Combined application of the traditional Chinese herbal medicine, Renvatinib, and Carrelizumab in a patient with primary liver cancer: A case report and literature review
Yan Zhu, Yaoshui Lai, Hongjie Song
Combined application of the traditional Chinese herbal medicine, Renvatinib, and Carrelizumab in a patient with primary liver cancer: A case report and literature review
The patient was diagnosed with primary liver cancer featuring intrahepatic metastasis (Barcelona stage B; Stage IIB), hepatitis B infection, and post-hepatitis B cirrhosis during the period of compensated liver function. Following a 7-month regimen combining traditional Chinese herbal medicine (TCHM) with Renvatinib and Carrelizumab, the patient exhibited favorable tolerability, no bleeding risks, and stable tumor progression. The effectiveness of TCHM in this case was marked by significant symptom alleviation, reduced serum molecular markers, minimized adverse reactions, and obviated surgical intervention. Blood tests displayed alpha-fetoprotein levels ranging from 8.85 to 20.65 IU/mL, with no increase in bleeding risks.
Carrelizumab / case report / literature review / primary liver cancer / Renvatinib / traditional Chinese herbal medicine
[1] |
Liao YH , Lin CC , Lai HC , Chiang JH , Lin JG , Li TC . Adjunctive traditional Chinese medicine therapy improves survival of liver cancer patients. Liver Int. 2015; 35 (12): 2595- 2602.
|
[2] |
Li HM . Microcirculation of liver cancer, microenvironment of liver regeneration, and the strategy of Chinese medicine. Chin J Integr Med. 2016; 22 (3): 163- 167.
|
[3] |
Dong S , Zhuang X , Yangyang L , et al. Efficacy and safety of acupuncture combined with Chinese herbal medicine in the treatment of primary liver cancer: a protocol for systematic review and meta-analysis. Medicine (Baltim). 2021; 100 (40): e27497.
|
[4] |
Li M , Qiao C , Qin L , Zhang J , Ling C . Application of traditional Chinese medicine injection in treatment of primary liver cancer: a review. J Tradit Chin Med. 2012; 32 (3): 299- 307.
|
[5] |
Zhang RR , Shao MY , Fu Y , et al. Network meta-analysis of oral Chinese patent medicine for adjuvant treatment of primary liver cancer. Zhongguo Zhongyao Zazhi. 2021; 46 (9): 2333- 2343 (in Chinese).
|
[6] |
Bray F , Ferlay J , Soerjomataram I , Siegel RL , Torre LA , Jemal A . Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018; 68 (6): 1- 31.
|
[7] |
An L , Zeng HM , Zheng RS , et al. Liver cancer epidemiology in China. Zhonghua Zhongliu Zazhi. 2019; 41 (10): 721- 727 (in Chinese).
|
[8] |
Bruix J , Sherman M . Management of hepatocellular carcinoma: an update. Hepatology. 2011; 53 (3): 1020- 1022.
|
[9] |
He S , Liao CX . Research progress on the mechanism of traditional Chinese medicine in the treatment of liver cancer. Chin Pat Med. 2017; 39 (1): 155- 160 (in Chinese).
|
[10] |
Zhang Y , Chen HG , Zhao C , et al. Research progress on anti-hepatoma mechanism of effective components of traditional Chinese medicine. Chin J Tradit Chin Med. 2020; 45 (14): 3395- 3406 (in Chinese).
|
[11] |
Zhang CH , Yang X , Wei JR , et al. Ethnopharmacology, phytochemistry, pharmacology, toxicology and clinical applications of Radix Astragali. Chin J Integr Med. 2021; 27 (3): 229- 240.
|
[12] |
Wang Y , Liu QG , Wang SS , et al. Progress in treatment of kidney disease with Astragalus. J Agric Sci Yanbian Univ (Chin). 2016; 38: 105- 108, 138.
|
[13] |
Jung YH , Jerng U , Lee SY . A systematic review of anticancer effects of Radix Astragali. Chin J Integr Med. 2016; 22 (3): 225- 236.
|
[14] |
Feng H , Yamazaki M , Matsuki N , Saito H . Anti-tumor effects of orally administered soft-shelled turtle powder in mice. Biol Pharm Bull. 1996; 19 (3): 367- 368.
