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Adjuvant treatment with Cordyceps sinensis for lung cancer: A systematic review and meta-analysis of randomized controlled trials.

  • 2024-03-12
  • Journal of ethnopharmacology 327
    • Canran Wang
    • Jiawei Wang
    • Yuanfu Qi

Study Design

Type
Meta-Analysis
Sample size
n = 928
Population
928 patients with lung cancer
Methods
Meta-analysis of 12 RCTs evaluating Cordyceps sinensis as adjuvant treatment for lung cancer
Funding
Unclear

Ethnopharmacological relevance

Cordyceps sinensis (CS) is a fungus parasitic on lepidopteran larvae which is often used to treat lung diseases and regulate immune function.

Aim of the study

This review aimed to evaluate the efficacy of CS in the adjuvant treatment of lung cancer.

Materials and methods

As of June 2022, the electronic database search was conducted in PubMed, EMBASE, Cochrane Library, China Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), Wanfang Database and China Science Journal Database (VIP database). Randomized clinical trials (RCTs) that evaluated the efficacy of CS as an adjuvant treatment for lung cancer were included. After the quality evaluation, meta-analysis was performed with Stata 16.0 software.

Results

A total of 12 RCTs with 928 patients were identified for this meta-analysis, which showed that as an adjuvant treatment, CS has the following advantages in the treatment of lung cancer: (1) Improved tumor response rate (TRR) (RR: 1.17， 95%CI: 1.05-1.29，P = 0.00); (2) improved immune function, including increased CD4 (MD: 4.98, 95%CI: 1.49-8.47, P = 0.01), CD8 (MD: 1.60, 95%CI: 0.40-2.81, P = 0.01, I2 = 0.00%), NK (MD: 4.17, 95%CI: 2.26-6.08, P = 0.00), IgA (MD: 1.29, 95%CI: 0.35-2.24, P = 0.01), IgG (MD: 3.95, 95%CI: 0.98-6.92, P = 0.01) and IgM (MD: 6.44, 95%CI: 0.63-12.26, P = 0.03); (3) improved patients' quality of life based on the mean ± SD of Karnofsky Performance Status (KPS) (MD: 8.20, 95%CI: 6.87-9.53, P = 0.00); (4) reduced the incidence of adverse drug reactions (ADRs), including the incidence of myelosuppression (RR: 0.38, 95%CI: 0.19-0.75, P = 0.01), leukopenia (RR: 0.76, 95%CI: 0.63-0.92, P = 0.00), and thrombocytopenia (RR: 0.52, 95%CI: 0.31-0.86, P = 0.01) (5) reduced the incidence of radiation pneumonitis (RR: 0.74, 95%CI: 0.62-0.88, P = 0.00). However, the number of improved patients based on KPS (RR: 1.47, 95%CI: 0.98-2.20, P = 0.06) were similar between two groups, liver and renal damage (RR: 0.32, 95%CI: 0.09-1.10, P = 0.07) and gastrointestinal adverse reactions (RR: 0.80, 95%CI: 0.47-1.37, P = 0.42) as well. Subgroup analysis showed that CS could increase the TRR in the treatment with 6 g/d and 21 days/3-4 cycles.

Conclusion

Compared with conventional treatment, adjuvant treatment with CS of lung cancer not only improve TRR, QOL and immune function, but also reduce the incidence of ADRs and radiation pneumonitis. The optimal usage may be 6 g/d and 21 days/3 to 4 cycles.

Prospero registration no

CRD42022333681.

Research Insights

Adverse Events Reported

  • Cordyceps→gastrointestinal adverse reactions

    gastrointestinal adverse reactions (RR: 0.80, 95%CI: 0.47-1.37, P = 0.42)

    Finding
    No significant difference
    Magnitude
    RR: 0.80, 95%CI: 0.47-1.37
    Significant
    No
  • Cordyceps→liver and renal damage

    liver and renal damage (RR: 0.32, 95%CI: 0.09-1.10, P = 0.07)

    Finding
    No significant difference
    Magnitude
    RR: 0.32, 95%CI: 0.09-1.10
    Significant
    No
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