Chinese medicine combined with EGFR-TKIs in EGFR-mutated advanced NSCLC: a meta-analysis of efficacy and safety
- 1Department of Scientific Research, The Fifth Affiliated Hospital of Yunnan University of Chinese Medicine, Chuxiong, China
- 2First Clinical Medical College, School of Pharmacy and School of Basic Medicine, Yunnan University of Chinese Medicine, Kunming, China
Abstract
Objective: For advanced EGFR-mutant non-small cell lung cancer (NSCLC), epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKI) therapy is the primary treatment, but drug resistance and side effects reduce its effectiveness. Integrating Chinese and Western medicine is a key focus in cancer treatment. This study evaluates the clinical benefits of combining traditional Chinese medicine (TCM) with EGFR-TKI, summarizing TCM syndromes and medication traits.
Methods: We searched six databases for relevant clinical studies. A meta-analysis assessed progression-free survival (PFS), disease control rate (DCR), and adverse reactions, with subgroup analysis by EGFR mutation type. A TCM syndrome network was created to examine syndrome distribution and core prescription patterns.
Results: TCM combined with EGFR-TKIs significantly improved PFS (HR = 0.70, 95%CI 0.65–0.76, p < 0.00001, I² = 0%), benefiting patients with Exon 19 deletion or L858R mutation equally (p = 0.75). The combination therapy increased DCR (RR = 1.19, 95% CI 1.01–1.40, p = 0.04), with substantial heterogeneity (I² = 89%), and reduced targeted-agent-related adverse reactions. Qi-Yin and Lung-Spleen deficiency were the dominant TCM syndromes, managed via Qi-tonifying, Yin-nourishing and spleen-strengthening regimens.
Conclusion: Integrating TCM with EGFR-TKI enhances tumor control and treatment safety in advanced NSCLC patients with EGFR mutations, showing consistent efficacy across various mutation types. This approach, which considers clinical syndrome differentiation and medication patterns in Chinese medicine, offers evidence-based guidance for personalized treatment. This review was performed following the PRISMA 2020 guidelines.
Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420261398486, identifier CRD420261398486.
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BibTeX
@article{li2026chinese,
title = {{Chinese medicine combined with EGFR-TKIs in EGFR-mutated advanced NSCLC: a meta-analysis of efficacy and safety}},
author = {Xiaohong Li and Die Qian and Shuai Liu and Mingmin Na and Bihong Dai and Chunping Wan},
journal = {Frontiers in Oncology},
year = {2026},
month = oct,
doi = {10.3389/fonc.2026.1942222},
url = {https://doi.org/10.3389/fonc.2026.1942222},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Chinese medicine combined with EGFR-TKIs in EGFR-mutated advanced NSCLC: a meta-analysis of efficacy and safety
AU - Xiaohong Li
AU - Die Qian
AU - Shuai Liu
AU - Mingmin Na
AU - Bihong Dai
AU - Chunping Wan
PY - 2026
DA - 2026/10/12
JO - Frontiers in Oncology
DO - 10.3389/fonc.2026.1942222
UR - https://doi.org/10.3389/fonc.2026.1942222
AB - Objective: For advanced EGFR-mutant non-small cell lung cancer (NSCLC), epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKI) therapy is the primary treatment, but drug resistance and side effects reduce its effectiveness. Integrating Chinese and Western medicine is a key focus in cancer treatment. This study evaluates the clinical benefits of combining traditional Chinese medicine (TCM) with EGFR-TKI, summarizing TCM syndromes and medication traits. Methods: We searched six databases for relevant clinical studies. A meta-analysis assessed progression-free survival (PFS), disease control rate (DCR), and adverse reactions, with subgroup analysis by EGFR mutation type. A TCM syndrome network was created to examine syndrome distribution and core prescription patterns. Results: TCM combined with EGFR-TKIs significantly improved PFS (HR = 0.70, 95%CI 0.65–0.76, p < 0.00001, I² = 0%), benefiting patients with Exon 19 deletion or L858R mutation equally (p = 0.75). The combination therapy increased DCR (RR = 1.19, 95% CI 1.01–1.40, p = 0.04), with substantial heterogeneity (I² = 89%), and reduced targeted-agent-related adverse reactions. Qi-Yin and Lung-Spleen deficiency were the dominant TCM syndromes, managed via Qi-tonifying, Yin-nourishing and spleen-strengthening regimens. Conclusion: Integrating TCM with EGFR-TKI enhances tumor control and treatment safety in advanced NSCLC patients with EGFR mutations, showing consistent efficacy across various mutation types. This approach, which considers clinical syndrome differentiation and medication patterns in Chinese medicine, offers evidence-based guidance for personalized treatment. This review was performed following the PRISMA 2020 guidelines. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420261398486, identifier CRD420261398486.
SN - 2234-943X
ER -