Efficacy of Modified Peanut Skin Decoction for Lung Cancer Myelosuppression

Jia-Rui Hu; Qiang Ji; Wei-Wei He; Ya-Fei Han; You-Tao Zhang; Zhan-Lin Li

doi:10.3791/68880

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Research Article

Efficacy of Modified Peanut Skin Decoction for Lung Cancer Myelosuppression

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DOI:

10.3791/68880

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September 16th, 2025

Jia-Rui Hu¹ , Qiang Ji² , Wei-Wei He³ , Ya-Fei Han⁴ , You-Tao Zhang⁵ , Zhan-Lin Li¹

¹Department of Traditional Chinese Medicine, The First Affiliated Hospital of Hebei North University, ²Department of Cardiothoracic Surgery, The First Affiliated Hospital of Hebei North University, ³Department of Stomatology, The First Affiliated Hospital of Hebei North University, ⁴College of Traditional Chinese Medicine, Hebei North University, ⁵Department of Geriatrics, The First Affiliated Hospital of Hebei North University

Summary

This study evaluates the efficacy of modified Peanut Skin Decoction (PSD) in alleviating myelosuppression in patients with advanced lung squamous carcinoma receiving chemoimmunotherapy. Clinical outcomes and network pharmacology reveal PSD's mechanisms via phosphoinositide 3-kinase-protein kinase B/hypoxia-inducible factor-1 pathways.

Abstract

This study conducted a randomized controlled trial to assess the efficacy and safety of modified Peanut Skin Decoction (PSD) for preventing myelosuppression in 60 patients with advanced squamous cell lung carcinoma receiving chemotherapy plus immunotherapy. Patients were randomised 1:1 to receive either standard supportive care granulocyte colony-stimulating factor (5 µg/kg) or supplemented by modified PSD as needed. Primary endpoints included white blood cell count, neutrophil count, haemoglobin level, platelet count, and World Health Organization Quality of Life Brief Version (WHOQOL-BREF) questionnaire scores measured on days 4, 8, 12, and 20. Secondary endpoints were onset time, duration, and recovery of grade III-IV myelosuppression, cumulative blood transfusion volumes, and adverse event rates. The results showed that PSD significantly delayed the onset of grade III-IV myelosuppression (5.63 ± 1.10 vs. 4.10 ± 1.24 days; p < 0.001) and shortened its duration (7.07 ± 1.72 vs. 9.97 ± 1.16 days; p < 0.001), while improving WHOQOL-BREF scores without increasing adverse event rates. Network pharmacology revealed that key active components target interleukin-6, tumour necrosis factor, and vascular endothelial growth factor A via the phosphoinositide 3-kinase-protein kinase B and hypoxia-inducible factor-1 signalling pathways, underpinning PSD's protective effects against myelosuppression. Overall, PSD effectively mitigates chemotherapy-induced myelosuppression and enhances patient quality of life.

Introduction

Lung cancer ranks as the malignancy with the highest incidence and mortality rates in China. Projections suggest that by 2025, the number of patients with lung cancer in China is projected to exceed one million, positioning the nation as the global epicentre of lung cancer burden. Non-small cell lung cancer (NSCLC) constitutes 80%-85% of all lung cancer cases¹, with squamous cell carcinoma of the lung accounting for 20%-30% of these instances². In recent years, the advent of immune checkpoint inhibitors (ICIs) has significantly altered the treatment landscape for advanced squamous cell lung carcinoma, significantly alter....