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According to research, astragalus enhances immunotherapy. Cancer patients undergoing immunotherapy can use adjunct therapy that can potentially enhance efficacy while reducing toxicity.
According to the American Cancer Society:
Several types of immunotherapy used to treat cancer, and many are being studied.
Long-term survivors of my cancer, multiple myeloma, often live with exhausted immune systems due to numerous cycles of different types of chemotherapy.
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Astragalus polysaccharide (APS) derived from A. membranaceus plays a crucial role in traditional Chinese medicine. These polysaccharides have shown antitumor effects and are considered safe. Thus, they have become increasingly important in cancer immunotherapy.
APS can limit the spread of cancer by influencing immune cells, promoting cell death, triggering cancer cell autophagy, and impacting the tumor microenvironment. When used in combination with other therapies, APS can enhance treatment outcomes and reduce toxicity and side effects.
APS combined with immune checkpoint inhibitors, relay cellular immunotherapy, and cancer vaccines have broadened the application of cancer immunotherapy and enhanced treatment effectiveness. By summarizing the research on APS in cancer immunotherapy over the past two decades, this review elaborates on the anticancer mechanism of APS and its use in cancer immunotherapy and clinical trials.
Considering the multiple roles of APS, this review emphasizes the importance of using APS as an adjunct to cancer immunotherapy and compares other polysaccharides with APS. This discussion provides insights into the specific mechanism of action of APS, reveals the molecular targets of APS for developing effective clinical strategies, and highlights the wide application of APS in clinical cancer therapy in the future.
Background: Accumulating evidence suggests that astragalus polysaccharide (APS) may enhance the efficacy of conventional cancer therapies through multiple mechanisms. However, the synergistic effects of APS have not been systematically quantified.
This meta-analysis was therefore conducted to quantify these potential synergistic antitumor effects and provide preclinical evidence to inform future clinical trials.
Methods: Following PRISMA 2020 guidelines, we systematically searched ten databases (including PubMed and Web of Science) for preclinical studies from inception to May 2025 using predefined inclusion criteria…
Results: Forty-one publications (44 independent studies) involving 748 animals were included. APS combination therapy was associated with significant improvements in tumor-related outcomes, including reduced tumor weight and volume, suppressed metastasis, and prolonged survival.
Mechanistically, APS co-administration enhanced CD8⁺ T-cell infiltration, increased splenic and thymic indices, modulated cytokine profiles (TNF-α, IL-2, IFN-γ, IL-12, IL-6, IL-10), and reduced PD-1/PD-L1 expression in tumor tissue.
Additionally, APS appeared to alleviate chemotherapy-induced nephrotoxicity, as evidenced by lower serum creatinine levels. Subgroup analyses indicated that heterogeneity was partially explained by model type, APS dosing regimen, and combination therapy modality. The certainty of evidence for primary outcomes was rated as low or very low according to the GRADE assessment.
Conclusion: This meta-analysis provides preclinical evidence that APS may serve as an adjunctive agent to enhance the efficacy of conventional cancer therapies. However, given the low certainty of current evidence, further mechanistic studies and well-designed clinical trials are urgently warranted to establish its efficacy and therapeutic role in oncology.
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