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Peer-reviewedCC BY-NC-NDTranslational cancer research

The pharmacological potential and metabolic risks of Xiaojin Pill in sorafenib-resistant papillary thyroid carcinoma: an integrated network analysis.

  • Junhao Zhang1
  • Jiajun Chen1
  • Kaibo Su1
  • Qingxuan Wang2
  • Chunjue Ni3
  • Endong Chen4
  • Boxi Wang5
  • Man Li6
  • Zhaokai Dong1
  • Yihan Cai1
  • Huazhen Mei1
  • Tianyu Han1
3 more authors
  • Haozhuo Huang1
  • Yefeng Cai2
  • Quan Li4
6 affiliations
  1. 1The First Clinical Medical College, Wenzhou Medical University, Wenzhou, China.
  2. 2Department of Thyroid Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
  3. 3Department of Anesthesiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
  4. 4Department of Breast Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
  5. 5Postgraduate Training Base Alliance of Wenzhou Medical University (Zhejiang Provincial People's Hospital), Wenzhou, China.
  6. 6The Alberta Institute, Wenzhou Medical University, Wenzhou, China.
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Abstract

Sorafenib resistance limits the efficacy of treatments for advanced papillary thyroid carcinoma (PTC). The antitumor potential of Xiaojin Pill (XJP) has been demonstrated, yet its mechanisms potentially implicated in sorafenib resistance and combinational toxicological risks remain unclear. This study aimed to examine the molecular mechanisms through which XJP may act on signaling pathways implicated in sorafenib resistance, and to assess its combinational toxicological risks during co-administration with sorafenib. Integrating network pharmacology and toxicology, we identified XJP's active ingredients and hub targets via protein-protein interaction networks. Clinical relevance and immune infiltration were examined in cohorts from The Cancer Genome Atlas (TCGA), while molecular docking was used to explore the structural affinities. Global toxicity and metabolic drug-drug interactions (DDIs) during XJP-sorafenib co-administration were evaluated with ADMETlab 3.0. We identified 43 bioactive ingredients and 78 intersection targets, along with five hub genes (SRC, STAT3, EGFR, ERBB2, and ESR1) predicted to converge on the PI3K/Akt and MAPK pathways. Clinically, these targets correlated with poor prognosis and an immunosuppressive microenvironment. Notably, network toxicology identified a potential herb-drug interaction signal: core XJP components were predicted to bind key metabolic enzymes (CYP3A4/CYP1A2), which warrants examination in dedicated pharmacokinetic studies. Furthermore, computational analysis indicated that combination therapy may act on shared toxicological modules (Ras/Rap1), warranting attention during co-administration. In this in silico analysis, XJP was predicted to act on multiple targets converging on PI3K/Akt and MAPK signaling and was associated with immune-related signatures in PTC; these findings provide a basis for further investigation. However, CYP-mediated metabolic interference may represent a potential herb-drug interaction that warrants attention in future pharmacokinetic studies.

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Cite

BibTeXRIS
BibTeX
@article{zhang2026pharmacological,
  title = {{The pharmacological potential and metabolic risks of Xiaojin Pill in sorafenib-resistant papillary thyroid carcinoma: an integrated network analysis.}},
  author = {Junhao Zhang and Jiajun Chen and Kaibo Su and Qingxuan Wang and Chunjue Ni and Endong Chen and Boxi Wang and Man Li and Zhaokai Dong and Yihan Cai and Huazhen Mei and Tianyu Han and Haozhuo Huang and Yefeng Cai and Quan Li},
  journal = {Translational cancer research},
  year = {2026},
  month = oct,
  doi = {10.21037/tcr-2026-2690},
  url = {https://europepmc.org/article/MED/42997877},
  note = {CC BY-NC-ND},
}
RIS
TY  - JOUR
TI  - The pharmacological potential and metabolic risks of Xiaojin Pill in sorafenib-resistant papillary thyroid carcinoma: an integrated network analysis.
AU  - Junhao Zhang
AU  - Jiajun Chen
AU  - Kaibo Su
AU  - Qingxuan Wang
AU  - Chunjue Ni
AU  - Endong Chen
AU  - Boxi Wang
AU  - Man Li
AU  - Zhaokai Dong
AU  - Yihan Cai
AU  - Huazhen Mei
AU  - Tianyu Han
AU  - Haozhuo Huang
AU  - Yefeng Cai
AU  - Quan Li
PY  - 2026
DA  - 2026/10/23
JO  - Translational cancer research
DO  - 10.21037/tcr-2026-2690
UR  - https://europepmc.org/article/MED/42997877
AB  - Sorafenib resistance limits the efficacy of treatments for advanced papillary thyroid carcinoma (PTC). The antitumor potential of Xiaojin Pill (XJP) has been demonstrated, yet its mechanisms potentially implicated in sorafenib resistance and combinational toxicological risks remain unclear. This study aimed to examine the molecular mechanisms through which XJP may act on signaling pathways implicated in sorafenib resistance, and to assess its combinational toxicological risks during co-administration with sorafenib. Integrating network pharmacology and toxicology, we identified XJP's active ingredients and hub targets via protein-protein interaction networks. Clinical relevance and immune infiltration were examined in cohorts from The Cancer Genome Atlas (TCGA), while molecular docking was used to explore the structural affinities. Global toxicity and metabolic drug-drug interactions (DDIs) during XJP-sorafenib co-administration were evaluated with ADMETlab 3.0. We identified 43 bioactive ingredients and 78 intersection targets, along with five hub genes (SRC, STAT3, EGFR, ERBB2, and ESR1) predicted to converge on the PI3K/Akt and MAPK pathways. Clinically, these targets correlated with poor prognosis and an immunosuppressive microenvironment. Notably, network toxicology identified a potential herb-drug interaction signal: core XJP components were predicted to bind key metabolic enzymes (CYP3A4/CYP1A2), which warrants examination in dedicated pharmacokinetic studies. Furthermore, computational analysis indicated that combination therapy may act on shared toxicological modules (Ras/Rap1), warranting attention during co-administration. In this in silico analysis, XJP was predicted to act on multiple targets converging on PI3K/Akt and MAPK signaling and was associated with immune-related signatures in PTC; these findings provide a basis for further investigation. However, CYP-mediated metabolic interference may represent a potential herb-drug interaction that warrants attention in future pharmacokinetic studies.
SN  - 2218-676X
SN  - 2219-6803
ER  -