cell lines, with the nanocrystals demonstrating enhanced activity, Caco-2, MCF-7, and HepG2 cells with IC₅₀ values of 9.69 ± 0.6, 12.52 ± 0.58, and 14.34 ± 0.62 µg/mL, respectively. Whereas, the prepared TMESLR-NCs displayed significantly the highest cytostatic potential against Caco-2 with IC₅₀ value of 5.733 ± 0.29 µg/mL. Metabolomic profiling revealed 17 secondary metabolites, including flavonoids, phenolic acids, and terpenoids. In silico analyses, including PPI network construction, GO enrichment, and KEGG pathway analysis, highlighted the involvement of apoptotic pathways, p53 signaling, and TNF signaling in the anticancer effects of TMESLR. Molecular docking studies identified chlorogenic acid and inosine as potential inhibitors of Histone Deacetylase 2 (HDAC2). Inosine (6) displayed a superior docking score of -7.86 kcal/mol, interacting with critical residues GLY154, ASP269, and HIS146. On the other hand, chlorogenic acid (12) achieved a docking score of -7.32 kcal/mol, forming stable interactions with TYR308, PHE210, and LEU276 residues. These findings suggest that TMESLR and TMESLR-NCs possess promising anticancer activity and warrant further investigation as potential therapeutic agents.

Objective: This study was conducted to elucidate the distribution characteristics of predominant unbalanced constitutions and TCM syndrome elements in patients with recurrent and metastatic gastric cancer. This study was also undertaken to analyze the potential relationship between the body constitutions of patients, syndrome elements, and biological indicators, as well as to investigate the effect of Yiqi Wenyang Jiedu prescription (YWJP) on symptoms and biological indicators before and after treatment.

Result: Yang-deficiency and Qi-deficiency were identified as prevalent imbalanced constitutions among patients with recurrent and metastatic gastric cancer. The primary syndrome factors associated with disease localization included the spleen-stomach and liver, with the main syndrome elements being Qi-deficiency, Yang-deficiency, and Qi-stagnation. Patients with Qi-deficiency and Yang-deficiency constitutions exhibited lower BMI and higher monocyte-to-lymphocyte ratio (MLR). A notable positive correlation was observed between cold (Yang-deficiency) and BMI, as well as between Qi-deficiency constitution and neutrophil-to-lymphocyte ratio (NLR). Furthermore, YWJP demonstrated efficacy in alleviating symptoms associated with Qi-deficiency and Yang-deficiency in patients with recurrent and metastatic gastric cancer, including dyspnea, fatigue, diaphoresis, cold intolerance, abdominal sounds, postural changes, and abdominal distension.

Discussion: Yang-deficiency and Qi-deficiency emerged as prevalent constitutional patterns in patients with recurrent and metastatic gastric cancer. Notably, BMI, MLR, and NLR may serve as physiological indicators of these conditions. Furthermore, YWJP treatment demonstrated potential efficacy in alleviating symptoms associated with Qi-deficiency and Yang-deficiency in this patient population.

Clinical trial registration: Chinese Clinical Trial Registry: ChiCTR2200055826.

Introduction: Most patients with pancreatic cancer experience systemic recurrence within 1 to 2 years after radical pancreatectomy. Phellinus linteus (PL) has demonstrated anti-inflammatory, antioxidant, and anti-cancer properties, suggesting potential as an adjunct to cancer therapy. This study aimed to evaluate the long-term oncological impact of perioperative PL in resected pancreatic cancer.

Method: This retrospective cohort study included 407 patients who underwent curative resection and adjuvant chemotherapy for pancreatic cancer at Severance Hospital (2012-2022). Among them, 103 patients who began PL postoperatively and continued throughout treatment were assigned to the PL group; 304 patients without PL intake comprised the control group.

Results: The mean overall survival (OS) was significantly longer in the PL group (47.0 months; 95% CI: 42.8-51.1) than in the control group (35.0 months; 95% CI: 30.3-39.7; P < .001). Recurrence-free survival (RFS) showed a borderline improvement (P = .053). PL use was marginally associated with improved OS in multivariate analysis (HR: 0.614; 95% CI: 0.376-1.002; P = .051). Subgroup analysis showed no significant OS or RFS benefit with PL in patients receiving FOLFIRINOX. However, among patients treated with non-FOLFIRINOX regimens, PL use led to significantly better OS (43.9 months vs 35.0 months; P = .021), though RFS remained similar. Notably, the OS of the non-FOLFIRINOX + PL group was comparable to that of the FOLFIRINOX group (P = .332) and superior to the non-FOLFIRINOX control group (P = .021).

