Abstract
Dear Editor,
We read with great interest the article by Lee et al, 1 published in Integrative Cancer Therapies, titled ‘Efficacy of Herbal Medicine Therapy Combined With Palliative Chemotherapy in Unresectable Advanced NSCLC: A Systematic Review and Meta-Analysis’. This meta-analysis included 81 randomized controlled trials involving 5955 patients and provides valuable evidence on the benefits of Fuzheng-Based Qi and Yin Therapy (FBQYT) in improving tumor response, quality of life, and survival outcomes in advanced non–small cell lung cancer (NSCLC). We commend the authors for their comprehensive work and would like to offer several constructive suggestions.
First, while the findings are promising, the methodological quality of the included studies varied considerably. Future multicenter, randomized controlled trials with appropriate control designs (eg, placebo or sham interventions where feasible) and adherence to CONSORT and STRICTA guidelines could enhance reproducibility and external validity.
Second, given the growing role of immunotherapy and targeted therapy in advanced NSCLC, it would be valuable to explore potential synergistic effects between FBQYT and immune checkpoint inhibitors or tyrosine kinase inhibitors. Incorporating biomarker-based endpoints, such as cytokine profiles or PD-L1 expression, may help elucidate the immunomodulatory mechanisms of herbal therapies and guide precision-based integrative oncology.
Finally, although the study observed fewer chemotherapy-related adverse events, distinguishing herbal-specific from regimen-related reactions remains challenging. We recommend adopting standardized toxicity reporting systems and pharmacovigilance frameworks to ensure safety monitoring in future integrative trials.
In conclusion, Lee et al’s study substantially advances our understanding of integrative oncology for advanced NSCLC. Further high-quality, mechanism-oriented clinical research may strengthen the evidence and facilitate broader clinical translation.
