Compounds and monomeric active ingredients of resolving phlegm and removing stasis therapy (RPST) for the treatment of non-small cell lung cancer: A comprehensive review.

ETHNOPHARMACOLOGICAL RELEVANCE: Non-small cell lung cancer (NSCLC) is the most common pathological type of lung cancer, accounting for approximately 85 %. Modern medical treatments are confronted with challenges such as drug resistance and poor patient tolerance. As a treasure of traditional Chinese medicine (TCM) in China, characterized by multi-component, multi-target and multi-channel, TCM shows direct anti-tumor effects and enhances immune function. Syndrome differentiation and treatment is an important core idea of TCM. In the TCM theoretical system, the occurrence and development of lung cancer are closely related to "phlegm" and "blood stasis". Therefore, Resolving Phlegm and Removing Stasis Therapy (RPST) has shown significant value in clinical application and mechanism research.

AIM OF THE REVIEW: We aim to summarize the progress of RPST in treating NSCLC. We not only analyze its clinical efficacy in TCM. but also summarize the mechanism of the active components of this method, providing the potential therapeutic strategies for NSCLC.

METHODS: All the literature information in this review was collected from relevant articles in the scientific databases PubMed, Web of Science, and CNKI from 2010 to 2025.

RESULTS: This review elaborates on the effects of compound TCM and their active components of RPST on NSCLC from the perspectives of clinical research and mechanism research respectively. We systematically summarized 11 modified prescriptions derived from ancient classic formulas, whose safety and efficacy have been confirmed through years of clinical practice. In addition, we systematically summarized 24 clinical studies in total and found that the application of TCM compounds for RPST can effectively reduce tumor size, enhance therapeutic efficacy, and alleviate TCM-related symptoms. Meanwhile, this review sorted out 26 single herbs that have been used since ancient times and possess anti-lung cancer effects. Studies on their active ingredients revealed that their anti-tumor mechanisms involve multi-pathway and multi-target effects, such as inducing apoptosis of lung cancer cells, inhibiting cell viability, invasion, and migration, and reversing drug resistance, etc. CONCLUSION: RPST compounds and their active ingredients have exhibited remarkable anti-cancer effects, particularly in suppressing the invasion and metastasis of lung cancer. A growing body of research has underscored its potential clinical significance in lung cancer treatment, providing robust evidence for the development of novel therapeutic strategies.