Efficacy and Safety of Compound Kushen Injection for Treating Advanced Colorectal Cancer: A Protocol for a Systematic Review and Meta-analysis

Overview

Journal Heliyon

Specialty Social Sciences

Date 2024 Mar 11

PMID 38463847

Authors

Jingyuan Wu

Xinyi Ma

Xinmiao Wang

Guanghui Zhu

Heping Wang

Jie Li

Affiliations

Soon will be listed here.

Abstract

Introduction: Compound Kushen Injection (CKI) is a traditional Chinese medicine extracted from Aiton and Kunth. Widely utilized in China for the comprehensive treatment of colorectal cancer (CRC), this study aims to systematically assess the efficacy and safety of CKI when combined with chemotherapy for the treatment of advanced CRC, based on available data.

Methods: Randomized controlled trials investigating the efficacy and safety of CKI combined with chemotherapy in the treatment of advanced CRC will be comprehensively searched from databases, including PubMed, Web of Science, Cochrane Library, EMBASE, China National Knowledge Infrastructure, Chinese Scientific Journal Database, Wanfang, Chinese Biomedicine Database Searches, Chinese Clinical Trial Registry, and ClinicalTrials.gov until November 2022. Two independent reviewers will screen the studies, assess the risk of bias, and extract data in duplicate. The ROB2 tool will be employed to assess the quality of included studies. Stata 16 will be used for data analysis, and publication bias will be assessed using funnel plots and Egger's test. The quality of evidence will be evaluated according to GRADE, and trial sequence analysis (TSA) will be utilized to calculate the final total sample size required for the meta-analysis. The results of this systematic review will be published in a peer-reviewed journal. The proposed review protocol has been registered with the International Prospective Register of Systematic Reviews (PROSPERO; CRD42022380106).

Discussion: This systematic review will integrate current evidence on CKI in advanced CRC and analyze the clinical efficacy and safety of CKI combined with different chemotherapy regimens, providing valuable guidance on the use of CKI in CRC patients.

Citing Articles

Efficacy and Safety of Compound Kushen Injection for Advanced Colorectal Cancer: A Systematic Review and Meta-Analysis of Randomized Clinical Trials with Trial Sequential Analysis.

Wu J, Ma X, Wang X, Zhu G, Wang H, Zhang Y Integr Cancer Ther. 2024; 23:15347354241258458.

PMID: 38853681 PMC: 11163932. DOI: 10.1177/15347354241258458.

References

Wang W, You R, Qin W, Hai L, Fang M, Huang G . Anti-tumor activities of active ingredients in Compound Kushen Injection. Acta Pharmacol Sin. 2015; 36(6):676-9. PMC: 4594177. DOI: 10.1038/aps.2015.24. View

Guyatt G, Oxman A, Vist G, Kunz R, Falck-Ytter Y, Alonso-Coello P . GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ. 2008; 336(7650):924-6. PMC: 2335261. DOI: 10.1136/bmj.39489.470347.AD. View

Wang S, Long S, Deng Z, Wu W . Positive Role of Chinese Herbal Medicine in Cancer Immune Regulation. Am J Chin Med. 2020; 48(7):1577-1592. DOI: 10.1142/S0192415X20500780. View

Bhatt P, Kumar V, Subramaniyan V, Nagarajan K, Sekar M, Chinni S . Plasma Modification Techniques for Natural Polymer-Based Drug Delivery Systems. Pharmaceutics. 2023; 15(8). PMC: 10459779. DOI: 10.3390/pharmaceutics15082066. View

Mao Z, Gao L, Wang G, Liu C, Zhao Y, Gu W . Subglottic secretion suction for preventing ventilator-associated pneumonia: an updated meta-analysis and trial sequential analysis. Crit Care. 2016; 20(1):353. PMC: 5084404. DOI: 10.1186/s13054-016-1527-7. View

Cao W, Chen H, Yu Y, Li N, Chen W . Changing profiles of cancer burden worldwide and in China: a secondary analysis of the global cancer statistics 2020. Chin Med J (Engl). 2021; 134(7):783-791. PMC: 8104205. DOI: 10.1097/CM9.0000000000001474. View

Ye Z, Yao X, Chen Z, Jin Q, You Q . Exploring the nucleotide molecular mechanism of compound kushen injection for lung adenocarcinoma based on network pharmacology and molecular docking. Front Oncol. 2022; 12:1013052. PMC: 9676978. DOI: 10.3389/fonc.2022.1013052. View

