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Combination of traditional Chinese medicine and EGFR-TKIs in the treatment of non-small cell lung cancer: a systematic review and meta-analysis
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  • xinbing Sui,
  • mingming zhang,
  • Xuemeng Han,
  • Ruonan Zhang,
  • liuxi Chen,
  • ying Liu,
  • yu xiang,
  • Tian Xie
xinbing Sui
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mingming zhang
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Xuemeng Han
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Ruonan Zhang
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liuxi Chen
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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.