Cancer is one of the leading causes of death in the world, with breast cancer being the most prevalent cancer. Chemotherapy-induced nausea and vomiting (CINV) is one of the most serious side effects of chemotherapy. Because the current CINV treatment option has several flaws, alternative treatment options are required. Ginger has traditionally been used to treat nausea and vomiting, and it also has anticancer properties in breast cancer cells. Based on these findings, researchers investigated whether using ginger to treat CINV in breast cancer patients is both effective and safe. We searched PubMed, Embase, Cochrane Library, CNKI, and Wanfang from inception to June 2022. Outcomes included Rhodes Index Scores of Nausea, Vomiting, and Retching, severity and frequency of CINV. Five RCTs were included. We pooled all included data and performed subgroup analysis by types of CINV. Overall, authors found that ginger was associated with a reduction in CINV. Subgroup and sensitivity analysis revealed that managing severity of acute CINV in breast cancer patients with ginger was efficient. In terms of managing delayed CINV in breast cancer patients, ginger was also statistically significant. The authors concluded that ginger may be helpful in lowering both acute and delayed CINV in breast cancer patients. Since there were no serious side effects, ginger is thought to be safe.

This study evaluates acute and subchronic toxicity of a Korean herbal formula HAD-B1 in rat to investigate whether HAD-B1 has potential toxicity to humans. First, the study to assess the acute oral toxicity at dose levels of 0, 500, 1000, and 2000mg/kg body weight (BW) was performed in male and female SD rats (Crl: CD, specific pathogen-free) (n=5/group). Based on the result of the acute oral study, 4 weeks dose range finding study and 13 weeks subchronic study were performed (dose range finding study, DRF; n=5/group) and 13 weeks (subchronic study; n=10/group) in male and female SD rats. The control group was administered with distilled water (DW). Clinical signs, body weight, food consumption, ophthalmic examination, urinalysis, hematological/biochemical parameters, gross finding at necropsy, and histopathological examination were investigated and recorded. In the oral acute toxicity study of SD rats, no clinical signs, mortality, body weight changes, and gross findings were observed. Also, there were no treatment-related changes in the 4-week DRF study. Based on these results, a 13-week repeated-dose toxicity study (subchronic) in SD rats was performed. HAD-B1 showed temporal hypersalivation in clinical signs and an increased tendency in body weight at 2000mg/kgBW. However, there were no treatment-related changes in mortality, food consumption, ophthalmology, urinalysis, hematology, biochemistry, gross finding at necropsy, organ weights, and histopathology in either sex of any group. Based on this toxicological evaluation of HAD-B1, we concluded that no target organ was determined, and the no observed adverse effect level (NOAEL) of HAD-B1 was determined to be>2000mg/kgBW. Therefore, we decided that consuming HAD-B1 is relatively nontoxic.

Su-Jeong Ha, Yeo-Ok Choi, Eun-Bin Kwag, Soo-Dam Kim, Hwa-seung Yoo, In-Cheol Kang, So-Jung Park. J Pharmacopuncture 2022;25:52-62. https://doi.org/10.3831/KPI.2022.25.1.52

Advanced gastric cancer (AGC) is a leading cause of cancer-related deaths worldwide, with its treatment complicated by challenges such as high recurrence rates, severe side effects, and limited effectiveness of current therapies. Herbal medicine (HM) has emerged as an adjunct to palliative chemotherapy (PC), potentially improving tumor response and reducing side effects. This study conducted a meta-analysis to evaluate the effectiveness and safety of HM in palliative therapy for inoperable stage Ⅲ and Ⅳ AGC patients. Databases were searched until August 2023, encompassing 10 electronic databases, including PubMed, Embase, Cochrane Library, CNKI, and ScienceON. The inclusion criteria focused on randomized controlled trials (RCTs) combining herbal medicine with palliative therapy for patients with AGC. Primary outcomes assessed were tumor response rates, overall survival, adverse drug reactions (ADRs), and patients' quality of life (QoL). In our analysis of 101 RCTs comparing PC alone to PC combined with HM, the meta-analysis demonstrated statistically significant improvements in overall response rate (ORR), disease control rate (DCR), survival rates, as well as a reduction in adverse drug reactions (ADRs) and an enhancement in quality of life (QoL) for patients receiving HM in combination with PC (p < 0.00001, I² = 0 %). The combination of HM with PC significantly enhances tumor response and survival rates while reducing overall adverse drug reactions (ADRs) and improving quality of life (QoL) in patients with stage Ⅲ and Ⅳ AGC. HMs not only improve the efficacy of PC but also help alleviate side effects, including myelosuppression, digestive symptoms, nausea, vomiting, diarrhea, liver and renal injuries, and neurotoxicity.Protocol registration: PROSPERO, CRD 42022354133.

HAD-B1 is a Korean herbal formula designed to treat solid tumors, and through cell experiments, it has proven to have an anticancer effect. The current study aims to test the safety of HAD-B1. This experiment is under the regulation of ICH. In order to find if HAD-B1 has any effect on the CNS, 0, 500, 1000, and 2000mg/kg/day of HAD-B1 were orally administered to male and female rats once. To discover any effect on the respiratory system, 0, 500, 1000, and 2000mg/kg/day of HAD-B1 were orally given to male rats followed by measuring the respiratory rate, tidal volume, and minute respiratory volume. To assess the possibility of a delayed QT period as a result of the drug administration, hERG analysis was conducted at 0, 0.1, 0.3, and 1μg/ml. To assess any effect on the cardiovascular system, 0, 500, 1000, and 2000mg/kg/day of HAD-B1 were orally given to male beagle dogs once followed by temperature, blood pressure, ECG, and heart rate analyses. There were no clinically significant changes in both male and female rats on assessing any effects on the CNS. There were no clinically significant changes in male rats respiratory assessment. There were no clinically significant changes in hERG analysis results. There were no clinically significant changes in the cardiovascular system of male beagle dogs. Our results demonstrate that HAD-B1 is a safe herbal formula that does not have a clinically significant effect on the CNS, respiratory, and cardiovascular systems.

Anxiety and insomnia frequently co-occur among cancer survivors and are strongly interconnected, yet no widely accepted intervention simultaneously targets both symptoms. Data were drawn from a dual-center, parallel-group, randomized, comparative effectiveness trial evaluating acupuncture versus CBT-I for insomnia. Seventy-six participants with baseline Hospital Anxiety and Depression Scale-Anxiety (HADS-A) scores of ≥8 were included. Both interventions were administered over eight weeks, with follow-up until 20 weeks. Anxiety was assessed at baseline, week 8, and week 20 using HADS-A. A linear mixed-effects model was used to examine mean change in HADS-A scores. Additionally, responder analyses were conducted, with insomnia and anxiety responders defined as patients demonstrating clinically meaningful improvements in either outcome by week 8. Both CBT-I and acupuncture significantly reduced HADS-A scores at week 8 (CBT-I: -3.75; acupuncture: -3.14) and week 20 (CBT-I: -3.05; acupuncture: -2.66) compared to baseline (all p < 0.001). There was no between-group difference (p=0.85). In responder analyses, CBT-I showed greater anxiety reduction in insomnia responders (-4.62) than non-responders (-0.45), at both time points (week 8: p=0.0046; week 20: p=0.038). In the acupuncture group, the difference in anxiety reduction between insomnia responders (-3.96) and non-responders (-1.58) was not statistically significant. Both acupuncture and CBT-I effectively manage comorbid anxiety and insomnia in cancer survivors. Acupuncture may address these symptoms independently, while CBT-I may improve them in an interconnected manner. ClinicalTrials.gov registration (NCT02356575).