Combination of traditional Chinese medicine and EGFR-TKIs in the
treatment of non-small cell lung cancer: a systematic review and
meta-analysis
Abstract
Traditional Chinese Medicines (TCMs) is used in China as part of the
treatment for non-small-cell lung cancer (NSCLC) and often includes
prescription in combination with conventional therapies based on
syndrome differentiation. Epidermal growth factor receptor-tyrosine
kinase inhibitors (EGFR-TKIs) represent the first-line treatment for
patients with advanced EGFR mutation-positive non-small-cell lung cancer
(NSCLC). In China, EGFR-TKIs may be combined with TCMs with the aim of
reducing the side effects and/or augmenting the efficacy of the
EGFR-TKIs. However, the relationship between TCMs and EGFR-TKIs remain
unclear. So, this meta-review evaluates the clinical evidence of TCMs
combined with EGFR-TKIs in the treatment of NSCLC. Seven electronic
databases were searched for randomized controlled trials of EGFR-TKI
combined with TCMs compared to the EGFR-TKIs alone. Fifty-seven
randomized controlled trials were involved in this study, and all the
data were analyzed by Stata software (version 12.0). This study
suggested that the objective response rate (ORR) of the group with TCMs
combined with EGFR-TKIs-based regimens was higher than the group of
EGFR-TKIs alone (RR 1.39, 95% CI [1.29, 1.50]). Further sensitivity
analysis of specific plant-based TCMs showed that Huangqi, Baishu,
Fuling, Gancao, Maidong, Baihuashecao, Shashen, Renshen and Dangshen,
had significantly higher contributions to the results. Therefore, TCMs
may have the potential to improve the efficacy of EGFR-TKIs for NSCLC.