Frontiers in oncology · 2026
Efficacy and safety of bupleurum-containing formulas combined with chemotherapy for triple-negative breast cancer: a systematic review and meta-analysis.
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Li Shangshang, Chen Jie, Ke Longzhu, Leng Yuanxiu, Cui Guanglai, He Qianyu, Chen Hong, Jiang Ping, Luo Li
Аннотация
BACKGROUND: Bupleurum-containing formulas are widely used in China as adjunct to chemotherapy for triple-negative breast cancer (TNBC). However, systematic evidence on their efficacy and safety remains limited. This study evaluates the clinical effects and safety of Bupleurum-containing formulas combined with chemotherapy in the patients with TNBC.
METHODS: We searched seven electronic databases (PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure (CNKI), Sinomed, VIP Database, and Wanfang Database) from inception to January 31, 2026. Studies meeting predefined inclusion criteria were identified through a systematic search. Two researchers independently conducted study selection, data extraction, and risk of bias assessment to ensure accuracy and reduce potential bias.
RESULTS: Compared with chemotherapy alone, Bupleurum-containing traditional Chinese medicine (TCM) formulas combined with chemotherapy improved several clinical outcomes in patients with TNBC. The combined treatment significantly increased the objective response rate (ORR) (RR = 1.32, 95% CI: 1.18-1.48, p < 0.00001) and disease control rate (DCR) (RR = 1.15, 95% CI: 1.09-1.21, p < 0.00001), and improved quality of life (QOL) (MD = 6.48, 95% CI: 4.93-8.03, p < 0.00001). It was also associated with changes in peripheral blood CD3+, CD4+, CD8+ T lymphocytes, as well as the CD4+/CD8+ ratio. Subgroup analysis indicated that interventions lasting ≥12 weeks was associated with greater improvements in ORR. In terms of safety, the combined regimen reduced the incidence of grade III-IV gastrointestinal adverse events.
CONCLUSION: Combining Bupleurum-containing TCM formulas with chemotherapy shows potential in improving ORR, DCR, and QOL, while reducing treatment-related toxicity in patients with TNBC. This approach may serve as an adjunctive strategy, but these findings should be interpreted with caution, and further high-quality studies are needed.This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The protocol was prospectively registered in the PROSPERO database (registration number: CRD420251269445).
SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/prospero/, identifier CRD420251269445.
METHODS: We searched seven electronic databases (PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure (CNKI), Sinomed, VIP Database, and Wanfang Database) from inception to January 31, 2026. Studies meeting predefined inclusion criteria were identified through a systematic search. Two researchers independently conducted study selection, data extraction, and risk of bias assessment to ensure accuracy and reduce potential bias.
RESULTS: Compared with chemotherapy alone, Bupleurum-containing traditional Chinese medicine (TCM) formulas combined with chemotherapy improved several clinical outcomes in patients with TNBC. The combined treatment significantly increased the objective response rate (ORR) (RR = 1.32, 95% CI: 1.18-1.48, p < 0.00001) and disease control rate (DCR) (RR = 1.15, 95% CI: 1.09-1.21, p < 0.00001), and improved quality of life (QOL) (MD = 6.48, 95% CI: 4.93-8.03, p < 0.00001). It was also associated with changes in peripheral blood CD3+, CD4+, CD8+ T lymphocytes, as well as the CD4+/CD8+ ratio. Subgroup analysis indicated that interventions lasting ≥12 weeks was associated with greater improvements in ORR. In terms of safety, the combined regimen reduced the incidence of grade III-IV gastrointestinal adverse events.
CONCLUSION: Combining Bupleurum-containing TCM formulas with chemotherapy shows potential in improving ORR, DCR, and QOL, while reducing treatment-related toxicity in patients with TNBC. This approach may serve as an adjunctive strategy, but these findings should be interpreted with caution, and further high-quality studies are needed.This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The protocol was prospectively registered in the PROSPERO database (registration number: CRD420251269445).
SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/prospero/, identifier CRD420251269445.