Research Progress on the Mechanism Exploration and Clinical Application of Traditional Chinese Medicine in Treating Non-Small Cell Lung Cancer

Abstract

Lung cancer is the malignant tumor with the highest incidence and mortality in China, among which non-small cell lung cancer (NSCLC) occupies a dominant position. Traditional therapies such as chemotherapy, radiotherapy and targeted therapy have limitations including drug resistance, systemic toxicity and poor selectivity. However, traditional Chinese medicine (TCM) has shown unique advantages in NSCLC treatment through a multi-target synergistic mechanism: active ingredients of TCM (such as polysaccharides, alkaloids, flavonoids) can block the tumor cell cycle, induce apoptosis and inhibit angiogenesis; compound preparations regulate immune function and inhibit metastasis and recurrence through syndrome differentiation and treatment. In the field of combined therapy, the combination of TCM and chemotherapy can enhance the tumor suppressive effect, reduce bone marrow suppression and digestive tract reactions, and significantly improve patients' quality of life; the combination with radiotherapy can sensitize the anti-tumor effect while alleviating adverse reactions such as radiation-induced lung injury and dermatitis; the combination with targeted drugs can delay the occurrence of drug resistance and reduce toxic and side effects. In summary, TCM, through multi-channel intervention in the tumor microenvironment and signaling pathways, has the dual value of enhancing efficacy and reducing toxicity in direct anti-tumor and auxiliary traditional therapies, providing a new strategy for the comprehensive treatment of NSCLC. In the future, it is necessary to deeply explore its molecular mechanisms and promote standardized clinical research. According to the 2022 Global Cancer Statistics Report jointly released by the International Agency for Research on Cancer and the National Cancer Center of China, lung cancer ranks first in the incidence of malignant tumors in China with 106.06 thousand new cases, accounting for 42.7% of the total number of lung cancer cases worldwide. Meanwhile, its number of fatal cases (51.9 cases per 100,000 people) also ranks first in the spectrum of cancer deaths in China. It is mainly divided into two categories: small cell lung cancer and non-small cell lung cancer. NSCLC accounts for 80%-85% of lung cancer cases and is further subdivided into four subtypes: lung adenocarcinoma, lung squamous cell carcinoma, large cell carcinoma and bronchial carcinoid. Among them, lung adenocarcinoma is the most common subtype of NSCLC, accounting for more than 40% of all lung cancer cases. In traditional lung cancer treatment research, methods such as chemotherapy, radiotherapy and targeted therapy are often used in combination with first-line drugs to treat non-small cell lung cancer. However, radiotherapy has the defect of multiple adverse reactions such as increased dosage causing physical discomfort; chemotherapy also has the defect of no selectivity, which can also eliminate normal cells; patients receiving targeted therapy often develop drug resistance. Therefore, we are in urgent need of new methods for the treatment of non-small cell lung cancer. TCM has unique advantages in the prevention and treatment of NSCLC, with definite efficacy and few side effects in the treatment of lung cancer. It exerts synergistic effects through multiple targets and multiple pathways, which can make up for the deficiencies in drug resistance of first-line drugs such as targeted chemotherapy, and has significant efficacy in reducing the high metastasis and recurrence rate of NSCLC, improving patients' clinical symptoms and radiotherapy side effects. In recent years, under the new model of advocating multi-disciplinary combined diagnosis and treatment of malignant tumors, a large number of clinical studies on the combined application of TCM and chemotherapy in non-small cell lung cancer have been initiated. This article reviews the relevant studies on TCM active ingredient monomers and TCM compound preparations in the treatment of NSCLC in recent years, and provides a reference for the research and clinical application of TCM against NSCLC.