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Recent Patents on Anti-Cancer Drug Discovery

Editor-in-Chief

ISSN (Print): 1574-8928
ISSN (Online): 2212-3970

Research Article

The FJQR Has Synergistic Effect with Fluoropyrimidine in the Maintenance Treatment for HER-2 Negative Gastric Cancer

Author(s): Fanming Kong*, Lu Zhao, Na Wang, Dou Zhang, Ziwei Wang, Qingyun Mei, Yongchao Yu and Yingjie Jia

Volume 19, Issue 2, 2024

Published on: 09 June, 2023

Page: [165 - 175] Pages: 11

DOI: 10.2174/1574892818666230522161742

Price: $65

Abstract

Introduction: Maintenance therapy aimed to strengthen the first-line chemotherapy and improve quality of life is needed for gastric cancer (GC). Currently, many clinical studies have confirmed the important role of fluoropyrimidine in the maintenance stage. Our team has created patented prescriptions “Fuzheng jiedu Quyu Method” recipe (FJQR), which was considered as an adjuvant therapeutic scheme (reduce toxicity and increase the efficacy of chemotherapy). This study aimed to evaluate the efficacy and safety of FJQR combined with fluoropyrimidine as a maintenance treatment in HER-2 negative GC patients.

Methods: We performed the analysis of 129 patients with HER-2 negative GC who entered the maintenance stage in our hospital and Tianjin Cancer Hospital between January 2018 and December 2020. Out of the 129 eligible patients, 64 were categorized into the maintenance treatment group with FJQR+fluoropyrimidine, and 65 patients were assigned to the control group if they received fluoropyrimidine alone. Capecitabine was orally 1000mg/m2, Qd, half an hour after meals, and FGQR was 15g Bid after capecitabine. The primary endpoint was progression-free survival (PFS). The secondary endpoints were overall survival (OS), overall remission rate (ORR), quality of Life (QOL), TCM syndrome and safety.

Results: The mPFS in the treatment group was significantly prolonged compared with the control group (6.3 vs. 5.0 months, p = 0.03), while the mOS was not substantially improved (11.4 vs. 10.5 months, p = 0.38). Gastrointestinal symptoms and pain became better in the treatment group. The number of distant metastatic organs, first-line chemotherapy cycles, and lymph node metastasis were independent risk predictors for PFS. Blood stasis syndrome may be the protective factor. In terms of safety, treatment-related adverse events (AEs) in the treatment group were relatively lighter, and the incidence of grade III-IV AEs could be significantly reduced.

Conclusion: FJQR and fluoropyrimidine have synergistic effects as maintenance treatment in HER-2 negative GC, with good efficacy and safety.

