Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Oncol. Nov 24, 2024; 15(11): 1404-1411
Published online Nov 24, 2024. doi: 10.5306/wjco.v15.i11.1404
Recent efficacy and long-term survival of Astragalus polysaccharide combined with gemcitabine and S-1 in pancreatic cancer
Guang-Yu Li, Jing Jiang
Guang-Yu Li, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou 310000, Zhejiang, China.
Guang-Yu Li, The First Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou 310000, Zhejiang Province, China
Jing Jiang, Zhejiang Cancer Hospital, Hangzhou 310000, Zhejiang Province, China
Author contributions: Li GY contributed to data collection, analyzed the data, drafted the first draft; Jiang J conducted guidance and edited the manuscript; All authors have read and approved the final manuscript.
Institutional review board statement: This study was approved by the Ethics Committee of Zhejiang Provincial Hospital of Chinese Medicine (Ethics No. 2024-KLS-266-02).
Informed consent statement: With the approval of the Ethics Committee of Zhejiang Provincial Hospital of Chinese Medicine, informed consent is waived for this study.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Jing Jiang, Professor, Zhejiang Cancer Hospital, Hangzhou 310000, Zhejiang Province, China. jjsgxhszlyy@gmail.com
Received: June 27, 2024
Revised: August 28, 2024
Accepted: September 12, 2024
Published online: November 24, 2024
Processing time: 108 Days and 22.4 Hours
Abstract
BACKGROUND

Pancreatic cancer is a highly malignant tumor with a rapid progression rate and a high susceptibility to infiltration and metastasis. Astragalus polysaccharide (APS), a pure Chinese medicine preparation primarily made from the traditional Chinese herb Astragalus, plays a positive role in the treatment of many malignant tumors.

AIM

To explore the recent efficacy of APS combined with gemcitabine plus tegafur gimeracil oteracil potassium capsule (S-1) (GS) regimen in the treatment of pancreatic cancer and assess its effect on the immune function and long-term survival of patients.

METHODS

A total of 97 patients who were diagnosed with pancreatic cancer and received GS chemotherapy at The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine) from March 2021 to December 2021 were included in the retrospective analysis. Among them, 41 patients received APS combined with GS chemotherapy, and 56 patients received GS chemotherapy only. The recent efficacy, immune function, adverse reactions, and long-term survival were compared among these patients.

RESULTS

After 4 cycles of treatment, the objective response rate of patients receiving the combined therapy of APS and GS was 51.22%, and the disease control rate (DCR) was 56.10%, higher than those of patients receiving the monotherapy with GS alone (30.36% and 35.71%, respectively). Besides, the percentages of CD3+ T cells (50.18% ± 9.57%) and CD4+ T cells (31.52% ± 5.33%) in the peripheral blood of patients receiving the combined therapy of APS and GS were higher compared with those treated with GS regimen alone [(44.06% ± 8.55%) and (26.01% ± 7.83%), respectively]. Additionally, the incidences of leukopenia, thrombocytopenia, and fatigue in patients receiving the combined therapy of APS and GS were significantly lower than those in patients receiving the monotherapy of GS alone (17.07%, 9.76%, 31.71% vs 37.50%, 28.57%, 60.71%). Moreover, the median survival time of patients receiving the combined therapy of APS and GS was 394 days, significantly longer than that of patients receiving the monotherapy of GS alone (339 days) (hazard ratio: 0.66; 95%CI: 0.45-0.99; P = 0.036). All these differences were statistically significant (P < 0.05).

CONCLUSION

The combined therapy of APS and GS improved the recent efficacy and long-term survival of patients with pancreatic cancer and alleviated chemotherapy-induced immune suppression and adverse reactions.

Keywords: Pancreatic cancer; Astragalus polysaccharide; Long-term survival; Immune function; Traditional Chinese medicine

Core Tip: Astragalus polysaccharide (APS) plays an active role in the treatment of malignant tumors based on traditional Chinese medicine (TCM). This study analyzed the effects of the combined therapy of APS and gemcitabine plus tegafur gimeracil oteracil potassium capsule (S-1) in the treatment of pancreatic cancer, showing improved objective response rate and disease control rate, increased CD4+ T cells and serum interleukin-2 levels, and prolonged median survival time. The findings demonstrated the potential of APS as an effective TCM-based treatment option in pancreatic cancer therapies.