|
[15] |
Wu YC , Liu X , Wang JL , et al. Soft-shelled turtle peptide modulates microRNA profile in human gastric cancer AGS cells. Oncol Lett. 2018; 15 (3): 3109- 3120.
|
[16] |
Fu JJ , Tan SL , Li YG , Lv H , Zhu WF , Liu HN . Adjuvant effects of snapping turtle co-peptide (STCP) on radiotherapy for cancer. J Jiangxi Uni Trad Chin Med. 2015; 27: 68- 71 (in Chinese).
|
[17] |
Wu Y , Liu L , Zhao Y , Zhao R . Polysaccharides of vinegar-baked radix bupleuri promote the hepatic targeting effect of oxymatrine by regulating the protein expression of HNF4α, Mrp2, and OCT1. J Ethnopharmacol. 2021; 267: 113471.
|
[18] |
Hang SJ , Lee YJ , Kim BM , et al. Effect of Bupleuri Radix extracts on the toxicity of 5-fluorouracil in HepG2 hepatoma cells and normal human lymphocytes. Basic Clin Pharmacol Toxicol. 2008; 103 (4): 305- 313.
|
[19] |
Chiang LC , Ng LT , Liu LT , Shieh DE , Lin CC . Cytotoxicity and anti-hepatitis B virus activities of saikosaponins from Bupleurum species. Planta Med. 2003; 69 (8): 705- 709.
|
[20] |
Hou HL , He SX , Zhu ZF , et al. The role of saikosaponin d in regulating HIF-1α/COX-2 signal transduction pathway in human hepatocellular carcinoma cells. J Xi'an Jiaot Univ. 2011; 32: 80- 84.
|
[21] |
Kwon DA , Kim YS , Kim SK , Baek SH , Kim HK , Lee HS . Antioxidant and antifatigue effect of a standardized fraction (HemoHIM) from Angelica gigas, Cnidium officinale, and Paeonia lactiflora. Pharm Biol. 2021; 59 (1): 391- 400.
|
[22] |
Bae T , Jang J , Lee H , et al. Paeonia lactiflora root extract suppresses cancer cachexia by down-regulating muscular NF-κB signalling and muscle-specific E3 ubiquitin ligases in cancer-bearing mice. J Ethnopharmacol. 2020; 246: 112222.
|
[23] |
Wu JJ , Sun WY , Hu SS , Zhang S , Wei W . A standardized extract from Paeonia lactiflora and Astragalus membranaceus induces apoptosis and inhibits the proliferation, migration and invasion of human hepatoma cell lines. Int J Oncol. 2013; 43 (5): 1643- 1651.
|
[24] |
Chen Y , Zhu Z , Chen J , et al. Terpenoids from Curcumae Rhizoma: their anticancer effects and clinical uses on combination and versus drug therapies. Biomed Pharmacother. 2021; 138: 111350.
|
[25] |
Lu JJ , Dang YY , Huang M , Xu WS , Chen XP , Wang YT . Anti-cancer properties of terpenoids isolated from Rhizoma Curcumae-a review. J Ethnopharmacol. 2012; 143 (2): 406- 411.
|
[26] |
Zhao M , Fu Y , Liu L , et al. Identification of key drug targets and molecular mechanisms of Curcumae Rhizoma acting on HBV-related HCC: weighted correlation network and network pharmacological analyses. Evid Based Complement Alternat Med. 2022; 2022: 5399766.
|
[27] |
Sun RL , Tang DC , Gu JF . Study on intervention effect of Astragali Radix-Curcumae Rhizoma on growth and metastasis of colon cancer in orthotopic transplantation mice model of colon cancer. Zhongguo Zhongyao Zazhi. 2021; 46 (9): 2267- 2275 (in Chinese).
|
[28] |
Zhao X , Wen F , Wang W , Lu Z , Guo Q . Actinidia arguta (Hardy Kiwi) root extract exerts anti-cancer effects via Mcl-1-mediated apoptosis in cholangiocarcinoma. Nutr Cancer. 2019; 71 (2): 246- 256.
|
[29] |
Hu W , Wu C , Yuan C , Chen M , Jin C , Zheng C . Ethanol extracted from Radix of Actinidia chinensis inhibits human colon tumor through inhibiting Notch-signaling pathway. J Cancer. 2021; 12 (3): 622- 629.
