Investigation on the Efficiency of Chinese Herbal Injections for Treating Non-small Cell Lung Cancer With Vinorelbine and Cisplatin Based on Multidimensional Bayesian Network Meta-Analysis.

Mengwei Ni,Xinkui Liu,Jiarui Wu,Xiaomeng Zhang,Wei Zhou,Zhiwei Jing,Shanshan Jia,Haojia Wang,Miaomiao Wang,Zhishan Wu,Jingyuan Zhang,Dan Zhang,Siyu Guo,Xiaoguang Sheng

doi:10.3389/fphar.2020.631170

Abstract

Background: As non-small cell lung cancer (NSCLC) seriously threatens human health, several clinical studies have reported that Chinese herbal injections (CHIs) combined with vinorelbine and cisplatin (NP) are beneficial. This multidimensional network meta-analysis was performed to explore the preferable options among different CHIs for treating NSCLC. Methods: A literature search was performed in several databases to identify randomized controlled trials (RCTs) of CHIs in the treatment of NSCLC from inception to January 31, 2019. Final included studies met the eligibility criteria and methodological quality recommendations. Data analysis was performed using Stata 13.0 and WinBUGS 14.0 software. Each outcome was presented as an odds ratio and the surface under the cumulative ranking curve value (SCURA). The “scatterplot3d” package in R 3.6.1 software was used to perform multidimensional cluster analysis. Results: Ultimately, 97 eligible RCTs involving 7,440 patients and 14 CHIs were included in this network meta-analysis. Combined with NP chemotherapy, Kanglaite injection plus NP exhibited a better impact on the clinical effectiveness rate (SCURA probability: 78.34%), and Javanica oil emulsion injection plus NP was better in the performance status (95.44%). Huachansu injection plus NP was dominant in reducing thrombocytopenia (92.67%) and gastrointestinal reactions (92.52%). As to multidimensional cluster analysis, Shenmai injection plus NP was superior considering improving the clinical effectiveness rate, performance status and relieving leukopenia. Conclusions: The combination of CHIs and NP has a better impact on patients with NSCLC than NP alone. Among them, Shenmai injection plus NP, Kanglaite injection plus NP and Javanica oil emulsion injection plus NP were notable. Nevertheless, more multicenter and better designed RCTs are needed to validate our findings.

Highlights

The global cancer statistics suggests that the number of new cancer cases and cancer deaths in 2018 are 18.1 million and 9.6 million
The number of studies included for different Chinese herbal injections (CHIs) was as follows: Aidi injection (20 randomized controlled trials (RCTs)), Astragalus injection (1 RCT), Chansu injection (1 RCT), Compound kushen injection (8 RCTs), Delisheng injection (2 RCTs), Huachansu injection (3 RCTs), Kangai injection (7 RCTs), Kanglaite injection (12 RCTs), Shenfu injection (9 RCTs), Shenma injection (9 RCTs), Shenqifuzheng injection (11 RCTs), Shengmai injection (5 RCTs), Xiaoaiping injection (1 RCTs), and Javanica oil emulsion injection (8 RCTs)
The results indicated that patients receiving 10 types of CHIs: Aidi injection, Compound kushen injection, Huachansu injection, Javanica oil emulsion injection, Kangai injection, Kanglaite injection, Shengmai injection, Shenmai injection, Shenqifuzheng injection, and Xiaoaiping injection, plus vinorelbine and cisplatin (NP) exhibited considerable improvements in performance status relative to those receiving NP alone

Summary

Introduction

The global cancer statistics suggests that the number of new cancer cases and cancer deaths in 2018 are 18.1 million and 9.6 million. NP is one of the most commonly used chemotherapy drugs for the clinical treatment of NSCLC, and its antineoplastic efficacy has been endorsed (Rinaldi et al, 2006; Li et al, 2014). As non-small cell lung cancer (NSCLC) seriously threatens human health, several clinical studies have reported that Chinese herbal injections (CHIs) combined with vinorelbine and cisplatin (NP) are beneficial.

Methods

Results

Conclusion