Presentation (CTI)

OBJECTIVES: This study performed a Bayesian network meta-analysis (NMA) to assess the efficacy and safety of epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) combined with seven frequently used herbal medicines in patients with locally advanced or metastatic (stage IIIA-IV) non-small cell lung cancer (NSCLC).
METHODS: On January 23, 2025, nine databases were systematically searched for randomized controlled trials (RCTs) in which control groups received EGFR-TKI monotherapy and experimental groups received EGFR-TKIs combined with oral herbal medicines. The risk of bias was assessed using the Cochrane Risk-of-Bias tool 2. The primary outcomes were progression-free survival (PFS) and overall survival (OS). The secondary outcomes were Karnofsky Performance Status (KPS) and major EGFR-TKI-related adverse events, specifically diarrhea and rash.
RESULTS: In this study, we included 20 RCTs involving 1,634 patients. In the PFS analysis, the EGFR-TKI plus FAF group showed a significant survival benefit over the EGFR-TKI monotherapy group, ranking first among all treatments. For OS, the EGFR-TKI plus YYJD group showed a trend toward prolonged survival compared with the monotherapy group, with the highest ranking. KPS was significantly improved in the EGFR-TKI plus FAF group compared to the monotherapy group, which ranked first among all treatments. The inciden
CONCLUSIONS: Combination therapy with herbal medicine was identified as a potential therapeutic strategy for delaying disease progression, prolonging survival, improving performance status, and reducing adverse events in patients with stage IIIA-IV NSCLC. FAF, YYJD, and SC showed potential as combination therapy candidates. These findings warrant further validation through high-quality RCTs.