Integrative Cancer Therapies最新文献

This study investigated the effects of peach gum polysaccharide (PGP) on chemotherapy-induced intestinal injury and behavioral changes in mice. Female C57BL/6 mice were injected with E0771 breast cancer cells and divided into 3 groups: control, chemotherapy (pirarubicin), and PGP treatment (pirarubicin plus PGP). Behavioral tests, colon length measurement, tissue staining, 16S rDNA sequencing, and metabolomics were performed. Transcriptomic data of colon and hippocampal tissues were analyzed and validated by Western blotting. PGP significantly alleviated colon damage, reduced inflammation and apoptosis, and restored colon length. It mitigated depressive behaviors by suppressing inflammasome activation in the hippocampus, increased gut microbiota diversity, and improved depression-associated metabolites. After the depletion of the intestinal flora, the antidepressant effect of PGP is significantly weakened. These findings suggest that PGP protects against chemotherapy-induced intestinal and behavioral damage by modulating the gut microbiota and gut-brain axis.

Introduction: Cancer treatment with chemotherapy frequently leads to side effects such as fatigue, pain, nausea, and anxiety. Healing Touch is a non-invasive complementary therapy often used by cancer patients to address side effects of treatment. To better inform the use of complementary therapies, there is a need to understand the biological mechanisms underlying the effects of such treatments.

Methods: This study included 44 patients with cervical cancer undergoing chemoradiation randomized into a Healing Touch (HT), a relaxation training (RT) and a usual care (UC) group. An exploratory metabolomics analysis was conducted on plasma samples taken at baseline, 4, and 6 weeks of ongoing treatment (4 sessions per week).

Results: A multivariate data analysis revealed no significant separation in metabolites between the 3 groups. Univariate data analysis revealed changes in metabolites between baseline and week 6 within each group. The main findings were lower levels of acylcarnitines, bile acids and proline in the HT group, higher levels of fatty acids in the HT and RT groups, and lower levels of kynurenine and quinolate in the UC group. The network of correlations between metabolites shows clear differences in correlations between steroids, fatty acids, sphyngomyelins, amino acids, and γ glutamyl peptides between the 3 groups, suggesting a more flexible and resilient metabolism in the HT and RT groups compared with UC.

Conclusion: This first exploratory study investigating metabolic effects of Healing Touch in cancer patients indicated suggestive differences in metabolic signatures which need further investigation in a larger study.

Background: Radiation therapy is commonly used for the curative or palliative treatment of lung, esophageal, breast, or mediastinal tumors, with radiation-induced esophagitis (RIE) being a prevalent adverse event. Despite its high incidence, no cure has been identified for RIE, and validated treatment methods remain elusive. This systematic review explores global clinical research on herbal medicines for RIE treatment, assessing their efficacy in prevention and treatment.

Methods: A comprehensive literature search across 5 databases targeted randomized controlled clinical trials (RCTs). RCTs published before June 2024 were eligible if they investigated herbal medicine use for RIE prevention or treatment. Using Cochrane methodology and RevMan 5.4 software, a meta-analysis was conducted, and the certainty of evidence was evaluated with the GRADE system.

Results: Following the literature selection process, 81 RCTs with 7283 patients were included in the analysis. All studies administered herbal medicine to the treatment group and usual care with conventional medicine to the control group. Meta-analysis revealed that, in terms of overall incidence rate, herbal medicine demonstrated a significantly greater preventive effect compared to usual care (relative risk [RR]: 0.71; 95% CI: 0.65-0.78). Similarly, herbal medicine showed superior efficacy in improving RIE treatment outcomes compared to usual care (RR: 1.29; 95% CI: 1.21-1.38). Herbal medicine exhibited a comparable safety profile with fewer gastrointestinal adverse events and no significant liver toxicity.

Conclusions: Herbal medicine demonstrated significant benefits in reducing RIE incidence, delaying onset, alleviating symptoms, and shortening duration in patients undergoing radiation therapy for thoracic malignancies. However, due to limited certainty of the evidence, well-designed, large-scale RCTs are essential to establish the clinical effectiveness of herbal medicine for prevention and treatment, ensuring high-quality evidence for incidence rate and treatment effective rates.

Background: Cancer remains one of the leading causes of death worldwide, underscoring the need for novel therapies. SH003, an herbal mixture composed of Astragalus membranaceus, Angelica gigas, and Trichosanthes kirilowii, is a traditional Korean medicine formulation with potential to enhance chemotherapy efficacy and reduce toxicity. This study aimed to assess the safety and determine maximum tolerated dose of SH003 in combination with docetaxel in patients with advanced solid tumors, specifically lung and breast cancer.

Methods: This Phase I, multi-center, open-label, dose-escalation study enrolled patients with advanced lung or breast cancer. Participants received SH003 orally at doses of 2400, 3600, or 4800 mg daily, alongside intravenous docetaxel (75 mg/m²) every 21 days. A 3 + 3 dose-escalation design was employed to determine the maximum tolerated dose. Safety assessments and adverse event monitoring were conducted at each treatment cycle.

Results: Twelve participants were enrolled. SH003 was well tolerated up to 4800 mg/day, with no dose-limiting toxicities attributed to SH003. The most common adverse events were neutropenia, primarily associated with docetaxel, and mild dermatologic reactions such as eczema, rash acneiform, and pruritus. Preliminary evidence of disease stabilization was observed in several participants.

