<iframe src="//www.googletagmanager.com/ns.html?id=GTM-5TSRKG" height="0" width="0" style="display: none; visibility: hidden">
Research Article
No access
Published Online: 29 January 2019

Herbal Medicines as Adjuncts to Cancer Chemotherapy—Part 1: Immunomodulators

Publication: Alternative and Complementary Therapies
Volume 25, Issue Number 1

Abstract

Immunomodulating herbs that have been studied in patients undergoing chemotherapy for cancer are reviewed in depth. Trametes versicolor (turkey tail, yún zhī) mushroom, formerly known as Coriolus versicolor, Astragalus membranaceus (astragalus, huáng qí) root, Panax ginseng (Asian ginseng, rén shēn) root, and Viscum album (European mistletoe) injectable extracts are reviewed in depth. These represent the four best-studied natural herbal immune adjuncts to chemotherapy. Various reports of these agents' abilities to reduce adverse effects and improve survival in cancer patients are discussed in depth. Other less well studied herbal immunomodulators are also mentioned more briefly. Part 2 of this article will focus on herbal therapies for other specific adverse effects of chemotherapy such as nausea, mucositis, neuropathies, and organ damage.

Get full access to this article

View all available purchase options and get full access to this article.

References

1. Galmarini D, Galmarini CM, Galmarini FC. Cancer chemotherapy: A critical analysis of its 60 years of history. Crit Rev Oncol Hematol 2012;84:181–199.
2. Ostvar S, Choi JG, Chu JN, et al. Cost-effectiveness of immune checkpoint inhibition in metastatic gastric and esophageal tumors. J Clin Oncol 2018;36:5-6.
3. Crawford J, Dale DC, Lyman GH. Chemotherapy-induced neutropenia: Risks, consequences, and new directions for its management. Cancer 2004;100:228–237.
4. Zitvogel L, Tesniere A, Kroemer G. Cancer despite immunosurveillance: Immunoselection and immunosubversion. Nat Rev Immunol 2006;6:715–727.
5. Galluzzi L, Buqué A, Kepp O, et al. Immunological effects of conventional chemotherapy and targeted anticancer agents. Cancer Cell 2015;28:690–714.
6. Oba K, Teramukai S, Kobayashi M, Matsui T, Kodera Y, et al. Efficacy of adjuvant immunochemotherapy with polysaccharide K for patients with curative resections of gastric cancer. Cancer Immunol Immunother 2007;56:905–911.
7. Sakamoto J, Morita S, Oba K, et al. Efficacy of adjuvant Immunochemotherapy with polysaccharide K for patients with curatively resected colorectal cancer: A meta-analysis of centrally randomized controlled clinical trials. Cancer Immunol Immunother 2006;55:404–411.
8. Eliza WL, Fai CK, Chung LP. Efficacy of yun zhi (Coriolus versicolor) on survival in cancer patients: Systematic review and meta-analysis. Recent Pat Inflamm Allergy Drug Discov 2012;6:78–87.
9. Ng TB. A review of research on the protein-bound polysaccharide (Polysaccharopeptide, PSP) from the mushroom Coriolus versicolor (Basidiomycetes: Polyporaceae). Gen Pharm 1998;30:1–4.
10. Tsang KW, Lam CL, Yan C, et al. Coriolous versicolor polysaccharide peptide slows progression of advanced non-small cell lung cancer. Resp Med 2003;97:618–624.
11. Wong CK, Bao YX, Wong EL, et al. Immunomodulatory activities of yunzhi and danshen in post-treatment breast cancer patients. Am J Chin Med 2005;33:381–395.
12. Shibata M, et al. Immunomodulatory effects of low dose cis-diaminedichloroplatinum (cisplatin) combined with UFT and PSK in patients with advanced colorectal cancer. Cancer Invest 2002;20:160–173.
13. Torkelson C, Sweet E, Martzen MR, et al. Phase 1 clinical trial of Trametes versicolor in women with breast cancer. ISRN Oncol 2012:2012;251632.
14. Morimasa K, Yamana S, Matsueda H, et al. Immunostimulant therapy with protein-bound polysaccharide preparation (PSK) in patients either SLE or RA. Clin Immunol 1980;12:393–398.
15. Auyeung KK Han QB, Ko JK. Astragalus membranaceus: A review of its protection against inflammation and gastrointestinal cancers. Am J Chin Med 2016;44:1–22.
16. Ma J, Liu H, Wang X. Effect of ginseng polysaccharides and dendritic cells on the balance of Th1/Th2 T helper cells in patients with non-small cell lung cancer. J Tradit Chin Med 2014;34:641–645.
17. Shahzad M, Shabbir A, Wojcikowski K, et al. The antioxidant effects of Radix Astragali (Astragalus membranaceus and related species) in protecting tissues from injury and disease. Curr Drug Targets 2016;17:1331–1340.
18. Li L, Hou X, Xu R, et al. Research review on the pharmacological effects of astragaloside IV. Fundam Clin Pharmacol 2017;31:17–36.
19. He CS, Liu YC, Xu ZP, et al. Astragaloside IV enhances cisplatin chemosensitivity in non-small cell lung cancer cells through inhibition of B7-H3. Cell Physiol Biochem 2016;40:1221–1229.
20. Dai PC, Liu DL, Zhang L, et al. Astragaloside IV sensitizes non-small cell lung cancer cells to gefitinib potentially via regulation of SIRT6. Tumour Biol 2017;39:1010428317697555.
