How Traditional Chinese Medicine May Help Improve Targeted Therapy for Lung Cancer

 Tiejun Tang

Lung cancer is one of the most common cancers worldwide. The most common type is non-small cell lung cancer (NSCLC).

In recent years, major progress has been made in the treatment of NSCLC through targeted therapy. These medicines are designed to block specific genetic changes that help cancer cells grow.

One of the most important targets is the epidermal growth factor receptor (EGFR) gene. Many patients with NSCLC have mutations in this gene. Drugs that block EGFR can slow the growth of cancer cells and significantly improve outcomes for these patients.

Common EGFR-targeted drugs include: Gefitinib, Erlotinib, Osimertinib

These medications have greatly improved treatment results. However, there are still important challenges.

Most patients eventually develop drug resistance, meaning the cancer begins to grow again despite treatment. This usually happens after 8–16 months of therapy ^[1]. In addition, some patients experience treatment-related side effects. Because of these limitations, researchers are exploring new strategies to improve treatment outcomes. One promising approach is the integration of Traditional Chinese Medicine (TCM) with modern targeted therapy.

Traditional Chinese Medicine has been used for thousands of years and includes treatments such as:

Chinese herbal medicine, Acupuncture, Dietary therapy, Lifestyle regulation.  Unlike many modern drugs that act on a single biological target, Chinese herbal formulas contain multiple active compounds that can influence several biological pathways at the same time.

Because of this multi-target effect, researchers believe that TCM may help:

• enhance the effectiveness of cancer treatments
• reduce treatment side effects
• support immune function
• improve overall quality of life

In recent years, increasing scientific research has begun to explore how TCM may work together with targeted cancer therapies ^[2,3].

How Chinese Herbal Medicine May Support Targeted Therapy

Researchers have identified several possible mechanisms through which Chinese herbal medicine may enhance the effects of EGFR-targeted therapy.

1. Improving the Sensitivity of Cancer Cells to Targeted Drugs

Some natural compounds appear to make cancer cells more sensitive to targeted therapy.

For example, studies have shown that shikonin, a compound derived from traditional medicinal plants, may enhance the anti-tumor effect of Gefitinib. Laboratory studies suggest that it works by blocking key cancer growth signals inside the cell ^[4].

2. Blocking Additional Cancer Growth Pathways

Cancer cells often use multiple signaling pathways to survive. Some herbal compounds may help block these pathways.

One well-known compound is curcumin, a natural substance found in turmeric. Research suggests that curcumin can:

• slow cancer cell growth
• promote cancer cell death
• reduce activation of EGFR signaling
• reduce certain digestive side effects associated with targeted therapy ^[5]

Another compound, Astragaloside IV, extracted from the traditional herb Astragalus (Huangqi), has also demonstrated anti-cancer activity in laboratory studies. It appears to slow the growth and spread of lung cancer cells and promote cancer cell death through specific cellular pathways ^[6].

A further natural compound, resveratrol, derived from Polygonum cuspidatum (Huzhang), has also shown anti-tumor effects in lung cancer cells by influencing proteins involved in cell survival and apoptosis ^[7].

3. Supporting the Immune System

Cancer develops within a complex biological environment known as the tumor microenvironment. This environment includes immune cells, signaling molecules, and surrounding tissues that interact with cancer cells.

Some Chinese herbal formulas may influence this environment and help regulate immune responses.

For example, a traditional formula known as Fei Liu Ping has been shown in experimental studies to affect immune regulation within tumors. Research suggests it may reduce certain immune cells that suppress anti-tumor immunity, potentially helping the body better fight cancer ^[8].

Clinical Evidence for Combining TCM with Targeted Therapy

In addition to laboratory research, several clinical studies have examined whether Chinese medicine can improve outcomes when used alongside EGFR-targeted therapy.

One large randomized clinical trial involving 354 patients with advanced lung adenocarcinoma compared two groups:

• patients receiving EGFR-targeted therapy plus Chinese herbal medicine
• patients receiving EGFR-targeted therapy plus placebo

The study found that patients who received herbal treatment experienced:

• longer progression-free survival (their cancer remained stable for longer)
• higher treatment response rates
• better quality of life
• fewer mild treatment-related side effects ^[9]

Another analysis combining 13 clinical trials involving 899 patients found that several Chinese herbal injections used together with EGFR-targeted therapy improved treatment response rates compared with targeted therapy alone ^[10].

These findings suggest that integrative approaches may provide additional benefits for some patients.

Why Integrative Medicine May Be Beneficial

Traditional Chinese Medicine takes a holistic approach to health, focusing on restoring balance within the body and strengthening the body's resistance to disease.

When used alongside modern cancer treatments, TCM may help:

• support the immune system
• improve treatment tolerance
• reduce side effects
• enhance overall wellbeing

However, it is important to emphasize that TCM should not replace standard cancer treatments. Instead, it may be used as a complementary therapy under professional supervision.

The Need for Further Research

Although current research is encouraging, more high-quality studies are still needed.

Future research should focus on:

• identifying the most effective herbal formulas
• understanding how herbal compounds interact with targeted drugs
• establishing optimal integrative treatment protocols
• confirming long-term safety and effectiveness

Large, well-designed clinical trials will help clarify the role of Traditional Chinese Medicine in modern cancer care.

Conclusion

Targeted therapies have significantly improved the treatment of non-small cell lung cancer, particularly for patients with EGFR mutations. At the same time, growing evidence suggests that Traditional Chinese Medicine may enhance the effectiveness of these treatments while improving patient wellbeing.

Integrating carefully selected Chinese medicine therapies with modern targeted treatments may represent a promising approach for improving outcomes in patients with lung cancer.

Patients interested in this approach should always consult qualified healthcare professionals experienced in both oncology and Traditional Chinese Medicine.

References

1. Absenger G. Resistance to epidermal growth factor receptor tyrosine kinase inhibitors in mutated non-small cell lung cancer. MEMO. 2019;12:128-135.
2. Tang M, Wang S, Zhao B, et al. Traditional Chinese Medicine prolongs progression-free survival in EGFR-TKI treated NSCLC patients. Med Sci Monit. 2019;25:8430-8437.
3. Wang Y, Wu G, Li R, et al. Chinese medicine combined with EGFR-TKIs prolongs survival in NSCLC patients with EGFR mutations. Front Public Health. 2021;9:677862.
4. Tang J, Ren Y, Zhao J, et al. Shikonin enhances sensitization of gefitinib against NSCLC via inhibition of PKM2/STAT3/cyclin D1 pathway. Life Sci. 2018;204:71-77.
5. Lee J, Lee Y, Chang G, et al. Curcumin induces EGFR degradation and enhances gefitinib therapy. PLoS One. 2011;6:e23756.
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