SYSTEMATIC REVIEW article
Front. Pharmacol.
Sec. Ethnopharmacology
Volume 16 - 2025 | doi: 10.3389/fphar.2025.1670501
This article is part of the Research TopicEnhancing Cancer Therapy: Integrating Plant-Derived Bioactives with Chemotherapy through Traditional Knowledge and Modern AdvancesView all 24 articles
Chinese herbal injections combined with EGFR-TKIs for intervention of non-small cell lung cancer: A systematic review and meta-analysis
Provisionally accepted
- 1Bejing University of Chinese Medicine, Beijing, China
- 2Beijing Hospital of Traditional Chinese Medicine, Beijing, China
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Objective: To serve as a clinical reference, we conducted a meta-analysis to assess and compare the efficacy and safety of combining Chinese herbal injections (CHIs) with epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) for treating advanced EGFR-mutated non-small cell lung cancer (NSCLC). Methods: Predetermined databases contained randomized controlled studies comparing CHIs + EGFR-TKIs to EGFR-TKIs alone. The Cochrane Reviewer's Handbook for Systematic Reviews of Interventions was used to evaluate study methodology. To assess the effects of CHIs on patients with NSCLC receiving EGFR-TKIs, R (version 4.4.0) and RevMan (version 5.4) were used to conduct a meta-analysis using the Mantel–Haenszel or Inverse Variance method. The quality of results was evaluated using the Grade of Recommendations Assessment, Development and Evaluation (GRADE) method. Results: The 13 qualifying trials included 899 subjects. The objective response rate (ORR) was significantly increased by Kanglaite injection (RR = 1.52, 95% confidence interval [CI]: 1.07–2.15, p = 0.02). The disease control rate (DCR) was influenced by Kanglaite injection (RR = 1.14, 95% CI: 1.01–1.29, p = 0.04) and Aidi injection (RR = 1.23, 95% CI: 1.02–1.48, p = 0.03). Shenmai injection + EGFR-TKIs reduced dermatologic toxicities (RR = 0.35, 95% CI: 0.18–0.69, p = 0.002). The combination of CHIs with EGFR-TKIs improved the expression of CD3+ (standardized mean difference [SMD] = 1.38, 95% CI: 0.46–2.30, p = 0.003), CD4+ (SMD = 1.08, 95% CI: 0.51–1.65, p = 0.0002), and the CD4+/CD8+ ratio (SMD = 0.96, 95% CI: 0.54–1.38, p < 0.00001) compared to EGFR-TKIs alone. The GRADE method revealed that most outcomes exhibited low certainty evidence. Conclusions: The combination of CHIs and EGFR-TKIs improved ORR, DCR, adverse effects, and immune function in patients with NSCLC. Due to limitations in the assessed research, high-quality clinical studies with rigorous designs are required to confirm the findings.
Keywords: Chinese herbal injections, EPIDERMAL GROWTH FACTOR RECEPTOR TYROSINE KINASE INHIBITORS, Non-small cell lung cancer, Meta-analysis, Systematic review
Received: 21 Jul 2025; Accepted: 22 Oct 2025.
Copyright: © 2025 Yuan, Yan, Wu, Zhang, Yang and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Guowang Yang, guowang_yang@163.com
Xiaomin Wang, wangxiaomin_bhtcm@126.com
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