Effect of Chinese Herbal Compound LC09 on Patients With Capecitabine-Associated Hand-Foot Syndrome: A Randomized, Double-Blind, and Parallel-Controlled Trial

Ran Yu, Xuefeng Wu, Liqun Jia, Yanni Lou, Ran Yu, Xuefeng Wu, Liqun Jia, Yanni Lou

Abstract

Background: LC09 is composed with 5 kinds of traditional Chinese herbal medicines (Astragalus membranaceus, flowers carthami, lithospermum, geranium wilfordii, and radix angelicae) which are used in China and developed over several thousand years. Aim: To assess the effectiveness and safety of herbal compound LC09 on patients with capecitabine-associated hand-foot syndrome (HFS). Materials and Methods: In this randomized, double-blind, and parallel-controlled study, 156 patients that diagnosed with HFS were randomly assigned to a treatment group (n = 78) or control group (n = 78). Patients were evaluated every week by the National Cancer Institute (NCI) grade and Numerical Rating Scale (NRS) pain scores. The Dermatology Life Quality Index (DLQI) scale and Instrumental Activity of Daily Living (IADL) scale were used to assess the quality of life before the treatment, and at 1 week and after the treatment of 2 cycles. Results: At the baseline, no significant differences were observed between the 2 groups. After treatment, significant differences in NCI grade and NRS pain scores were observed between the 2 groups (P < .01). In addition, HFS effectiveness rate and pain alleviation rate were significantly higher in the treatment group compared with the control group (P < .01). Furthermore, the chemotherapy completion rate between 2 groups was significantly different (P = .002). In addition, no adverse reactions were observed in either LC09 or control group. Conclusion: LC09 can decrease NCI grade and significantly alleviate pain in HFS patients. Besides, it can also increase chemotherapy completion rate.

Trial registration: ClinicalTrials.gov NCT02794493.

Keywords: capecitabine; granular formulation; hand-foot syndrome; medicine; traditional Chinese.

Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
High-performance liquid chromatography/photo diode array detection of LC09.
Figure 2.
Figure 2.
Inclusion and exclusion criteria.
Figure 3.
Figure 3.
Proportion of 3 NCI (National Cancer Institute) grades at baseline (week 0) and after treatment (2 cycles).
Figure 4.
Figure 4.
Variation of NRS (Numerical Rating Scale) pain score at baseline (week 0) and after treatment (2 cycles).

