Efficacy of Modified Peanut Skin Decoction for Lung Cancer Myelosuppression

This study conducted a randomized controlled trial to assess the efficacy and safety of modified Peanut Skin Decoction (PSD) for preventing myelosuppression in 60 patients with advanced squamous cell lung carcinoma receiving chemotherapy plus immunotherapy. Patients were randomised 1:1 to receive either standard supportive care granulocyte colony-stimulating factor (5 µg/kg) or supplemented by modified PSD as needed. Primary endpoints included white blood cell count, neutrophil count, haemoglobin level, platelet count, and World Health Organization Quality of Life Brief Version (WHOQOL-BREF) questionnaire scores measured on days 4, 8, 12, and 20. Secondary endpoints were onset time, duration, and recovery of grade III-IV myelosuppression, cumulative blood transfusion volumes, and adverse event rates. The results showed that PSD significantly delayed the onset of grade III-IV myelosuppression (5.63 ± 1.10 vs. 4.10 ± 1.24 days; p < 0.001) and shortened its duration (7.07 ± 1.72 vs. 9.97 ± 1.16 days; p < 0.001), while improving WHOQOL-BREF scores without increasing adverse event rates. Network pharmacology revealed that key active components target interleukin-6, tumour necrosis factor, and vascular endothelial growth factor A via the phosphoinositide 3-kinase-protein kinase B and hypoxia-inducible factor-1 signalling pathways, underpinning PSD's protective effects against myelosuppression. Overall, PSD effectively mitigates chemotherapy-induced myelosuppression and enhances patient quality of life.