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Open AccessArticle

Astragalus polysaccharide (PG2) Ameliorates Cancer Symptom Clusters, as well as Improves Quality of Life in Patients with Metastatic Disease, through Modulation of the Inflammatory Cascade

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Department of Medicine, MacKay Medical College, Taipei 110, Taiwan
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Division of Thoracic Surgery, Department of Surgery, MacKay Memorial Hospital, Taipei 110, Taiwan
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Division of Thoracic Surgery, Department of Surgery, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235, Taiwan
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Division of Thoracic Surgery, Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
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Department of Medical Research and Education, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235, Taiwan
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Division of Hematology/Oncology, Department of Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235, Taiwan
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Biostatistics Center, Taipei Medical University, Taipei 110, Taiwan
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Department of Dermatology, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, New Taipei City 235, Taiwan
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School of Medicine, Buddhist Tzu Chi University, Hualien 970, Taiwan
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Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235, Taiwan
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Department of Radiation Oncology, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235, Taiwan
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Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 235, Taiwan
*
Authors to whom correspondence should be addressed.
Those authors contributed equally to this work.
Cancers 2019, 11(8), 1054; https://doi.org/10.3390/cancers11081054
Received: 18 June 2019 / Revised: 17 July 2019 / Accepted: 19 July 2019 / Published: 25 July 2019
Background: Improving patients’ quality of life (QoL) is a principal objective of all treatment in any clinical setting, including oncology practices. Cancer-associated inflammation is implicated in disease progression and worsening of patients’ QoL. Conventional anticancer therapeutics while selectively eliminating cancerous cells, are evaded by stem cell-like cells, and associated with varying degrees of adverse effects, thus reducing patients’ QoL. This necessitates novel therapeutic approaches with enhanced efficacy, minimal or no treatment-related adverse effects, and improved QoL in patients with cancer, especially those with metastatic/advance stage disease. Methods: Sequel to our team’s previous publication, the present study explores probable effects of Astragalus polysaccharides (PG2) on cancer-related inflammatory landscape and known determinants of QoL, as well as the probable link between the two to provide mechanistic insight. In an exploratory double blind randomized controlled trial using patients with metastatic disease (n = 23), we comparatively evaluated the therapeutic efficacy of high (500 mg) or low (250 mg) dose PG2 administered intravenously (i.v.), with particular focus on its suggested anti-inflammatory function and the probable effect of same on QoL indices at baseline, then at weeks 4 and 8 post-PG2 treatment. Results: All 23 patients with metastatic disease treated with either low or high PG2 experienced reduced pain, nausea, vomiting, and fatigue, as well as better appetite and sleep, culminating in improved global QoL. This was most apparent in the high dose group, with significant co-suppression of pro-inflammatory interleukin (IL)-1β, IL-4, IL-6, IL-13, IL-17, monocytes chemotactic protein (MCP)1, granulocyte-macrophage colony-stimulating factor (GM-CSF), vascular endothelial growth factor (VEGF), tumor growth factor (TGF)-β1, interferon (IFN)-γ, and immune suppressors IL-10 and IL-12. Univariate and multivariate analyses revealed that IL-1β, IL-13 and GM-CSF are independent prognosticators of improved QoL. Conclusion: This proof-of-concept study provides premier evidence of functional association between PG2 anti-inflammatory effects and improved QoL in patients with advanced stage cancers, laying the groundwork for future larger cohort blinded controlled trials to establish the efficacy of PG2 as adjuvant anticancer therapy in metastatic or advanced stage clinical settings. View Full-Text
Keywords: Astragalus polysaccharides; PG2; cytokine; inflammatory cascade; cancer cachexia; quality of life; QoL; fatigue Astragalus polysaccharides; PG2; cytokine; inflammatory cascade; cancer cachexia; quality of life; QoL; fatigue
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Huang, W.-C.; Kuo, K.-T.; Bamodu, O.A.; Lin, Y.-K.; Wang, C.-H.; Lee, K.-Y.; Wang, L.-S.; Yeh, C.-T.; Tsai, J.-T. Astragalus polysaccharide (PG2) Ameliorates Cancer Symptom Clusters, as well as Improves Quality of Life in Patients with Metastatic Disease, through Modulation of the Inflammatory Cascade. Cancers 2019, 11, 1054.

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