|
[30] |
Cheng QL , Li HL , Li YC , Liu ZW , Guo XH , Cheng YJ . CRA (Crosolic Acid) isolated from Actinidia valvata Dunn.Radix induces apoptosis of human gastric cancer cell line BGC823 in vitro via down-regulation of the NF-κB pathway. Food Chem Toxicol. 2017; 105: 475- 485.
|
[31] |
Bailly C . Anticancer properties of lobetyolin, an essential component of Radix Codonopsis (Dangshen). Nat Prod Bioprospect. 2021; 11 (2): 143- 153.
|
[32] |
Liu Z , Sun Y , Zhen H , Nie C . Network pharmacology integrated with transcriptomics deciphered the potential mechanism of Codonopsis pilosula against hepatocellular carcinoma. Evid Based Complement Alternat Med. 2022; 2022: 1340194.
|
[33] |
Ko PH , Huang CW , Chang HH , Chuang EY , Tsai MH , Lai LC . Identifying the functions and biomarkers of Codonopsis pilosula and Astragalus membranaceus aqueous extracts in hepatic cells. Chin Med. 2019; 14 (1): 10.
|
[34] |
Xin T , Zhang F , Jiang Q , et al. The inhibitory effect of a polysaccharide from Codonopsis pilosula on tumor growth and metastasis in vitro. Int J Biol Macromol. 2012; 51 (5): 788- 793.
|
[35] |
Unlu A , Nayir E , Kirca O , Ozdogan M . Ganoderma lucidum (Reishi mushroom) and cancer. J BUON. 2016; 21 (4): 792- 798.
|
[36] |
Joseph S , Sabulal B , George V , Antony KR , Janardhanan KK . Antitumor and anti-inflammatory activities of polysaccharides isolated from Ganoderma lucidum. Acta Pharm. 2011; 61 (3): 335- 342.
|
[37] |
Jin H , Jin F , Jin JX , et al. Protective effects of Ganoderma lucidum spore on cadmium hepatotoxicity in mice. Food Chem Toxicol. 2013; 52: 171- 175.
|
[38] |
Chen HS , Tsai YF , Lin S , et al. Studies on the immuno-modulating and anti-tumor activities of Ganoderma lucidum (Reishi) polysaccharides. Bioorg Med Chem. 2004; 12 (21): 5595- 5601.
|
[39] |
Gao Y , Zhou S , Wen J , Huang M , Xu A . Mechanism of the antiulcerogenic effect of Ganoderma lucidum polysaccharides on indomethacin-induced lesions in the rat. Life Sci. 2002; 72 (6): 731- 745.
|
[40] |
Hsu MJ , Lee SS , Lin WW . Polysaccharide purified from Ganoderma lucidum inhibits spontaneous and Fas-mediated apoptosis in human neutrophils through activation of the phosphatidylinositol 3 kinase/Akt signaling pathway. J Leukoc Biol. 2002; 72 (1): 207- 216.
|
[41] |
Shieh YH , Liu CF , Huang YK , et al. Evaluation of the hepatic and renal-protective effects of Ganoderma lucidum in mice. Am J Chin Med. 2001; 29 (03n04): 501- 507.
|
[42] |
Sohretoglu D , Huang S . Ganoderma lucidum polysaccharides as an anti-cancer agent. Anti Cancer Agents Med Chem. 2018; 18 (5): 667- 674.
|
[43] |
Jin X , Ruiz Beguerie J , Sze DM , Chan GC . Ganoderma lucidum (Reishi mushroom) for cancer treatment. Cochrane Database Syst Rev. 2016; 4 (4): CD007731.
|
[44] |
Xu Y , Tan HY , Li S , Wang N , Feng Y . Panax notoginseng for inflammation-related chronic diseases: a review on the modulations of multiple pathways. Am J Chin Med. 2018; 46 (5): 971- 996.
|
[45] |
Zhong H , Wu H , Bai H , et al. Panax notoginseng saponins promote liver regeneration through activation of the PI3K/AKT/mTOR cell proliferation pathway and upregulation of the AKT/Bad cell survival pathway in mice. BMC Compl Alternative Med. 2019; 19 (1): 122.
|
[46] |
Liu YH , Qin HY , Zhong YY , et al. Neutral polysaccharide from Panax notoginseng enhanced cyclophosphamide antitumor efficacy in hepatoma H22-bearing mice. BMC Cancer. 2021; 21 (1): 37.
|
/
〈 | 〉 |