Sui Xinbing, Zhang Mingming, Han Xuemeng, Zhang Ruonan, Chen Liuxi, Liu Ying, Xiang Yu, Xie Tian
Holistic Integrative Pharmacy Institutes and Department of Medical Oncology, the Affiliated Hospital of Hangzhou Normal University, College of Medicine, Hangzhou Normal University.
Zhejiang Key Laboratory of Elemene Anticancer Traditional Chinese Medicine, Hangzhou Normal University, Zhejiang Provincial Engineering Laboratory of Traditional Chinese Medicine Development and Application, Hangzhou, Zhejiang.
Medicine (Baltimore). 2020 Aug 7;99(32):e20683. doi: 10.1097/MD.0000000000020683.
In China, traditional Chinese medicine (TCM) is an increasingly important part of the treatment of non-small cell lung cancer (NSCLC), which usually includes a combination of prescription and syndrome differentiation. Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) have been proven to be the first-line drugs for the treatment of advanced EGFR mutation-positive NSCLC. In China, EGFR-TKIs are used in combination with traditional Chinese medicines to reduce side effects and/or enhance effectiveness. Nevertheless, the relationship between TCMs and EGFR-TKIs remain unclear. This meta-review aimed to explore the clinical evidence of TCMs combined with EGFR-TKIs in the treatment of NSCLC.
Related studies were found by searching the databases of EMBASE, PubMed, Web of Science, MEDLINE, Cochrane library database, China Academic Journals (CNKI), Wanfang and Weipu. This study included 57 randomized controlled trials, all of these were processed by Stata software (version 12.0). In the study, all the materials are published articles, patient anonymity and informed consent and ethics Approval/Institutional review board are not necessary.
This study demonstrated that the objective response rate was higher in the group of TCMs plus EGFR-TKIs than in the group of EGFR-TKIs alone (risk ratios 1.39, 95% confidence intervals [1.29, 1.50]). Further research of specific herbal medicines showed that Huangqi, Baishu, Fuling, Gancao, Maidong, Baihuashecao, Shashen, Dangshen and Renshen, had significant higher contributions to results.
TCMs may improve the efficacy of EGFR-TKIs in the treatment of NSCLC.
在中国，传统中药（TCM）在非小细胞肺癌（NSCLC）治疗中所占的比重日益增加，其治疗通常包括方剂与辨证相结合。表皮生长因子受体酪氨酸激酶抑制剂（EGFR-TKIs）已被证实是治疗晚期EGFR突变阳性NSCLC的一线药物。在中国，EGFR-TKIs与传统中药联合使用以减轻副作用和/或提高疗效。然而，中药与EGFR-TKIs之间的关系仍不明确。本荟萃综述旨在探讨中药联合EGFR-TKIs治疗NSCLC的临床证据。
通过检索EMBASE、PubMed、科学网、MEDLINE、Cochrane图书馆数据库、中国学术期刊全文数据库（CNKI）、万方数据库和维普数据库查找相关研究。本研究纳入57项随机对照试验，所有试验均采用Stata软件（版本12.0）进行处理。在本研究中，所有资料均为已发表文章，无需对患者进行匿名处理，也无需患者知情同意以及伦理批准/机构审查委员会批准。
本研究表明，中药联合EGFR-TKIs组的客观缓解率高于单纯EGFR-TKIs组（风险比1.39，95%置信区间[1.29，1.50]）。对特定草药的进一步研究表明，黄芪、白术、茯苓、甘草、麦冬、白花蛇舌草、沙参、党参和人参对结果的贡献显著更高。
中药可能会提高EGFR-TKIs治疗NSCLC的疗效。
