title: [Effect of traditional Chinese medicine treatment as maintenance therapy on regulating the serum concentration of sCTLA-4 in patients with advanced non-small-cell lung cancer and its relationship with prognosis].
abstract: Objective:To evaluate the effect of traditional Chinese medicine (TCM) treatment as maintenance therapy on regulating the serum concentration of soluble cytotoxic T lymphocyte associated antigen-4 (sCTLA-4) in patients with advanced non-small-cell lung cancer (NSCLC) and the relationship between sCTLA-4 and time to progression (TTP).Methods:This study was conducted as a prospective, randomized, controlled trial. 64 non-progressive patients who responded to initial therapy were randomized 1∶1 to the TCM arm (treated with cinobufacini injection, herbal decoction and Chinese acupoint application,n=32) or to the chemotherapy arm (n=32). Each cycle was 21 days. Cycles were repeated until disease progression, unacceptable toxicity, or until the patient requested therapy discontinuation.The serum concentration of sCTLA-4 was detected by enzyme linked immunosorbent assay (ELISA) in the 64 patients with advanced NSCLC before and after two cycles of maintenance treatment. Cox regression was used to analyze the relative ratio for the risk of disease progression.Results:After 2 cycles of maintenance TCM treatment, the serum concentration of sCTLA-4 in patients with advanced NSCLC was (12.77±2.37 pg/ml), significantly lower than that before treatment (40.30±10.75)(P=0.013). After 2 cycles of maintenance chemotherapy, the serum concentration of sCTLA-4 was higher than that before treatment, but was not significantly different (44.48±10.12 vs. 46.64±11.21 pg/ml,P=0.612). After 2 cycles of maintenance treatment, TCM treatment can significantly bring down the serum concentration of sCTLA-4 compared to chemotherapy (12.77±2.37 vs. 46.64±11.21 pg/ml,P=0.004). The multivariate analysis indicated that sCTLA-4 levels and treatment regimen were independent prognostic factors for TTP (P<0.05 for both).Conclusions:Regulating the serum concentration of sCTLA-4 may be one of the mechanisms of TCM maintenance treatment of NSCLC. Trial registration Chinese Clinical Trial Register, ChiCTR-TRC-10001017.
authors: Department of Oncology, Longhua Hospital affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China.
authors: Y
authors: Y
authors: Jiang
authors: Department of Rehabilitation, E Mei Shan Hospital of Traditional Chinese Medicine, Emeishan 614200, China.
authors: L B
authors: LB
authors: Wu
authors: Department of Oncology, Longhua Hospital affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China.
authors: L P
authors: LP
authors: Shen
authors: Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China.
authors: P
authors: P
authors: Zhang
authors: Department of Central Laboratory, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China.
authors: W J
authors: WJ
authors: Jiang
authors: Oncology Institute of Traditional Chinese Medicine, Shanghai Research Institute of Traditional Chinese Medicine, Shanghai 200032, China.
authors: J H
authors: JH
authors: Tian
authors: Department of Oncology, Longhua Hospital affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China.
authors: L S
authors: LS
authors: Liu
mesh_terms: D015669:Acupuncture Points; D000368:Aged; D000664:Amphibian Venoms / Q000627:therapeutic use*; D000951:Antigens, Neoplasm / Q000097:blood; D060908:CTLA-4 Antigen / Q000097:blood*; D002289:Carcinoma, Non-Small-Cell Lung / Q000097:blood / Q000188:drug therapy*; D003131:Combined Modality Therapy / Q000379:methods; D018450:Disease Progression; D004365:Drugs, Chinese Herbal; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000097:blood / Q000188:drug therapy*; D060046:Maintenance Chemotherapy / Q000379:methods*; D008297:Male; D008516:Medicine, Chinese Traditional; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000097:blood; D008517:Phytotherapy; D011379:Prognosis; D011446:Prospective Studies
chemical_list: D000664:Amphibian Venoms; D000951:Antigens, Neoplasm; D060908:CTLA-4 Antigen; C556706:CTLA4 protein, human; D004365:Drugs, Chinese Herbal; D009363:Neoplasm Proteins; C545813:huachansu