Effectiveness and safety of Pingxiao capsule ((sic)) as adjuvant therapy in treatment of breast cancer: a systematic review and Meta-analysis

OBJECTIVE: To systematically review the effectiveness and safety of Pingxiao capsule ((sic)) adjuvant chemotherapy in the treatment of breast cancer. METHODS: A total of 8 databases including the Cochrane Library, PubMed, EMBASE, Engineering Index, Chinese Biomedical Literature Database, Wanfang database, China National Knowledge Infrastructure Database, and China Science and Technology Journal Database were searched for the Randomized Controlled Trials (RCTs) of Pingxiao capsule combined with chemotherapy in the treatment of breast cancer published before June 2022. Two researchers independently screened the literature, extracted data, and evaluated the risk of bias. R language was used for estimating risks of bias of included studies, data analysis, and plotting. RESULTS: A total of 15 RCTs involving 1272 patients were included in this study. Meta-analysis results indicated that compared with chemotherapy alone, Pingxiao capsule combined with chemotherapy could significantly improve breast cancer patients' objective response rate of breast cancer patients [rate ratio (RR) = 1.35, 95% confidence interval (CI) (1.12, 1.63), P = 0.0017], the disease control rate [RR=1.16, 95% CI (1.08, 1.25), P < 0.0001], the quality of life [RR =1.42, 95% CI (1.16, 1.74), P = 0.007], and the level of the immune cells [CD3+: standardized mean difference (SMD) =1.42, 95% CI (0.76, 2.09), P < 0.001; CD4+: SMD =1.18, 95% CI (0.70, 1.66), P < 0.001]. In addition, Pingxiao capsule combined with chemotherapy can also significantly reduce CD8+ level (P < 0.0001) and reduce the symptoms of decreased white blood cell count [SMD = 0.62, 95% CI (0.39, 0.85), P < 0.0001], and the occurrence of adverse reactions such as gastrointestinal adverse reactions and limb pain (P < 0.05). CONCLUSIONS: Pingxiao capsule can significantly improve the efficacy of chemotherapy, the quality of life and immune function of patients, and reduce the clinical side effects caused by chemotherapy. However, high-quality randomized clinical trials with large samples are required for further verification of these results. (c) 2023 JTCM. All rights reserved.