5. Conclusion

Dahuang zhechong pill (DHZCP) is one of the most famous prescriptions from an ancient Chinese medical classic "Jin Kui Yao Lue (Essential Prescriptions from the Golden Cabinet)." DHZCP is officially recorded in the Chinese Pharmacopeia and is commonly used for clinical practice of hepatoma. Wu et al. found that inhibitory growth of doxorubicin-resistant HCC subcutaneous xenografts in nude mice was achieved by DHZCP, and apoptosis promotion was accelerated by doxorubicin. The reversal of doxorubicin resistance by DHZCP was related with energy metabolism decline and regulation of proapoptotic proteins expression [95].

Accumulating researches have demonstrated that Chinese medicine is a promising substitute for therapy of liver cancer. Furthermore, increasing scholars starts to pay attention to clinical studies of Chinese medicine. For example, gambogic acid (GA), a naturally occurring compound from ancient China, has been demonstrated efficient antineoplastic activity in a number of malignancies. More importantly, it has entered phase II clinical trials. A team ?found GA might lead to oxidative stress and subsequently induce apoptosis in hepatoma cells through interacting with TrxR1. Thus, targeting TrxR1 by GA disclosed a previously unrecognized mechanism underlying the biological action of GA and provides useful information for further development of GA as a potential agent for cancer therapy [96]. On the other hand, the theory of "Jianpi Huayu Therapy" (JPHY) was rooted from "Jin Kui Yao Lue." According to the selection criteria, Zhong et al. recruited a total of 120 patients in a randomized trial, aiming to compare the curative outcome and safety profile of surgery in combination with "Jianpi Huayu Therapy" HCC treatment to surgery alone. The patients in treatment group received the basic prescription based on JPHY. The results showed that hepatectomy combined with JPHY was more effective with reducing postoperative metastasis and recurrence and prolonged overall survival of HCC patients [97]. JQ1, one of the bromodomain and extra-terminal domain (BET) inhibitors, has been emerged as a novel agent candidate for cancer treatment in clinical research. Nevertheless, a number of solid cancers are resistant to BET inhibitors. The results from a group showed that oridonin synergistically increased JQ1 capacity of inhibiting HCC cell survival, and considerably enhanced JQ1 caused apoptosis in HCC cells and in HCC cancer stem-like cells. Furthermore, they demonstrated that oridonin distinctly augmented the sensitivity of JQ1 via downregulation of the level of multiple antiapoptotic proteins, including Bcl-2, Mcl-1, and x-linked inhibitor of apoptosis, suggesting that the combination treatment of JQ1 and oridonin could be further pursued for clinical application and it was expected to provide a rational for HCC tumor prevention [98].

Collectively, the aforementioned findings showed the potential efficacy of Chinese medicine on numerous types of cancer, either alone or in combination with conventional treatment of method such as surgery, chemotherapy, or radiation. In particular, as stated above, when integrated with chemotherapy or radiotherapy, Chinese medicine may serve as complementary drugs strongly enhancing the positive effects or reducing the negative events induced by radiochemotherapy. However, in comparison with a great deal of laboratory researches, clinical trials still remain poor, which limits the wide application of Chinese medicine throughout

4. Discussion

126 Liver Cancer

the world.

Chinese medicine is increasingly emerging as a novel curative choice for liver cancer. This retrospective review systemically introduced and evaluated the functional roles of Chinese medicine in treating liver cancer. Chinese medicine has potentially exerted efficient anticancer properties. For example, liver cancer progression can be repressed by active constituents derived from Chinese medicine through multiple pathways. The specific network with regard to the potential therapeutic targets for liver cancer treatment was constructed (Figure 1). The detailed relationships between biological factors and refined extracts could be directly visualized in Figure 1. Moreover, composite formulae as promising curative are increasingly indispensable in current clinical practice. As summarized in Table 1, formulae potentially employed in practice were studied in laboratory and the regulatory mechanisms for the treatment of liver cancer have been showed clearly. Also, Chinese medicine may serve as adjuvant agents in surgery as well as in combination with conventional radio- and chemotherapy, to decrease the adverse events or enhance the treatment outcome. Taken all together, Chinese medicine possesses the potential in liver cancer treatment, and rational application in clinical therapy needs to be warranted in the future.


Figure 1. Target identification of Chinese medicine-derived compounds and extracts for liver cancer. Literature mining in PubMed with "Chinese Medicine" integrated with "liver cancer" was performed. All filtered data during the last 5 years were imported into a professional software Cytoscape for the establishment of the analysis of network pharmacology. The top five influential molecules including Akt, Bax, Bcl-2, mTOR, and PI3K could be figured out.


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A comprehensive screening among literature searched with "Chinese Medicine" combined with "liver cancer" was performed. Potential composite formulae for therapeutic of liver cancer were screened out and corresponding possible action mechanisms were summarized.

Table 1. Summary on Chinese medicine composite formulae potentially used for liver cancer treatment.