[1]
Siegel RL, Miller KD, Fuchs HE, Jemal A. Cancer statistics, 2022. CA Cancer J Clin 2022; 72(1): 7-33.
[http://dx.doi.org/10.3322/caac.21708] [PMID: 35020204]
[2]
Xia C, Dong X, Li H, et al. Cancer statistics in China and United States, 2022: Profiles, trends, and determinants. Chin Med J 2022; 135(5): 584-90.
[http://dx.doi.org/10.1097/CM9.0000000000002108] [PMID: 35143424]
[3]
Chang C, Pei Y, Xu J, Zhang W, Zhang J, Shi S. The full management from first-line to third-line treatments in patients with Her-2–negative advanced gastric cancer. Front Oncol 2022; 12: 949941.
[http://dx.doi.org/10.3389/fonc.2022.949941] [PMID: 36457494]
[4]
Joshi SS, Badgwell BD. Current treatment and recent progress in gastric cancer. CA Cancer J Clin 2021; 71(3): 264-79.
[http://dx.doi.org/10.3322/caac.21657] [PMID: 33592120]
[5]
Zhu Y, Zhu X, Wei X, Tang C, Zhang W. HER2-targeted therapies in gastric cancer. Biochim Biophys Acta Rev Cancer 2021; 1876(1): 188549.
[http://dx.doi.org/10.1016/j.bbcan.2021.188549] [PMID: 33894300]
[6]
Kawakami H, Fujitani K, Matsuyama J, et al. Comparison of S-1–cisplatin every 5 weeks with capecitabine-cisplatin every 3 weeks for HER2-negative gastric cancer (recurrent after S-1 adjuvant therapy or chemotherapy-naïve advanced): Pooled analysis of HERBIS-2 (OGSG 1103) and HERBIS-4A (OGSG 1105) trials. Int J Clin Oncol 2020; 25(9): 1635-43.
[http://dx.doi.org/10.1007/s10147-020-01711-z] [PMID: 32494981]
[7]
Takahari D, Chin K, Yamaguchi K. Upcoming first-line chemotherapy for HER2-negative gastric cancer in Japan: Which patients benefit from immunotherapy? Future Oncol 2020; 16(24): 1797-9.
[http://dx.doi.org/10.2217/fon-2020-0421] [PMID: 32539457]
[8]
Zhou C, Feng X, Yuan F, et al. Difference of molecular alterations in HER2-positive and HER2-negative gastric cancers by whole-genome sequencing analysis. Cancer Manag Res 2018; 10: 3945-54.
[http://dx.doi.org/10.2147/CMAR.S172710] [PMID: 30310315]
[9]
Wagner AD, Syn NL, Moehler M, et al. Chemotherapy for advanced gastric cancer. Cochrane Database Syst Rev 2017; 8(8): CD004064.
[PMID: 28850174]
[10]
Kang YK, Chen LT, Ryu MH, et al. Nivolumab plus chemotherapy versus placebo plus chemotherapy in patients with HER2-negative, untreated, unresectable advanced or recurrent gastric or gastro-oesophageal junction cancer (ATTRACTION-4): A randomised, multicentre, double-blind, placebo-controlled, phase 3 trial. Lancet Oncol 2022; 23(2): 234-47.
[http://dx.doi.org/10.1016/S1470-2045(21)00692-6] [PMID: 35030335]
[11]
Gridelli C, de Marinis F, Pujol JL, et al. Safety, resource use, and quality of life in paramount: A phase III study of maintenance pemetrexed versus placebo after induction pemetrexed plus cisplatin for advanced nonsquamous non-small-cell lung cancer. J Thorac Oncol 2012; 7(11): 1713-21.
[http://dx.doi.org/10.1097/JTO.0b013e318267cf84]
[12]
Modest DP, Karthaus M, Fruehauf S, et al. Panitumumab plus fluorouracil and folinic acid versus fluorouracil and folinic acid alone as maintenance therapy in RAS Wild-Type metastatic colorectal cancer: The randomized PANAMA trial (AIO KRK 0212). J Clin Oncol 2022; 40(1): 72-82.
[http://dx.doi.org/10.1200/JCO.21.01332] [PMID: 34533973]
[13]
Esin E, Yalcin S. Maintenance strategy in metastatic colorectal cancer: A systematic review. Cancer Treat Rev 2016; 42: 82-90.
[http://dx.doi.org/10.1016/j.ctrv.2015.10.012] [PMID: 26608114]
[14]
Roviello G, Rodriquenz MG, Aprile G, et al. Maintenance in gastric cancer: New life for an old issue? Crit Rev Oncol Hematol 2021; 160: 103307.
[http://dx.doi.org/10.1016/j.critrevonc.2021.103307] [PMID: 33753249]
[15]
Arslan C, Atilla FD. Modified docetaxel, cisplatin, and 5-fluorouracil combination regimen and capecitabine maintenance in metastatic gastric cancer: Toxicity and efficacy results. Support Care Cancer 2022; 30(5): 4447-55.
[16]
Li J, Niu J, Yang M, et al. Using single-patient (n-of-1) trials to determine effectiveness of traditional Chinese medicine on chemotherapy-induced leukopenia in gastric cancer: A feasibility study. Ann Transl Med 2019; 7(6): 124.
