1. Introduction
Lung cancer remains the most common cancer worldwide and the leading cause of cancer-related deaths [1]. There are two main types of lung cancer: small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC). While NSCLC accounts for approximately 85% of all lung cancer cases [2]. If patients are NSCLC, they are often diagnosed at an advanced stage and some new oncogene-targeted drugs and treatment regimens have been applied in clinical practice of NSCLC and achieved remarkable results. EGFR mutated NSCLC patients are sensitive to small molecule receptor tyrosine kinase inhibitors (TKIs), which occur in 60-70% of patients[3, 4]. However, unfortunately, acquired drug resistance inevitably develops, leading to disease progression. Therefore, how to augment the efficacy and/or prevent the resistance of EGFR-TKIs are an imperative issue.
Natural product-based TCMs are widely used in China and have long been combined with traditional therapies to treat cancer patients[5]. Currently, the treatment of lung cancer by combination of TCMs and traditional therapy has become one of the most important means recognized in China. This treatment may assist in reducing the side effects, enhancing cytotoxic effects, preventing or overcoming resistance to anticancer drugs, and/or improving the quality of life of patients [6-8]. However, the relationship between TCMs and EGFR-TKIs remain less well elucidated.
In this article, we compared the objective tumor response rate (ORR) between EGFR-TKIs alone and EGFR-TKIs combined with TCMs in NSCLC. As a result, data of our study showed that the ORR was significantly higher in the TCM plus EGFR-TKIs group than in the EGFR-TKIs alone group. Further research of specific plant-based TCMs showed that Huangqi, Baishu, Fuling, Gancao, Maidong, Baihuashecao, Shashen, Dangshen and Renshen, had significant higher contributions to results. Taken together, our meta-analysis provides evidence that TCMs have the potential to enhance the efficacy of EGFR-TKIs in the treatment of NSCLC.