21. McCulloch M, See C, Shu XJ, et al. Astragalus-based Chinese herbs and platinum-based chemotherapy for advanced non-small-cell lung cancer: Meta-analysis of randomized trials. J Clin Oncol 2006;24:419–430.
22. Dugoua JJ Wu P, Dugald Seely D, et al. Astragalus-containing Chinese herbal combinations for advanced non-small-cell lung cancer: A meta-analysis of 65 clinical trials enrolling 4751 patients. Lung Cancer (Auckl) 2010;1:85–100.
23. Shu XJ, McCulloch M, Xiao H, et al. Chinese herbal medicine and chemotherapy in the treatment of hepatocellular carcinoma: A meta-analysis of randomized controlled trials. Integr Cancer Ther 2005;4:219–229.
24. Zhang C, Zhu C, Ling Y, et al. The clinical value of huangqi injection in the treatment of leucopenia: A meta-analysis of clinical controlled trials. PLoS One 2013;8:1–8.
25. Pao LH, Hu OY, Fan HY, et al. Herb–drug interaction of 50 Chinese herbal medicines on CYP3A4 activity in vitro and in vivo. Am J Chin Med 2012;40:57–73.
26. Or PM, Lam FF, Kwan YW, et al. Effects of Radix Astragali and Radix Rehmanniae, the components of an anti-diabetic foot ulcer herbal formula, on metabolism of model CYP1A2, CYP2C9, CYP2D6, CYP2E1 and CYP3A4 probe substrates in pooled human liver microsomes and specific CYP isoforms. Phytomedicine 2012;19:535–544.
27. Zhang Y, Huang L, Bi H, et al. Study of the upregulation of the activity of cytochrome P450 3A isoforms by Astragalus injection and Astragalus granules in rats and in cells. Eur J Drug Metab Pharmacokinet 2013;38:105–113.
28. Cheng BH, Zhou X, Wang Y, et al. Herb-drug interaction between an anti-HIV Chinese herbal SH formula and atazanavir in vitro and in vivo. J Ethnopharmacol 2015;162:369–376.
29. Zhou Q, Ye Z, Ruan Z, Zeng S. Investigation on modulation of human P-gp by multiple doses of Radix Astragali extract granules using fexofenadine as a phenotyping probe. J Ethnopharmacol 2013;146:744–749.
30. Xie J, Shao J, Lu Y, et al. Separation of ginseng active ingredients and their roles in cancer metastasis supplementary therapy. Curr Drug Metab 2013;14:616–623.
31. Jiang SL, Liu HJ, Liu ZC, et al. Adjuvant effects of fermented red ginseng extract on advanced non-small cell lung cancer patients treated with chemotherapy. Chin J Integr Med 2017;23:331–337.
32. Zhang Y, Wang XQ, Liu H, et al. [A multicenter, large-sample, randomized clinical trial on improving the median survival time of advanced non-small cell lung cancer by combination of ginseng Rg3 and chemotherapy]. Zhonghua Zhong Liu Za Zhi 2018;40:295–299 [in Chinese].
33. Suh SO, Kroh M, Kim NR, et al. Effects of red ginseng upon postoperative immunity and survival in patients with stage III gastric cancer. Am J Chin Med 2002;30:483–494.
34. Kim HS, Kim MK, Lee M, et al. Effect of red ginseng on genotoxicity and health-related quality of life after adjuvant chemotherapy in patients with epithelial ovarian cancer: A randomized, double blind, placebo-controlled trial. Nutrients 2017;9:E77-2.
35. Barton DL, Soori GS, Bauer BA, et al. Pilot study of Panax quinquefolius (American ginseng) to improve cancer-related fatigue: A randomized, double-blind, dose-finding evaluation: NCCTG trial N03CA. Support Care Cancer 2010;18:179–187.
36. Barton DL, Liu H, Dakhil SR, et al. Wisconsin Ginseng (Panax quinquefolius) to improve cancer-related fatigue: A randomized, double-blind trial, N07C2. J Natl Cancer Inst 2013;105:1230–1238.
37. Pelzer F, Tröger W. Complementary treatment with mistletoe extracts during chemotherapy: Safety, neutropenia, fever, and quality of life assessed in a randomized study. J Altern Complement Med 2018;24:954–961.
38. Tröger W, Zdrale Z, Stanković N, Matijašević M. Five-year follow-up of patients with early stage breast cancer after a randomized study comparing additional treatment with Viscum album (L) extract to chemotherapy alone. Breast Cancer (Auckl) 2012;6:173–180.
39. Tröger W, Galun D, Reif M, et al. Viscum album [L.] extract therapy in patients with locally advanced or metastatic pancreatic cancer: A randomised clinical trial on overall survival. Eur J Cancer 2013;49:3788–3797.
40. Kienle GS, Kiene H. Review article: Influence of Viscum album L (European mistletoe) extracts on quality of life in cancer patients: A systematic review of controlled clinical studies. Integr Cancer Ther 2010;9:142–157.
41. Zuzak TJ, Wasmuth A, Bernitzki S, et al. Safety of high-dose intravenous mistletoe therapy in pediatric cancer patients: A case series. Complement Ther Med 2018;40:198–202.
42. Steele ML, Axtner J, Happe A, et al. Use and safety of intratumoral application of European mistletoe (Viscum album L) preparations in oncology. Integr Cancer Ther 2015;14:140–148.
43. Steele ML, Axtner J, Happe A, et al. Safety of intravenous application of mistletoe (Viscum album L.) preparations in oncology: An observational study. Evid Based Complement Alternat Med 2014;2014:236310.

