• Country: TAIWAN
  • Official Title: 主治醫師
  • Department: 長庚紀念醫院中醫內兒科

Speech Title

The association between mortality and the use of Chinese herbal medicine among triplenegative breast cancer patients: a retrospective cohort study with core herbs exploration 中草藥用於三陰性乳癌：藥物網絡與存活分析

Background:

Triple-negative breast cancer (TNBC) continues to be a major cause of mortality both globally and in Taiwan, particularly in advanced stages where treatment options are limited and prognosis is poor. Chinese herbal medicine (CHM) is commonly used as a complementary therapy for cancer, but its long-term effects on TNBC remain uncertain.

Materials and methods:

This study used a multi-institutional cohort from the Chang Gung Research Database to examine the long-term outcomes of CHM use in patients newly diagnosed with TNBC between January 1, 2011, and December 31, 2021. Patients were monitored for up to 10 years or until death. Overall survival (OS) and disease-specific survival rates were calculated using Kaplan–Meier analysis. To address confounding and immortal time biases, overlap weighting and landmark analysis methods were applied. Additionally, core CHMs for TNBC were identified through an analysis of prescription patterns using the Chinese Herbal Medicine Network (CMN).

Results:

The analysis included 2,174 patients with TNBC, consisting of 464 CHM users and 1,710 non-users. CHM use was associated with a significantly higher 10-year OS rate compared to non-users, with cumulative probabilities of 77.7% versus 70.2% (log-rank test: p = 0.007; p = 0.033 with overlap weighting). In stages 1-3, the survival rate for CHM users was 6.6% higher than that for non-users, with cumulative probabilities of 80.7% versus 74.1% (log-rank test: p = 0.018). However, CHM users exhibited lower 5- and 10-year disease-specific survival rates. After adjusting for demographic covariates, CHM use was linked to a reduced risk of all-cause mortality (adjusted hazard ratio [aHR]: 0.71, 95% confidence interval [CI]: 0.51–0.99, p = 0.044). Analysis of the CMN identified specific CHMs that may improve health and alleviate tumor burden in TNBC. For example, Hedyotis diffusa Willd. was recognized as a core CHM with anti-cancer effects, while combinations such as Jia-Wei-Xiao-Yao-San, Scutellaria barbata D. Don., and Suan-Zao-Ren-Tang were used to manage cancer-related symptoms.

Conclusion:

CHM appears to be a safe and potentially beneficial treatment option for patients with TNBC, demonstrating improved 10-year OS rates. Further clinical trials are needed to thoroughly investigate the role of CHM in managing TNBC.