Clinical efficacy and safety evaluation of traditional Chinese medicine for nourishing yin and Replenishing qi in combination with PD-1/PD-L1 inhibitors in the treatment of NSCLC patients: a meta-analysis

To examine the therapeutic effectiveness and safety of traditional Chinese medicine in conjunction with PD-1/PD-L1 inhibitors for nourishing yin and replenishing qi in patients with non-small cell lung cancer. A systematic search was conducted across seven electronic databases, namely PubMed, Cochrane Library, Excerpt Medica Database, Web of Science, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, and Wan-fang Database, to identify eligible studies from 2,000 to 2,023. This study includes a total of 14 randomized controlled clinical trials, with 514 patients in the TCM combo therapy group and 506 patients in the control group. The meta-analysis demonstrated the efficacy of combining TCM in oral and injectable forms with PD-1/PD-L1 inhibitors, with or without chemotherapy, in enhancing objective response rate, disease control rate, and quality of life in patients with NSCLC. Additionally, this combination therapy improved the proportion of CD3 + T cells and CD4 + T cells, as well as the ratio of CD4+/CD8 + T lymphocytes. The group receiving combined treatment with TCM successfully decreased the expression of the tumor marker CYFRA21-1. The group receiving combination therapy with TCM decreased the probability of experiencing adverse effects such as nausea, leukopenia, thrombocytopenia, and exhaustion in patients. Additionally, this treatment did not place additional strain on the liver and kidney functions. The integration of TCM techniques that nourishing yin and replenishing qi with PD-1/PD-L1 inhibitors greatly enhances the clinical effectiveness and safety of treating NSCLC. Additionally, the combination of Chinese and Western drugs improves the efficacy of neoadjuvant chemotherapy in NSCLC patients.