Conclusion: PL may enhance survival in resected pancreatic cancer, particularly in patients receiving non-FOLFIRINOX chemotherapy, supporting its role as a potential adjunct when FOLFIRINOX is not feasible.

Background: Chinese herbal medicine (CHM), a commonly used alternative therapy, has been reported to reduce the side effects of cancer treatments and improve the quality of life (QOL) in breast cancer (BC) patients. However, there is limited research on the effects of CHM in BC patients experiencing hot flushes (HFs) during adjuvant chemotherapy. We conducted a non-randomized controlled trial to evaluate the effectiveness of CHM on side effects, QOL, and changes in meridian electrodermal activity.

Methods: Forty-eight patients with stage I-III BC undergoing adjuvant chemotherapy were non-randomly assigned to either a 24-week CHM treatment group or a 24-week non-CHM control group. The CHM intervention involved a combination of Jia Wei Xiao Yao San and Er Zhi Wan in a 3:1 ratio, with a total daily dose of 4 g taken 3 times a day. The primary outcome was the occurrence of 10 or more HFs per week and the severity of symptoms, rated using a visual analog scale (1-10). Secondary outcomes included the Functional Assessment of Cancer Therapy-Breast Cancer questionnaire to assess health-related QOL, and meridian energy analysis to measure skin electrical conductance and sympathetic activity. The difference between the CHM and non-CHM groups in individual changes from baseline to week 24 was evaluated using an independent t-test.

Results: A total of 43 participants completed the study, with 25 in the CHM group and 18 in the control group. The CHM group showed a statistically significant reduction in HF frequency at 12 and 24 weeks and a decrease in HF severity at 12 weeks compared to the control group (P < .05). Physical well-being and specific concerns scores also improved significantly over time in the CHM group compared to the control group (P < .05). While CHM treatment did not lead to significant changes in overall electrical conductance at acupoints (P = .251), it did significantly affect specific meridians, including the heart, liver, and kidney (P = .032, P = .035, and P = .035, respectively). Additionally, sympathetic activity was reduced in the CHM group after completing chemotherapy (P = .045).

Conclusions: CHM therapy appears to have a preventive effect on chemotherapy-related HFs in BC patients and is safe, with no severe adverse effects observed.

Background: Chemotherapy-induced nausea and vomiting is a common problem in patients undergoing chemotherapy, influencing quality of life (QoL) and daily activities. This study will investigate whether therapists' positive communication may strengthen positive treatment expectations and induce antiemetic effects during antiemetic treatment using standard care, sham acupuncture, or verum acupuncture, compared to neutral communication. It will also investigate whether a variety of patient, therapist and treatment components modify the treatment outcomes.

Methods: This is a trial protocol for a randomized, sham-controlled, patient- and evaluator-blinded clinical trial. Patients (n = 198 patients according to a sample size calculation) with breast, colorectal, or bladder cancer undergoing neo-/adjuvant moderately to highly emetogenic chemotherapy are being randomized in 2 × 3 factorial design to the following conditions: 1. neutral or 2. positive communication style regarding expected treatment effects, during the antiemetic treatment types: A) standard care only (including antiemetics, no acupuncture), or, in addition to standard care, B) sham acupuncture with telescopic non-penetrating needles, or C) verum, penetrating acupuncture. The 2 communication styles 1 and 2 are carried out during the antiemetic treatments given by an intervention therapist immediately pre and post (20 minutes × 2) an intravenous chemotherapy session. Data are being collected at baseline on the day before the chemotherapy session, daily for 10 days, at a 10-day follow-up, and at a follow-up after completing the entire chemotherapy period, lasting about 6 months. Primary outcome is mean score Visual Analog Scale nausea grading for the first 5 days of the chemotherapy session period. Secondary outcomes are for example, vomiting, treatment expectations, QoL, daily and physical activity, and physiological measures. Treatment effect modifiers will be analyzed, for example, blinding success, treatment expectations, and previous nausea experiences.

Conclusions: This trial will expand integrative cancer care's understanding of the effects of communication for strengthening treatment expectations and thus alleviating chemotherapy-induced nausea and vomiting. If proven effective, the communication model of strengthening positive treatment expectations in patients with risk for nausea and vomiting can be implemented in routine clinical care as part of side-effect management for patients with cancer.

Trial registration: US National Institutes of Health, https://clinicaltrials.gov/study/NCT03232541?term=NCT03232541&rank=1), # NCT03232541.