[http://dx.doi.org/10.21037/atm.2019.02.03] [PMID: 31032279]
[17]
Qi F, Zhao L, Zhou A, et al. The advantages of using traditional Chinese medicine as an adjunctive therapy in the whole course of cancer treatment instead of only terminal stage of cancer. Biosci Trends 2015; 9(1): 16-34.
[http://dx.doi.org/10.5582/bst.2015.01019] [PMID: 25787906]
[18]
Hong XC, Liang QL, Luo XB, et al. Clinical study of XiangShaLiuJunZi decoction combined with S-1 as maintenance therapy for stage III or IV gastric carcinoma and colorectal carcinoma. Medicine 2020; 99(19): e20081.
[http://dx.doi.org/10.1097/MD.0000000000020081] [PMID: 32384478]
[19]
Yang X, Feng Y, Liu Y, et al. Fuzheng Jiedu Xiaoji formulation inhibits hepatocellular carcinoma progression in patients by targeting the AKT/CyclinD1/p21/p27 pathway. Phytomedicine 2021; 87: 153575.
[http://dx.doi.org/10.1016/j.phymed.2021.153575] [PMID: 33984593]
[20]
Xu H, Li M, Wang C, et al. Evaluation on clinical efficacy of Fuzheng Jiedu Huayu Decoction combined with antibiotics in the treatment of pneumonia in the elderly – A multi-center, double-blind, parallel, randomized controlled trial. Complement Ther Med 2018; 37: 127-32.
[http://dx.doi.org/10.1016/j.ctim.2017.11.012] [PMID: 29609923]
[21]
Yan F, Wang X, Xie Y, et al. Yangyin Fuzheng Jiedu Prescription exerts anti-tumor immunity in hepatocellular carcinoma by alleviating exhausted T cells. Phytomedicine 2021; 91: 153722.
[http://dx.doi.org/10.1016/j.phymed.2021.153722] [PMID: 34488188]
[22]
Yang H, Li H, Lu S, Shan S, Guo Y. Fuzheng Jiedu Decoction induces Apoptosis and enhances Cisplatin Efficacy in Ovarian Cancer Cells In Vitro and In Vivo through Inhibiting the PI3K/AKT/mTOR/NF-κB Signaling Pathway. BioMed Res Int 2022; 2022: 1-18.
[http://dx.doi.org/10.1155/2022/5739909] [PMID: 35281608]
[23]
Yao Y, Deng R, Liao D, et al. Maintenance treatment in advanced HER2-negative gastric cancer. Clin Transl Oncol 2020; 22(12): 2206-12.
[http://dx.doi.org/10.1007/s12094-020-02379-7]
[24]
Zavros Y. Initiation and maintenance of gastric cancer: A focus on CD44 variant isoforms and cancer stem cells. Cell Mol Gastroenterol Hepatol 2017; 4(1): 55-63.
[http://dx.doi.org/10.1016/j.jcmgh.2017.03.003] [PMID: 28560289]
[25]
Petrioli R, Francini E, Roviello F, et al. Treatment of advanced oesophagogastric cancer with FOLFOX-4 regimen followed by leucovorin/bolus and continuous infusion 5-FU as maintenance chemotherapy in patients aged ≥75years with impaired performance status. J Geriatr Oncol 2015; 6(5): 380-6.
[http://dx.doi.org/10.1016/j.jgo.2015.06.002] [PMID: 26228711]
[26]
Moehler M, Dvorkin M, Boku N, et al. Phase III trial of Avelumab maintenance after First-Line induction chemotherapy versus continuation of chemotherapy in patients with gastric cancers: Results from JAVELIN gastric 100. J Clin Oncol 2021; 39(9): 966-77.
[http://dx.doi.org/10.1200/JCO.20.00892] [PMID: 33197226]
[27]
Di Bartolomeo M, Niger M, Morano F, et al. Assessment of Ramucirumab plus paclitaxel as switch maintenance versus continuation of first-line chemotherapy in patients with advanced HER-2 negative gastric or gastroesophageal junction cancers: The ARMANI phase III trial. BMC Cancer 2019; 19(1): 283.
[http://dx.doi.org/10.1186/s12885-019-5498-3] [PMID: 30922323]
[28]
Wang M, Jiang H, Zhang M, Chen Y, Wang T, Li P. “Highly Exposed Chinese Herbal Medicine” combined With Apatinib as maintenance treatment following first-line or second-line chemotherapy for extensive-stage small-cell lung cancer: A single-arm, prospective study. Dose Response 2021; 19(4)
[http://dx.doi.org/10.1177/15593258211055016] [PMID: 34790081]
[29]
Yang L, Zhao L, Zeng T, et al. Mechanisms underlying therapeutic effects of traditional chinese medicine on gastric cancer. Cancer Manag Res 2019; 11: 8407-18.
[http://dx.doi.org/10.2147/CMAR.S218214] [PMID: 31571996]
[30]
Wang Z, Qi F, Cui Y, et al. An update on Chinese herbal medicines as adjuvant treatment of anticancer therapeutics. Biosci Trends 2018; 12(3): 220-39.
[http://dx.doi.org/10.5582/bst.2018.01144] [PMID: 30012913]

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