Information & Authors

Information

Published In

cover image Alternative and Complementary Therapies
Alternative and Complementary Therapies
Volume 25Issue Number 1February 2019
Pages: 46 - 52

History

Published in print: February 2019
Published online: 29 January 2019
Published ahead of print: 10 January 2019

Permissions

Request permissions for this article.

Topics

Authors

Affiliations

Eric Yarnell, ND, RH (AHG)
Eric Yarnell, ND, RH (AHG), is chief medical officer of Northwest Naturopathic Urology, in Seattle, Washington, and is a faculty member at Bastyr University in Kenmore, Washington.
Claire Zimmerman, ND, RH (AHG)
Claire Zimmerman, ND, RH (AHG), is in private practice in Seattle, Washington, and is adjunct faculty at Bastyr University in Kenmore, Washington.

Metrics & Citations

Metrics

Citations

Export citation

Select the format you want to export the citations of this publication.

View Options

Get Access

Access content

To read the fulltext, please use one of the options below to sign in or purchase access.

Society Access

If you are a member of a society that has access to this content please log in via your society website and then return to this publication.

Restore your content access

Enter your email address to restore your content access:

Note: This functionality works only for purchases done as a guest. If you already have an account, log in to access the content to which you are entitled.

View options

PDF/EPUB

View PDF/ePub

Full Text

View Full Text

Media

Figures

Other

Tables

Share

Share

Copy the content Link

Share on social media

Back to Top