Traditional Chinese medicine (TCM) Yi-Fei-Jie-Du-Tang (YFJDT) has shown potential in lung cancer treatment. However, the mechanisms underlying the effects of YFJDT on lung cancer remain unclear. Bioinformatics analysis is conducted to identify potential targets of YFJDT. The impact of YFJDT on hypoxia-inducible factor 1 alpha (HIF1A), ferroptosis, and vasculogenic mimicry (VM) is investigated using xenograft tumor models and A549 cells. Additionally, A549 cells are stimulated with CoCl2 to mimic the hypoxic microenvironment of the tumor. The role of HIF1A overexpression in modulating ferroptosis is assessed. The effects of HIF1A and ferroptosis on epithelial-mesenchymal transition (EMT) and VM in vitro are evaluated. Results: YFJDT treatment led to a concentration-dependent decrease in HIF1A levels in xenograft tumors and A549 cells. Overexpression of HIF1A counteractes the inhibitory effects of YFJDT on proliferation, EMT, and VM in transplanted tumors. Moreover, HIF1A overexpression attenuates YFJDT-induced lipid peroxidation and iron accumulation, indicating inhibition of ferroptosis in A549 cells. Hypoxia-induced alterations in EMT markers and VM are reversed by YFJDT but exacerbated by HIF1A overexpression. Molecular docking identified salicylic acid and psoralen as potential components of YFJDT targeting HIF1A. YFJDT exerts anti-tumor effects in lung cancer by downregulating HIF1A and promoting ferroptosis.
OBJECTIVE:To investigate the benefits of Traditional Chinese Medicine (TCM) therapy for improving the survival of patients with stage I gastric cancer (GC) and high-risk factors in a real-world setting. METHODS:The clinical data of patients who were diagnosed with stage I GC from March 1, 2012 to October 31, 2020 were collected. Prognostic analysis was performed to explore the high-risk factors that affected the survival of the patients. A Cox multivariate regression model was used to compare the hazard ratios for the mortality risk of patients, especially those with high-risk factors. Kaplan-Meier survival curve and log-rank test were utilized to assess the survival time. RESULTS:Prognostic analysis demonstrated that female sex, tumor invasion into blood vessels, and Ib stage were independent risk factors. The 1-, 3-, and 5-year survival rates of the TCM group those of the non-TCM group were 100.0% 91.0%, 97.6% 64.5%, and 81.4% 55.5%, respectively. A significant difference in median overall survival (mOS) was found between the two groups (χ = 7.670, = 0.006). Subgroup analysis showed that the mOS of female patients and stage Ib patients in the TCM group were longer than those in the non-TCM group ( ≤ 0.001 and 0.001, respectively). CONCLUSIONS:TCM treatment can improve the survival of patients with stage I GC and high-risk factors.
Objective To evaluate the therapeutic effect of Traditional Chinese Medicine (TCM), specifically Fuzheng Qingdu (FZQD) therapy, on the survival time of metastatic GC patients. Patients and Methods Databases of medical records of 6 hospitals showed that 432 patients with stage IV GC were enrolled from March 1, 2012 to October 31, 2020. Propensity score matching (PSM) was used to reduce the bias caused by confounding factors in the comparison between the TCM and the non-TCM users. We used a Cox multivariate regression model to compare the hazard ratio (HR) value for mortality risk, and Kaplan-Meier survival curve for the survival time of GC patients Results The same number of subjects from the non-TCM group were matched with 122 TCM-treated patients after PSM to evaluate their overall survival (OS) and progression-free survival (PFS). Median time of OS of TCM and non-TCM users were 16.53 and 9.10 months, respectively. TCM and non-TCM groups demonstrated a 1-year survival rate of 68.5% and 34.5%, 2-year survival rate of 28.6% and 3.5%, and 3-year survival rate of 17.8% and 0.0%, respectively. A statistical difference exists in OS between the 2 groups (χ 2 = 33.39 and P < .0001). The PFS of TCM users was also longer than that of non-TCM users (χ 2 = 4.95 and P = 0.026). Notably, Chinese herbal decoction, Shenmai and compound Kushen injections were commonly used for FZQD therapy. Conclusion This propensity-matched study showed that FZQD therapy could improve the survival of metastatic GC patients.