Traditional Chinese Medicines as Anticancer Agents for Non-Small Cell Lung Cancer with EGFR Mutations: A Review
Zhiying Wang1, Zhixian Zhong2, Wenxiao Yang1
1Department of Oncology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, 200437, People's Republic of China.
Abstract:
Non‑small cell lung cancer (NSCLC) accounts for 85% of all cases of lung cancer cases. Epidermal growth factor receptor (EGFR) with L858R/T790M mutations are commonly found in clinical practice and usually results in resistance to first- and second-generation epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs). Osimertinib is currently the first-line treatment choice for patients with EGFR L858R/T790M mutations, however, as to other EGFR-TKIs, resistance inevitably occurs. There is substantial evidence supporting the efficacy of traditional Chinese medicine (TCM) in the prevention and treatment of non-small cell lung cancer (NSCLC). The mechanisms underlying these effects involve the modulation of key cellular processes, including proliferation, apoptosis, cell cycle regulation, migration, invasion, autophagy, and epithelial-mesenchymal transition. TCM achieves these effects by regulating multiple signaling pathways and mechanisms, while also exhibiting synergistic interactions with EGFR tyrosine kinase inhibitors (TKIs). This review highlights the mechanisms through which TCM influences NSCLC patients harboring EGFR mutations, offering a promising therapeutic strategy for those with EGFR-TKI resistance.
Insights
Traditional Chinese Medicine (TCM) offers a promising approach to combatting resistance to epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) in non-small cell lung cancer (NSCLC). TCM modulates key cellular processes and pathways, showing synergistic effects with EGFR-TKIs for improved treatment outcomes.
Area of Science:
- Oncology
- Pharmacology
- Traditional Chinese Medicine
Background:
- Non-small cell lung cancer (NSCLC) is the most common type of lung cancer, accounting for 85% of cases.
- Epidermal growth factor receptor (EGFR) mutations, specifically L858R/T790M, are prevalent and often lead to resistance against first- and second-generation EGFR tyrosine kinase inhibitors (EGFR-TKIs).
- Osimertinib is a first-line treatment for EGFR L858R/T790M mutations, but resistance remains a significant clinical challenge.
Purpose of the Study:
- To review the mechanisms by which Traditional Chinese Medicine (TCM) influences non-small cell lung cancer (NSCLC) patients with EGFR mutations.
- To explore the potential of TCM as a therapeutic strategy for overcoming EGFR-TKI resistance in NSCLC.
- To highlight the synergistic interactions between TCM and EGFR-TKIs.
Main Methods:
- Review of existing scientific literature on Traditional Chinese Medicine (TCM) and its role in non-small cell lung cancer (NSCLC) treatment.
- Analysis of studies detailing the mechanisms of TCM in modulating cellular processes and signaling pathways relevant to cancer.
- Examination of research on the combined efficacy of TCM and EGFR tyrosine kinase inhibitors (EGFR-TKIs).
Main Results:
- Traditional Chinese Medicine (TCM) demonstrates efficacy in preventing and treating non-small cell lung cancer (NSCLC).
- TCM modulates critical cellular processes including proliferation, apoptosis, cell cycle regulation, migration, invasion, autophagy, and epithelial-mesenchymal transition.
- TCM exhibits synergistic effects when combined with EGFR tyrosine kinase inhibitors (EGFR-TKIs), offering a strategy to overcome treatment resistance.
Conclusions:
- Traditional Chinese Medicine (TCM) presents a promising therapeutic avenue for non-small cell lung cancer (NSCLC) patients, particularly those with EGFR mutations.
- The multifaceted mechanisms of TCM, including pathway regulation and synergistic interactions with EGFR-TKIs, are crucial for addressing EGFR-TKI resistance.
- Further research into TCM offers potential for novel treatment strategies in NSCLC management.
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