Review Article

Antitumor Activities of Kushen: Literature Review

Table 1

Clinical trials using compound kushen injection.

Dose and course of treatmentCombined medicationCase/controlCancer typeIndications and symptomsEfficacyPositive controlSide effectReference

11,000–1,500 mg + GS 500 mL, i.v., q.d., 30–45 daysNo68/37Gastric cancerFever, pain, GI reactions, ascitesReliefMMC + UFTAbdominal distention, constipation[11]

21,000–1,500 mg + GS 500 mL, i.v., q.d., 30 days, total dose of 30–45 gNo44HepatocarcinomaEvaluation of curative effect, immune effect, toxic effectEffective treatment, reduction in tumor size, improvement in symptoms and signs, improvement in immune functionNoNausea[14]

330 mL + GS 250 mL, i.v., q.d., 10 daysHydroxycamptothecin20/20Hepatocellular carcinomaRecurrence rateHCPT and CKI postoperative arterial infusion may be helpful for reducing intrahepatic recurrence after curative resection for HCCPDD and 5-FUNo[15]

41,000 mg + GS 500 mL, i.v., q.d., 30 days Carboplatin or 5-FU21Malignant ascitesEvaluation of curative effect (ascites)Lessening of ascites Carboplatin or 5-FUAbdominal distention[16]

5 50 mL intrapleural injection or 100 mL peritoneal injection, b.i.w., 3 weeksDexamethasone24Virulent succus inside the thorax and belly: lung cancer, breast cancer, ovarian cancerAscitesLessening of ascites, effective rate (CR and PR) 68.8%NoMild abdominal pain[17]

61,000 mg + GS 500 mL, i.v., q.d., 30 days, 2–4 cyclesMVP/FAM/CAF/FP65/61Malignant tumor: lung, esophageal, liver, gastric, breast, colon, nasopharyngealToxic effect, QoLImprovement in QoL, reduce the toxic effects (leukopenia, GI reactions) of chemotherapyMVP/FAM/CAF/FPNo[18]

712–15 mL + NS 250 mL, i.v., q.d., 10 daysNo52/52Malignant tumor: lung, breast, gastric, esophageal, colorectal, pancreaticPainPain reliefSustained-release indomethacin or tramadol hydrochlorideNo[19]

815 mL + NaCl 250 mL, i.v., q.d., for 12 daysFentanyl31/31Advanced cancer: gastric, esophageal, breastPainPain relief and KPS better than fentanyl, 𝑃 < 0 . 0 5 Fentanyl aloneNo[20]

920 mL + NaCl 250 mL, i.v., q.d., for 14 days, 3 cyclesOxaliplatin and capecitabine36/30Advanced gastric cancer in senile subjectsKPS; toxic effectKPS better than oxaliplatin and capecitabine, 𝑃 < 0 . 0 5 ; CKI has a low incidence rate for leukopenia, pain and hepatotoxicity, 𝑃 < 0 . 0 5 Oxaliplatin and capecitabineNo[21]

1020 mL, i.v., q.d., 10–14 daysChemotherapy: CAVP or CAP61/60Lung cancerImmuneImprovement in immune functionChemotherapy: CAVP or CAPNo[22]

1130 mL + NaCl 250 mL, i.v., q.d., 7 daysTaxol and epirubicin34/34Breast cancerImmuneImprovement in immune functionTaxol and epirubicinNo[23]

1220 mL + GS/NaCl 250 mL, i.v., q.d., 14 days, 2 cyclesTACE (5-FU 1,000–2,000 mg, MMC 10–20 mg, EP I60–100 mg)27/23Liver cancerKPS; toxic effectKPS better than TACE, 𝑃 < 0 . 0 5 ; The incidence rate of nausea and vomiting hepatotoxicity were significantly lower than for TACE chemotherapy, 𝑃 < 0 . 0 5 TACENo[24]

1330 mL + GS/NaCl 250 mL, i.v., q.d., 10 days, 4 cyclesFOLRIRI chemotherapy50/50Advanced colorectal cancerPain, toxic effect, KPSPain relief, reduced toxic effect (leukopenia, GI reactions, hepatotoxicity and renal toxicity) of FOLFIRI chemotherapy; improved QoLFOLRIRI chemotherapyNo[25]

1420 mL, i.v., q.d., 14 days, 3 cyclesRadiotherapy33/33Cervical cancerEvaluation of curative effect, KPS, immune toxic effectImprove therapeutic effects, QoL, immune function; attenuate myelosuppressionRadiotherapy aloneNo[26]

