Efficacy and safety of Kang’ai injection adjunct with TP chemotherapy for the treatment of non-small cell lung cancer: a systematic review and meta-analysis of randomized controlled trials

Background:Combination therapy with traditional Chinese medicine and chemotherapy was proposed as a therapeutic strategy for non-small cell lung cancer patients.Therefore,we performed a systematic review and metaanalysis of randomized controlled trials to assess effects of this combination therapy on non-small cell lung cancer.To evaluate the efficacy and safety of the Chinese patent medicine Kang’ai injection adjunct with TP chemotherapy in the treatment of non-small cell lung cancer.Methods:A randomized controlled study of the Chinese patent medicine Kang’ai injection adjunct with TP chemotherapy in the databases of China National Knowledge Infrastructure Database,WanFang Database,VIP Database,Sino-Med Database,PUBMED,EMBASE and Cochrane library was searched by computer.The literatures published from the database establishment to July 1,2020 were included in the search scope.After 2 evaluators independently evaluated and cross checked the quality of the study,Revman 5.3 was used to meta analyze the clinical effect of the Chinese patent medicine Kang’ai injection adjunct with TP chemotherapy on patients with non-small cell lung cancer.Results:A total of 1,370 lung cancer patients were included in 20 RCTs.The results of meta-analysis showed that there were significant differences between the 2 groups in clinical efficacy(RR=1.32,95%CI(1.20,1.44)),quality of life(RR=1.44,95%CI(1.32,1.57)),immune function(MD=0.53,95%CI(0.23–0.83)),adverse reactions(RR=0.49,95%CI(0.41,0.58)).Conclusion:The Chinese patent medicine Kang’ai injection adjunct with TP chemotherapy is effective and safe in the treatment of non-small cell lung cancer,and has great prospects for further development.However,the quality of evidence was very low-to-moderate.Considering the poor quality of evidence,we are not very confident in the results.We look forward to more research and update results in the future and improve the evidence quality.

Network pharmacology to predicting therapy targets of traditional Chinese medicine Kang’ai injection on breast cancer

Background:To predict the effective targets of Kang’ai injection and analyze the pharmacological mechanism for the treatment of breast cancer based on the method of network pharmacology.Methods:The Traditional Chinese Medicine Systems Pharmacology database was used to predict the effective components of the Chinese patent medicine Kang’ai injection,and GeneCards database,Online Mendelian Inheritance in Man database and the Therapeutic Target Database were used to predict the therapeutic targets of breast cancer.Cytoscape 3.7.2 was used to construct active ingredient-disease-target network.String database and Cytoscape 3.7.2 software were used to draw the protein-protein interaction network and obtain the core target.Bioconductor and R language were used to analyze the effective action target for gene ontology and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis.Results:There were 42 effective active ingredients in the Chinese patent medicine Kang’ai injection,which acted on 105 targets,and it had 32 components that acted on 96 targets associated with breast cancer.The target regulates various biological processes such as inflammation,angiogenesis,apoptosis and cell proliferation,and regulates pathways such as PI3K-Akt signaling pathway,MAPK signaling pathway,AGE-RAGE signaling pathway in diabetic complications and thyroid hormone signaling pathway through gene ontology and Kyoto Encyclopedia of Genes and Genomes analysis.Conclusion:The treatment of breast cancer with the Chinese patent medicine Kang’ai injection is a complex mechanism process with multiple targets,multiple pathways,and multiple choices,which provides a theoretical basis for the further extraction of effective components in the treatment of breast cancer.

Meta-analysis of therapy of Kang’ai injection combined with chemotherapy in the treatment of non-small cell lung cancer

Objective:To compare the safety and efficacy of Kang’ai injection combined with chemotherapy and chemotherapy alone in the treatment of non-small cell lung cancer.Methods:The related control and randomized studies from 1966 to October 01,2022,were retrieved in the following databases:China National Knowledge Infrastructure,Wanfang databases,Value In Paper,SinoMed,PubMed,Embase and Cochrane Library.A comprehensive literature search was conducted in 7 electronic databases identifying all the relevant randomized controlled trials.Cochrane handbook 5.2.3 was applied to evaluate the quality of included trials,and the RevMan 5.3 software was used to analyze data and assess the publication bias.Results:From the 16 studies reviewed,a total of 1,398 patients were included.Compared with docetaxel+cis-platinum chemotherapy alone,Kang’ai injection combined with docetaxel+cis-platinum chemotherapy showed significant effects in improving clinical response rate(RR:1.40,95%confidence interval(CI)(1.25,1.58)),quality of life score(Karnofsky score)(RR:1.53,95%CI(1.32,1.78)),traditional Chinese medicine syndrome(RR:2.01,95%CI(1.43,2.83))and safety(RR:0.62,95%CI(0.54,0.71)),the differences were statistically significant.Conclusion:Kang’ai injection may increase the therapeutic effectiveness,improve the quality of life,and reduce the toxicity of chemotherapy in patients with non-small cell lung cancer.These results require confirmation by further rigorously designed randomized controlled trials(PROSPERO registration number:CRD42020176917).

Effect of Kang’ai Injection (康艾注射液) on Serum Level of Soluble Interleukin-2 Receptor and Vascular Endothelial Growth Factor in Patients with Esophageal Carcinoma during Radiotherapy

Objective： To observe the effect of Kang＇ai Injection （康艾注射液, KAI） on serum level of soluble interleukin-2 receptor （sIL-2R） and vascular endothelial growth factor （VEGF） in patients with esophageal carcinoma （EC） during radiotherapy （RT）, and to investigate its synergistic effect with RT and its influence on immunological function of the body. Methods： One hundred and seventy patients with EC, who had missed the chance of surgical operational therapy, were assigned to the treated group （90 cases） and the RT group （80 cases）, and at the same time a control group consisting of 80 inpatients without tumors was set up. Patients in the RT group were treated with RT alone but KAI was given additionally to those in the treated group, with 50 ml given once per day via intravenous dripping, 15 days as one course, and 2 courses administered in total. The immediate therapeutic efficacy and changes of serum slL-2R and VEGF levels were observed, and the effect of KAI on patients＇ quality of life （QOF） was evaluated by Karnofsky scoring. Results： In 16 patients of the treated group it was completely remission （OR）, in 54 partially remission （PR）, in 18 it was stabilized disease （SD） and in 2 progressive disease （PD）, with the total effective rate （CR ＋ PR） as 77.8%, while in those of the control group it was 12, 46, 18, 4 and 72.5%, respectively, the immediate therapeutic efficacy in the treated group was somewhat better than that in the RT group, but showed no statistical significance （P〉0.05）. Serum levels of slL-2R and VEGF in all the patients before treatment were higher than those in the control group, which were decreased after treatment in both groups （P〈0.05）, but the improvement in the treated group was better than that in the RT group, showing significant difference （P〈0.05）, and patients＇ QOF improved more significantly in the former as well （62.2 % vs 40.0%, P〈 0.05）. Conclusion： KAI in combination with RT in treating patients with EC could enhance the immunological function of patients, improve their QOF and enhance their sensitivity to RT.