Lentinula edodes in Cancer Treatment: A Systematic Review and Meta-Analysis

Lentinula edodes extracts are used by cancer patients as alternative or complementary therapies; however, no systematic review has evaluated their actual benefits. We searched several databases (Medline, Embase, Cochrane Library, CINAHL, AMED, and KoreanMed) and included studies comparing groups receiving L. edodes extracts alongside standard treatment with those receiving standard treatment alone. A total of 22 trials involving 1,723 cancer patients were included. Of these, 13 were randomized controlled trials (RCTs) and nine were controlled non-randomized trials (NRTs). In the analysis of the 13 RCTs, the L. edodes group showed a better response rate than the control group (odds ratio, 1.45; 95% confidence interval [CI], 1.01-2.07; P = 0.04). However, there was no significant difference in overall survival between the two groups (hazards ratio, 0.66; 95% CI, 0.34-1.28; P = 0.22). There was also no difference in the incidence of hematological or non-hematological adverse events (AEs) between the groups. Similarly, no significant difference in overall quality of life (QoL) was observed (standard mean difference, 0.23; 95% CI [-0.16, 0.62]; P = 0.25). In the nine NRTs, the L. edodes group demonstrated favorable outcomes in tumor response and QoL (P < 0.05). This review found that L. edodes extracts were associated with improved tumor response. However, these results have many limitations and do not translate into improved survival. Additionally, no differences were found in AEs or QoL. Overall, the evidence does not support clear recommendations, and more high-quality, well-designed randomized trials are needed.