Effectiveness of Huachansu injection combined with chemotherapy for treatment of gastric cancer in China: a systematic review and Meta-analysis

OBJECTIVE:to evaluate the effectiveness and safety of Huachansu(HCS)injection plus chemotherapy in the treatment of gastric cancer.METHODS:A thorough and systematic retrieval of randomized controlled trials(RCTs)concerning HCS injection for treating gastric cancer was conducted in several electronic databases from inception to May 10,2018.The quality of the RCTs was assessed by the Cochrane risk of bias tool.And the data about objective remission rate,performance status,adverse drug reactions(ADRs)and other outcomes were extracted and analyzed by Review Manager 5.3 and Stata 13.0 software.RESULTS:A total of 14 RCTs with 976 participants were involved in the current Meta-analysis.The results suggested that HCS injection combined with chemotherapy was associated with better effects than receiving conventional chemotherapy alone in respect of improving the objective response rate[RR=1.18,95%CI(1.03,1.37),Z=2.32,P=0.02],and performance status[RR=1.84,95%CI(1.43,2.36),Z=4.74,P<0.00001].In addition,HCS injection combined with chemotherapy could relieve pain for patients with gastric cancer.CONCLUSION:This Meta-analysis revealed that HCS injection plus chemotherapy might more effective than chemotherapy in treating gastric cancer.Nevertheless,more large-scale and rigorously designed RCTs should be performed to validate this finding.

Efficacy and safety of gemcitabine-oxaliplatin combined with huachansu in patients with advanced gallbladder carcinoma

AIM: To evaluate the efficacy and safety of gemcitabine-oxaliplatin (GEMOX) combined with huachansu (cinobufagin) injection treatment in patients with locally advanced or metastatic gallbladder carcinoma (GBC), and to assess the quality of life (QOL) of such patients. METHODS: Twenty-fi ve patients with locally advanced or metastatic GBC were treated with intravenous gemcitabine (1000 mg/m2) over 30 min on days 1 and 8, 2 h infusion of oxaliplatin (120 mg/m2) on day 1, and 2-3 h infusion of huachansu (20 mL/m2) on days -3-11, every 3-4 wk. Treatment was continued until occurrence of unacceptable toxicity or disease progression. QOL of patients was assessed by the EORTC QLQ-C30 at baseline, at the end of the fi rst, third and sixth chemotherapy cycles, and 1 mo after the treatment. RESULTS: Among the 25 patients with a median age of 64 years (range 42-78 years), 23 were evaluable in the study. A total of 137 cycles of therapy were performed and the median cycle was 5 (range 1-8) per patient. Out of the 23 patients whose response couldbe evaluated, 8 partial responses (PR) were observed (34.8%), while 7 patients (30.4%) demonstrated a stable disease (SD). The disease control rate was 65.2%. Progression of cancer was observed in 8 (34.8%) patients. The median progression-free and overall survival time was 5.8 mo (95% CI: 4.5-7.1 mo) and 10.5 mo, respectively. The therapy was well tolerated, with moderate myelosuppression as the main toxicity. Anemia grade 2 was seen in 16.0%, neutropenia grade 3 in 8.0% and thrombocytopenia grade 3 in 24.0% of patients, respectively. Non-hematologic toxicity ranged from mild to moderate. No death occurred due to toxicity. The QOL of patients was improved after chemotherapy, and the scores of QOL were increased by 10 to 20 points. CONCLUSION: GEMOX combined with huachansu (cinobufagin) injection is well tolerated, effective, thus improving the QOL of patients with advanced GBC.