Long-term efficacy of traditional Chinese medicine combined with chemotherapy for advanced non-small cell lung cancer: a systematic review and meta-analysis of reconstructed individual patient data over 3 years
In brief
Adding Chinese herbal therapy to chemo extends three-year survival by ~4 months
A meta-analysis of 18 trials reconstructing individual patient data found that chemotherapy plus traditional Chinese medicine increased overall survival by about four months over three years and lengthened progression-free survival by roughly one and a half months. The benefit was strongest early on and waned later, indicating a need for longer-term trials to confirm durability.
- Journal
- Frontiers in pharmacology (Q1)
- Published
- 2 July 2026
- Study design
- Systematic review / meta-analysis of RCTs
- Evidence level
- Level 1, High (CEBM 1a)
- Authors
- Yixuan Guo, Dan Wang, Xuexiu Jia
- PMID
- 42465999
- DOI
- 10.3389/fphar.2026.1818515
Why clinicians should know about it
- Picked for Geriatrics and Gerontology (top studies of the week, 19 July 2026).
- Picked for Oncology and Radiation Oncology (top studies of the week, 19 July 2026): SR/MA of TCM plus chemotherapy for advanced NSCLC
- Picked for Radiology, Radiation Oncology, Nuclear Medicine, Medical Physics and Imaging (top studies of the week, 19 July 2026): Systematic review/meta-analysis of RCTs
- Picked for Pharmacology (medical) (top studies of the week, 19 July 2026).
Abstract
INTRODUCTION: To evaluate the 3-year efficacy of combining traditional Chinese medicine with chemotherapy in the treatment of advanced non-small cell lung cancer, taking into account time-dependent survival effects. METHODS: A systematic review and meta-analysis was conducted following PRISMA guidelines, including randomized controlled trials and observational studies that compared chemotherapy plus traditional Chinese medicine with chemotherapy alone. Individual patient data were reconstructed from Kaplan-Meier curves. For the primary endpoints of overall survival and progression-free survival, one-stage analyses employed frailty Cox models when the proportional hazards assumption held; otherwise, Royston-Parmar models incorporating time-varying effects were used. Restricted mean survival time over 0-36 months was estimated, and a two-stage random-effects model was applied for sensitivity analysis. RESULTS: Eighteen studies (12 RCTs and 6 cohort studies) were included, with individual patient data reconstructed from 15 overall survival and 7 progression-free survival curves. The proportional hazards assumption was violated for overall survival; time-varying modeling revealed significantly better overall survival with chemotherapy plus traditional Chinese medicine therapy, with a 3-year restricted mean survival time difference of 4.149 months. In the personalized treatment subgroup, CT + TCM showed a pronounced early survival benefit, a similar benefit was observed in the fixed-regimen subgroup. For progression-free survival, combination therapy significantly improved it (HR = 0.85, 95% CI 0.77-0.93, P < 0.001), corresponding to a restricted mean survival time difference of 1.582 months. In the fixed-regimen subgroup, CT + TCM significantly improved PFS (HR = 0.85, 95% CI 0.77-0.94, P < 0.05), while in the personalized TCM subgroup the PFS benefit was not statistically significant (HR = 0.85, 95% CI 0.67-1.07, P = 0.17). CONCLUSION: The addition of traditional Chinese medicine to chemotherapy is associated with improved overall and progression-free survival in advanced non-small cell lung cancer, although the overall survival benefit diminishes over time. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/prospero/ Identifier CRD420261280359.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.