Chinese Herbal Medicine for Advanced Non-Small-Cell Lung Cancer: A Systematic Review and Meta-Analysis.

Chinese herbal medicine (CHM) has been widely used in the treatment of advanced non-small-cell lung cancer (NSCLC), but their efficacy and safety remain controversial. We sought to comprehensively aggregate and evaluate the available evidence on the efficacy and safety of the combination treatment with CHM and epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) in NSCLC patients. Our exhausted and systematical searching strategy yielded 64 related randomized controlled trials involving 4384 patients. Compared with EGFR-TKIs therapy alone, meta-analysis showed significant differences favoring the combination treatment in progression- free survival (P < 0.0001), median survival time (P < 0.0001), one-year survival rate (P = 0.002), two-year survival rate (P = 0.005), probability of severe toxicities (P < 0.0001), objective response rate (P < 0.0001), Karnofsky performance status (P < 0.0001), and improvement in percentage of CD3(+) T lymphocyte (P < 0.0001) and CD4(+) T lymphocyte (P < 0.0001). Though these results require further confirmation, they are prone to show a potential therapeutic value of CHM in improving the clinical effect, overcoming the drug resistance and toxicities as an adjunctive therapy to EGFR-TKIs.