In stage IV pulmonary adenocarcinoma patients, treatment with Traditional Chinese Medicine alone gives prognostically superior results to treatment with Platinum-Based Chemotherapy alone

• Published in: Phytomedicine (Stuttgart) Vol. 121; p. 155087
• Main Authors: Guo, Huiru, Li, Hegen, Zhu, Lihua, Huang, Xiange, Feng, Jiali, Baak, Jan P.A.
• Format: Journal Article
• Language: English
• Published: Elsevier GmbH 01.12.2023
• Subjects: Adenocarcinoma; Chemotherapy; Stage-IV; Targeted Therapy; Traditional Chinese Medicine; Adenocarcinoma; TT; PS; NSCLC; OS; Stage-IV; HR; Targeted Therapy; AWD; EGFR; Traditional Chinese Medicine; MST; p; PBC; Chemotherapy; 95%CI; DOD; LH; TCM
• ISSN: 0944-7113; 1618-095X
• DOI: 10.1016/j.phymed.2023.155087

•Thirty % of stage IV adenocarcinomas die before 3 months. Patients with >3 months survival, have a much better survival.•Methodological flaws from other stage IV studies are avoided: 1027 consecutive stage IV NSCLs, 3–120 months follow-up.•Traditional Chinese Medicines treatment (TCM) is prognostically superior to Platinum-Based Chemotherapy (PBC).•Adding PBC or TKT-targeted therapy, or both, to TCM, further improves prognosis. About 30% of pulmonary stage IV adenocarcinomas die within 3 months of diagnosis. Western medical treatments with Platinum-Based Chemotherapy=PBC and tyrosine-kinase inhibitors Targeted Therapy=TT can improve prognosis. In China, Traditional Chinese Medicine herbal treatments (TCM) are often used in addition to PBC and TT. A considerable number of patients refuse Western medical treatments and use TCM alone. However, the survival impact of the latter is unknown. Treatment with TCM alone is prognostically superior to PBC alone. Addition of PBC or TT or both TT to TCM improves survival. In this prospective observational, non-interventional study of 1017 consecutive first-onset stage IV NSCLC patients with up to 10 years follow-up, 261 who Died of Disease (DOD) within 3 months were omitted, as they never got the optimal Western medical therapies. All 218 non-adenocarcinomas were also omitted, leaving 538 stage IV adenocarcinomas treated by TCM alone (n = 29), PBC alone (N = 19) and TCM and other Western medical combinations (299 TCM and PBC, 50 TCM and TT, 141 TCM and PBC and TT) with 3 – 120 months follow-up. Survivals were compared using Alive with Disease (AWD) and DOD as endpoints. The patients treated only with TCM had 7 months better median survival than those that received PBC alone (17 and 10 months). The patients that received TCM and PBC had a better median survival (24 months) than TCM alone and much better than PBC alone. None of the patients that received TCM alone survived > 54 months, whereas 18% of TCM and PBC patients survived much longer. Over the observation period of 3 – 120 months, survivals of TCM and TT, TCM and PBC and TT, and TCM and PBC were not different and therefore grouped as TCM and Western medicines. Median survival times of PBC alone and TCM alone were lower than that of TCM and Western medical treatments (p < 0.0001, 10, 17 and 27 months). Pulmonary stage IV adenocarcinoma patients with at least 3 months survival, treated with TCM alone have a significantly better survival than those treated with PBC alone. Adding Western PBC, TT or both to TCM further improves prognosis. [Display omitted]