Integrative Chinese Herbal Medicine as Adjuvant Management for Triple-Negative Breast Cancer: A Multi-Institutional Real-World Study With Mechanism Exploration.

BACKGROUND

Triple-negative breast cancer (TNBC) is a major cause of mortality worldwide. Chinese herbal medicine (CHM) is often used as adjunctive therapy, but its long-term impact on TNBC remains unclear.

MATERIALS AND

METHODS

This study analyzed a multi-institutional cohort from the Chang Gung Research Database, investigating long-term outcomes of integrative CHM use in TNBC patients newly diagnosed between January 1, 2011, and December 31, 2021. Patients were followed for up to 10 years or until death. Overall survival rate (OS) and disease-specific survival rates were assessed using Kaplan-Meier estimation with overlap weighting and landmark analysis to reduce bias. Core CHMs were identified through network pharmacology analysis on prescriptions made for TNBC patients.

RESULTS

The analysis included 2174 TNBC patients, with 464 using CHM. CHM use was associated with a significantly higher 10-year OS compared to non-users (77.7% vs 70.2%, P = .007). In stages 1 to 3, the OS among CHM users was 6.6% higher (80.7% vs 74.1%, P = .018). After adjusting for demographic factors, CHM use reduced the risk of all-cause mortality (adjusted hazard ratio [aHR]: 0.71, P = .044). Lower disease-specific survival rates were observed among CHM users. Core CHMs, such as Hedyotis diffusa Willd., may have potential anti-cancer effects, while combinations like Jia-Wei-Xiao-Yao-San, Scutellaria barbata D. Don. and Suan-Zao-Ren-Tang may have a complementary role to standard treatments for TNBC.

CONCLUSION

Use of CHM may improve 10-year OS in TNBC patients, and core CHMs provided crucial references for further studies.