Conclusion: The combination of SH003 and docetaxel demonstrated a favorable safety profile, with 4800 mg/day identified as maximum tolerated dose for SH003. These findings support further investigation in Phase II trials to assess therapeutic efficacy.Trial Registration: Clinical Research Information Service (https://cris.nih.go.kr) KCT0004770.

Background: Evidence regarding Chinese herbal medicine for facial rash related to epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) is limited. Therefore, this study aimed to investigate whether ex ternal application of a Xiaozhen zhiyang (XZZY) decoction is effective for EGFR-TKI-related facial rash in Chinese patients.

Methods: In this prospective cohort study, 123 participants with EGFR-TKI-related facial rash were recruited from July 18, 2019 to May 20, 2021. The intervention was external application of the XZZY decoction twice daily for 2 weeks using a facial mask. Treatment efficacy, change in the WoMo score, and quality of life were evaluated as endpoints.

Results: The average age of the 123 enrolled participants was 54.83 ± 12.45 years, and 48.78% were female. The total efficiency of treatment was 93.5%, including 12 (10%) cases were cured, 20 (16.26%) cases were markedly improved and 83 (67.48%) cases were improved. The generalized estimating equations showed decreased WoMo scores, itching, and pain, as well as an improved quality of life after the treatment. Only 1 participant reported skin allergies, and no other adverse effects were reported.

Conclusion: This study showed the effectiveness and safety of a XZZY decoction for EGFR-TKI-related rash.

Objective: To evaluate the clinical efficacy and safety of Shuanghuang Yangxue Decoction in treating lung cancer patients with cancer-related anemia (CRA) accompanied by serum iron deficiency.

Method: One hundred lung cancer patients with CRA and serum iron deficiency were included in this prospective randomized controlled study and randomly divided into control and treatment groups. The treatment group received Shuanghuang Yangxue Decoction plus ferrous succinate, while the control group received ferrous succinate alone. Related indicators were observed and recorded before and after treatment. Statistical analysis was performed using SPSS 26.0.

Results: The effective correction rate of anemia in the treatment group was significantly higher than that in the control group (64 vs 34%, P < .01). Through stratified analysis of patients with moderate anemia, the effective correction rate in the treatment group was significantly higher than that in the control group (75 vs 45%, P < 0.01). After treatment, the treatment group showed statistically significant differences (P < .05) in peripheral blood routine parameters (hemoglobin, erythrocyte count, and hematocrit), anemia indicators (serum iron, ferritin, transferrin saturation, and erythropoietin [EPO]), immune function markers (cytotoxic T lymphocytes [Tc] and natural killer [NK] lymphocytes), and inflammatory factors (interleukin-1β [IL-1β], IL-6, tumor necrosis factor-α [TNF-α], and interferon-γ [IFN-γ]) compared to baseline values. Between-group comparisons showed that mean hemoglobin in the treatment group increased from 106.60 to 119.86 g/L, which was not significantly different from the control group increase from 110.00 to 116.18 g/L (P > .05). However, mean serum iron in the treatment group increased from 7.03 to 12.33 μmol/L, which was significantly higher than the control group increase from 7.33 to 9.45 μmol/L (P < .01). Throughout the study, no adverse reaction events occurred in either group.

Conclusion: Shuanghuang Yangxue Decoction demonstrates superior efficacy compared to ferrous succinate alone in treating lung cancer CRA with serum iron deficiency. It effectively corrects anemia, increases serum iron levels, reduces inflammation, and is both safe and effective.

Background: Non-small cell lung cancer (NSCLC) exhibits low survival rates. Although immune checkpoint inhibitors (ICIs) have become first-line treatment for NSCLC, their limited response to ICI monotherapy has led to exploration of combination treatments. However, the high incidence of treatment-related adverse events associated with conventional drug combinations has highlighted the need for alternative herbal therapy. Bojungikki-tang (BJIKT), a traditional herbal medicine, has been used to treat gastrointestinal disorders and enhance immune function. Our preclinical studies have demonstrated that BJIKT combined with anti-PD-1 or anti-PD-L1 antibodies exhibits significant efficacy in suppressing tumor growth by modulating the immunosuppressive tumor microenvironment. Building on these preclinical findings, this study aims to evaluate the efficacy and safety of BJIKT with pembrolizumab combination therapy compared to pembrolizumab monotherapy in advanced NSCLC patients.

Methods: 70 individuals with stage IV NSCLC scheduled for first-line pembrolizumab monotherapy will be randomly assigned to intervention or control groups. The primary outcome will be progression-free survival, with secondary outcomes including disease control rate, overall survival, and quality of life assessment. Adverse events will be monitored for safety. This study will explore the synergistic mechanism of combinatorial therapy using immune profiling and multi-omics analysis, and the possibility for personalized integrative therapy based on cold-heat syndrome differentiation (SD) types in East Asian medicine.

Discussion: This study will provide novel evidence regarding survival outcomes, quality of life, and safety profiles of combined ICI and BJIKT therapy for advanced NSCLC. The exploratory data will contribute to tailoring treatments to immune-based SD types in NSCLC patients.