A meta-analysis of randomized controlled trials examining the efficacy and safety of elemene in combination with chemotherapy for the treatment of gastric cancer

Background: Elemene is a naturally occurring chemical derived from plants of the Zingiberaceae family, and it finds application in several cancer-related contexts. Nevertheless, there is a dearth of comprehensive assessment about the combined effectiveness and safety of chemotherapy in gastric cancer (GC).

Objective: To investigate the safety and effectiveness of elemene in conjunction with chemotherapy for the treatment of Gastric cancer.

Methods: A comprehensive search of Medline, EMBASE, Scopus, and Cochrane Library identified peer-reviewed journal papers. OR and RR were calculated, along with their 95 % confidence ranges. We assessed heterogeneity using Cochrane Q and I2 statistics and the relevant P-value. The analysis used RevMan 5.3.

Results: Current meta-analysis includes 11 RCTs with 726 GC patients, 364 of whom received elemene paired with treatment and 362 received standard chemotherapy. Elemene-coated chemotherapy improves ORR (RR 1.43, 95 % CI 1.22-1.67, p < 0.00001), reduces blood system toxicity (OR 0.49, 95 % CI 0.35-0.69, p < 0.0001), nausea and vomiting (RR 0.65, 95 % CI 0.55-0.77), diarrhea (RR 0.73, 95 % CI 0.58-0.90), and liver problems (RR 0.64, 95 % CI 0.49-0.83).Subgroup analysis showed that both oral and intravenous administration improved ORR statistically, and a network diagram with consistent connectivity, well-defined network architecture, and high-quality evidence shows that elemene combined with chemotherapy has significant therapeutic efficacy.

Conclusion: Elemene may possess the capacity to enhance the effectiveness and mitigate the adverse effects of gastric cancer chemotherapy. Nevertheless, due to the restricted number of studies incorporated, additional research studies utilizing sizable samples are required to validate the aforementioned findings.