He R, Ou S, Chen S, Ding S . Network Pharmacology-Based Study on the Molecular Biological Mechanism of Action for Compound Kushen Injection in Anti-Cancer Effect. Med Sci Monit. 2020; 26:e918520. PMC: 6977710. DOI: 10.12659/MSM.918520. View

Sun J, Li M, Lin T, Wang D, Chen J, Zhang Y . Cell cycle arrest is an important mechanism of action of compound Kushen injection in the prevention of colorectal cancer. Sci Rep. 2022; 12(1):4384. PMC: 8921286. DOI: 10.1038/s41598-022-08336-4. View

10.

Nourmohammadi S, Aung T, Cui J, Pei J, De Ieso M, Harata-Lee Y . Effect of Compound Kushen Injection, a Natural Compound Mixture, and Its Identified Chemical Components on Migration and Invasion of Colon, Brain, and Breast Cancer Cell Lines. Front Oncol. 2019; 9:314. PMC: 6498862. DOI: 10.3389/fonc.2019.00314. View

11.

Bhat A, Thapa R, Goyal A, Subramaniyan V, Kumar D, Gupta S . Curcumin-based nanoformulations as an emerging therapeutic strategy for inflammatory lung diseases. Future Med Chem. 2023; 15(7):583-586. DOI: 10.4155/fmc-2023-0048. View

12.

Aung T, Qu Z, Kortschak R, Adelson D . Understanding the Effectiveness of Natural Compound Mixtures in Cancer through Their Molecular Mode of Action. Int J Mol Sci. 2017; 18(3). PMC: 5372668. DOI: 10.3390/ijms18030656. View

13.

Gao L, Wang K, Zhou Y, Fang J, Qin X, Du G . Uncovering the anticancer mechanism of Compound Kushen Injection against HCC by integrating quantitative analysis, network analysis and experimental validation. Sci Rep. 2018; 8(1):624. PMC: 5766629. DOI: 10.1038/s41598-017-18325-7. View

14.

Jiao L, Bi L, Lu Y, Wang Q, Gong Y, Shi J . Cancer chemoprevention and therapy using chinese herbal medicine. Biol Proced Online. 2018; 20:1. PMC: 5757296. DOI: 10.1186/s12575-017-0066-1. View

15.

Akash S, Baeza J, Mahmood S, Mukerjee N, Subramaniyan V, Islam M . Development of a new drug candidate for the inhibition of Lassa virus glycoprotein and nucleoprotein by modification of evodiamine as promising therapeutic agents. Front Microbiol. 2023; 14:1206872. PMC: 10366616. DOI: 10.3389/fmicb.2023.1206872. View

16.

Mujafarkani N, Ahamed F, Suresh Babu K, Debnath S, Sayed A, Albadrani G . Unveiling a novel terpolymer-metal complex: A detailed exploration of synthesis, characterization, and its potential as an antimicrobial and antioxidant agent. Heliyon. 2023; 9(10):e20459. PMC: 10551568. DOI: 10.1016/j.heliyon.2023.e20459. View

17.

Ke G, Zhang J, Gao W, Chen J, Liu L, Wang S . Application of advanced technology in traditional Chinese medicine for cancer therapy. Front Pharmacol. 2022; 13:1038063. PMC: 9606699. DOI: 10.3389/fphar.2022.1038063. View

18.

Mukherjee S, Nag S, Mukerjee N, Maitra S, Muthusamy R, Fuloria N . Unlocking Exosome-Based Theragnostic Signatures: Deciphering Secrets of Ovarian Cancer Metastasis. ACS Omega. 2023; 8(40):36614-36627. PMC: 10568589. DOI: 10.1021/acsomega.3c02837. View

19.

Sung H, Ferlay J, Siegel R, Laversanne M, Soerjomataram I, Jemal A . Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021; 71(3):209-249. DOI: 10.3322/caac.21660. View

20.

Zhou X, Seto S, Chang D, Kiat H, Razmovski-Naumovski V, Chan K . Synergistic Effects of Chinese Herbal Medicine: A Comprehensive Review of Methodology and Current Research. Front Pharmacol. 2016; 7:201. PMC: 4940614. DOI: 10.3389/fphar.2016.00201. View