References

    1. Miller KK, Gorcey L, McLellan BN. Chemotherapy-induced hand-foot syndrome and nail changes: a review of clinical presentation, etiology, pathogenesis, and management. J Am Acad Dermatol. 2014;71:787-794. doi:10.1016/j.jaad.2014.03.019
    1. Cohen PR. Capecitabine-associated loss of fingerprints: report of capecitabine-induced adermatoglyphia in two women with breast cancer and review of acquired dermatoglyphic absence in oncology patients treated with capecitabine. Cureus. 2017;9:e969. doi:10.7759/cureus.969
    1. Suzuki S, Nawata S, Inada Y, et al. A cross-sectional survey of methods for controlling hand-foot syndrome in patients receiving capecitabine treatment. Mol Clin Oncol. 2018;9:443-448. doi:10.3892/mco.2018.1689
    1. Hoesly FJ, Baker SG, Gunawardane ND, Cotliar JA. Capecitabine-induced hand-foot syndrome complicated by pseudomonal superinfection resulting in bacterial sepsis and death: case report and review of the literature. Arch Dermatol. 2011;147:1418-1423. doi:10.1001/archdermatol.2011.320
    1. Lou Y, Wang Q, Zheng J, et al. Possible pathways of capecitabine-induced hand-foot syndrome. Chem Res Toxicol. 2016;29:1591-1601. doi:10.1021/acs.chemrestox.6b00215
    1. Huang XZ, Chen Y, Chen WJ, et al. Clinical evidence of prevention strategies for capecitabine-induced hand-foot syndrome. Int J Cancer. 2018;142:2567-2577. doi:10.1002/ijc.31269
    1. Toyama T, Yoshimura A, Hayashi T, et al. A randomized phase II study evaluating pyridoxine for the prevention of hand-foot syndrome associated with capecitabine therapy for advanced or metastatic breast cancer. Breast Cancer. 2018;25:729-735. doi:10.1007/s12282-018-0879-z
    1. Yap YS, Kwok LL, Syn N, et al. Predictors of hand-foot syndrome and pyridoxine for prevention of capecitabine-induced hand-foot syndrome: a randomized clinical trial. JAMA Oncol. 2017;3:1538-1545. doi:10.1001/jamaoncol.2017.1269
    1. Liu M, Xu C, Sun Y. Efficacy and safety of sodium cantharidinate and vitamin B6 injection for the treatment of digestive system neoplasms: a meta-analysis of randomized controlled trials. Drug Des Devel Ther. 2019;13:183-203. doi:10.2147/DDDT.S190674
    1. Orare K, Nambafu J, Mwanzi S, Ali SK. Pregabalin for treatment of docetaxel-related hand-foot syndrome. J Pain Symptom Manage. 2019;58:e1-e2. doi:10.1016/j.jpainsymman.2019.03.005
    1. Macedo LT, Lima JP, dos Santos LV, Sasse AD. Prevention strategies for chemotherapy-induced hand-foot syndrome: a systematic review and meta-analysis of prospective randomised trials. Support Care Cancer. 2014;22:1585-1593. doi:10.1007/s00520-014-2129-z
    1. Ren Z, Zhu K, Kang H, et al. Randomized controlled trial of the prophylactic effect of urea-based cream on sorafenib-associated hand-foot skin reactions in patients with advanced hepatocellular carcinoma. J Clin Oncol. 2015;33:894-900. doi:10.1200/jco.2013.52.9651
    1. Azuma Y, Hata K, Sai K, et al. Significant association between hand-foot syndrome and efficacy of capecitabine in patients with metastatic breast cancer. Biol Pharm Bull. 2012;35:717-724. 10.1248/bpb.35.717
    1. Zielinski C, Lang I, Beslija S, et al. Predictive role of hand-foot syndrome in patients receiving first-line capecitabine plus bevacizumab for HER2-negative metastatic breast cancer. Br J Cancer. 2016;114:163-170. doi:10.1038/bjc.2015.419
    1. Lou Y, Chen X, Tian P. External treatment of chemotherapeutic hand and foot pain by Chinese medicine—a multicentre, randomized, controlled clinical study. Beijing J Tradit Chin Med. 2013;32:261-265.
    1. Bian LQ, Li BS, Li ZH, Wang FY, Wen YD, Tang XD. A preparation model of Chinese medicine decoction placebo. Chin J Integr Med. 2017;23:631-634. doi:10.1007/s11655-016-2538-6
    1. US Department of Health and Human Services; National Institute of Health; National Cancer Institute. Common Terminology Criteria for Adverse Events (CTCAE) v4.03. Published May 28, 2009. Accessed February 1, 2016
    1. Zhou W, Hong ZJ, Hu RR. Reliability and validity of Comprehensive Loss of Intelligence and Energy Scale. China J Health Psychol. 2019;27:453-456.
    1. Wang XL, Zhao TE, Zhang XQ. Reliability and validity of Chinese Version Dermatology Life Quality Index [in Chinese]. Chin J Epidemiol. 2004:63-65.
    1. Zhao C, Chen J, Yu B, et al. Effect of modified taohongsiwu decoction on patients with chemotherapy-induced hand-foot syndrome. J Tradit Chin Med. 2014;34:10-14.
    1. Liu Y, May BH, Zhang AL, et al. Integrative herbal medicine for chemotherapy-induced peripheral neuropathy and hand-foot syndrome in colorectal cancer: a systematic review and meta-analysis. Integr Cancer Ther. 2019;18:1534735418817833. doi:10.1177/1534735418817833
    1. Deng B, Sun W. Herbal medicine for hand-foot syndrome induced by fluoropyrimidines: a systematic review and meta-analysis. Phytother Res. 2018;32:1211-1228.
    1. Mikoshiba N, Yamamoto-Mitani N, Sato K, et al. Validation of the Japanese version of HFS-14, a disease-specific quality of life scale for patients suffering from hand-foot syndrome. Support Care Cancer. 2015;23:2739-2745. doi:10.1007/s00520-015-2638-4
    1. Anderson RT, Keating KN, Doll HA, Camacho F. The hand-foot skin reaction and quality of life questionnaire: an assessment tool for oncology. Oncologist. 2015;20:831-838. doi:10.1634/theoncologist.2014-0219
    1. Lai JS, Beaumont JL, Diaz J, Khan S, Cella D. Validation of a short questionnaire to measure symptoms and functional limitations associated with hand-foot syndrome and mucositis in patients with metastatic renal cell carcinoma. Cancer. 2016;122:287-295. doi:10.1002/cncr.29655

Source: PubMed

3
Tilaa