Peng Ze, Wu Wen Wen, Yi Ping
Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
West China School of Medicine, Sichuan University, Chengdu, China.
Front Pharmacol. 2021 Mar 18;11:630825. doi: 10.3389/fphar.2020.630825. eCollection 2020.
For advanced non-small cell lung cancer (NSCLC) patients, first-line chemotherapy is the main treatment in the clinic despite its efficacy is limited and adverse effects are always inescapable. Ginsenoside Rg3, an anti-cancer active ingredient by suppressing angiogenesis, has been increasingly widely used as an adjuvant in first-line chemotherapy for advanced NSCLC to optimize treatment in China. However, no comprehensive meta-analyses have been conducted to estimate the efficacy and safety of the therapy combining ginsenoside Rg3 and first-line chemotherapy in advanced NSCLC patients. Randomized controlled trails using a combination of first-line chemotherapy and ginsenoside Rg3 for advanced NSCLC patients were searched and selected from six databases. The Cochrane Risk of Bias tool was used to assessed the quality of these selected original researches. And we used Review Manager 5.3 and STATA to analyze the data. Twenty-two RCTs that matched our selection criteria with a number of 2202 patients were included in our review. The results showed that compared with first-line chemotherapy alone, the combination of ginsenoside Rg3 and first-line chemotherapy could better improve the objective response rate (ORR) (RR [95% CI], 1.44 [1.27, 1.63], < 0.00001 ), the disease control rate (DCR) (RR [95% CI], 1.24 [1.12, 1.38], < 0.0001), karnofsky performance status (KPS) (RR [95% CI], 1.62 [1.42, 1.84], < 0.00001), one-year survival rate (RR [95% CI], 1.49 [1.08, 2.06], = 0.01), two-year survival rate (RR [95% CI], 6.22 [1.68, 22.95], = 0.006), weight change (RR [95% CI], 1.31 [1.04, 1.66], = 0.02), and higher reduce the VEGF levels (RR [95% CI], -2.21 [-4.03, -0.38], = 0.02), the incidence of gastrointestinal reactions (RR [95% CI], 0.66 [0.47, 0.93], = 0.02) and bone marrow suppression (RR [95% CI], 0.43 [0.30, 0.61], < 0.00001). Ginsenoside Rg3 can enhance drug efficacy and reduce drug-induced toxicity from chemotherapy. These findings provide helpful information for clinicians indicating that a therapy combined of ginsenoside Rg3 and first-line chemotherapy may be used to optimal the treatment of advanced NSCLC.
对于晚期非小细胞肺癌（NSCLC）患者，一线化疗是临床上的主要治疗方法，尽管其疗效有限且不良反应总是难以避免。人参皂苷Rg3是一种通过抑制血管生成发挥抗癌作用的活性成分，在中国已越来越广泛地用作晚期NSCLC一线化疗的辅助药物，以优化治疗方案。然而，尚未进行全面的荟萃分析来评估人参皂苷Rg3联合一线化疗在晚期NSCLC患者中的疗效和安全性。从六个数据库中检索并筛选了使用一线化疗联合人参皂苷Rg3治疗晚期NSCLC患者的随机对照试验。使用Cochrane偏倚风险工具评估这些所选原始研究的质量。并且我们使用Review Manager 5.3和STATA对数据进行分析。本综述纳入了22项符合我们选择标准的随机对照试验，共2202例患者。结果显示，与单纯一线化疗相比，人参皂苷Rg3联合一线化疗能更好地提高客观缓解率（ORR）（RR [95% CI]，1.44 [1.27，1.63]，<0.00001）、疾病控制率（DCR）（RR [95% CI]，1.24 [1.12，1.38]，<0.0001）、卡诺夫斯基功能状态（KPS）（RR [95% CI]，1.62 [1.42，1.84]，<0.00001）、一年生存率（RR [95% CI]，1.49 [1.08，2.06]，=0.01）、两年生存率（RR [95% CI]，6.22 [1.68，22.95]，=0.006）、体重变化（RR [95% CI]，1.31 [1.04，1.66]，=0.02），并能更显著降低血管内皮生长因子（VEGF）水平（RR [95% CI]，-2.21 [-4.03，-0.38]，=0.02）、胃肠道反应发生率（RR [95% CI]，0.66 [0.47，0.93]，=0.02）和骨髓抑制（RR [95% CI]，0.43 [0.30，0.61]，<0.00001）。人参皂苷Rg3可增强药物疗效并降低化疗药物诱导的毒性。这些发现为临床医生提供了有用信息，表明人参皂苷Rg3联合一线化疗可能用于优化晚期NSCLC的治疗。