1510 mL + NaCl 250 mL i.v. q.d. 10 daysDA/TA/MA chemotherapy35/35AMLKPS, hematotoxicityImprove QoL; attenuate hematotoxicity (leukopenia) of chemotherapyDA/TA/MA chemotherapyNo[27]

1620 mL intrapleural injection; keep 48 h q2W and 20 mL + 100 mL NaCl, i.v., q.d., 4 weeksNo32/32Malignant pleural effusionKPS, evaluation of curative effect, toxic effectImprove QoL and therapeutic effects; reduce toxic effectsCisplatinNo[28]

17100 mL, i.v. b.i.d., 10 daysGastric cancer: TPF chemotherapy; colorectal cancer: FOLFOX or FOLFRI chemotherapy; breast cancer: TA or CAF chemotherapy; lung cancer: GP/TP/NP chemotherapy83/83Malignant tumors: gastric, lung, colorectal, breastHepatotoxicityCKI can effectively prevent hepatic injury caused by chemotherapy (incidence and degree of hepatic injuries)Chemotherapy: gastric cancer: TPF; colorectal cancer FOLFOX or FOLFRI; breast cancer: TA or CAF; lung cancer GP/TP/NPNo[29]

1820 mL + NaCl 250 mL, i.v., q.d., 21 days, 2 cyclesFOLFOX4 chemotherapy27/21Gastric cancerToxic effectIncidence rate of alopecia lower than for FOLFOX4 chemotherapy, 𝑃 < 0 . 0 5 .FOLFOX4 chemotherapyNo[30]

1920 mL + NaCl 200 mL, i.v., q.d., 14 days, 2 cyclesFOLFX chemotherapy30/30Gastric cancerToxic effect, QoL, symptomsPromote reduction of symptoms, reduce chemotherapy side effects (alopecia, leukopenia, thrombocytopenia, GI reactions), improve QoL and prolong median survival timeFOLFX chemotherapyNo[31]

2020 mL in NaCl 250 mL, i.v., q.d., for 3-4 weeks, 2-3 cyclesChemotherapy and radiotherapy75/75Mid-late-stage cancer: lung, breast, esophageal, nasopharyngeal, colorectal, pancreatic, ovarianImmune, CBR, KPS, toxic effectImprovement in immune function, increase the CBR and QoL and reduce adverse reactions of chemotherapy in patients with midlate-stage cancer.Chemotherapy and radiotherapy (lung cancer: NP/GP/TP + radiotherapy; breast cancer: CAF/TA + radiotherapy: esophageal cancer: PF + radiotherapy; nasopharyngeal carcinoma: DDP + radiotherapy; colorectal cancer: oxaliplatin + 5FU + CF/oxaliplatin + xeloda; pancreatic cancer: GP; ovarian cancer: CAP/TP)No[32]

AML: acute myeloid leukemia; CAF: cyclophosphamide, adriamycin, and fluorouracil; CAP: cyclophosphamide, doxorubicin, and cisplatin; CAVP: cyclophosphamide, doxorubicin, and etoposide; CBR: clinical benefit rate; CF: calcium 5-formyletrahydrofolate; CR: complete remission; DA: daunorubicin and cytarabine; DDP: cisplatin; FAM: fluorouracil, adriamycin, and mitomycin; FOLFOX: oxaliplatin, calcium folinate, and fluorouracil; FOLFOX4: oxaliplatin, calcium folinate and fluorouracil; fOLFRI: irinotecan, calcium folinate and fluorouracil; FOLFX: oxaliplatin, calcium folinate and fluorouracil; FOLRIRI: leucovorin, fluorouracil, and irinotecan; FP: fluorouracil and cisplatin; 5-FU: fluorouracil; GI: gastrointestinal; GP: gemcitabine and cisplatin; HCC: hepatocellular carcinoma; HCPT: hydroxycamptothecin; KPS: karnofsky performance scale; MA: mitoxantrone and cytarabine; MMC: mitomycin; MVP: mitomycin, vinblastine, and cisplatin; NP: vinorelbine and cisplatin; PDD: cisplatin; PR: partial remission; QoL: quality-of-life; TA: paclitaxel and epirubicin; TA(9): pirarubicin and cytarabine; TACE: fluorouracil, mitomycin, and epirubicin; TP: paclitaxel and cisplatin; TPF: paclitaxel, fluorouracil, and cisplatin; UFT: Tegafur-Uracil.