Are there herbal remedies for diarrhea during chemotherapy for CRC?
For the treatment or alleviation of diarrhea occurring during chemotherapy for colorectal cancer (CRC), certain herbal-based formulas and phytotherapeutic preparations are being researched in clinical trials, but they do not currently replace standard pharmacological care (e.g., loperamide, supportive therapy) as standard oncological therapy. Among clinical trials, the traditional multi-component herbal preparation called Xiao-Chai-Hu-Tang has been studied in combination with irinotecan-based chemotherapy, where preliminary data showed no severe-grade diarrhea. In addition, the TiaoPi AnChang decoction (TPACD) reduced the overall side effects caused by CAPOX chemotherapy in a randomized, double-blind trial, and the effect of Huangqin Houpo decoction on gut flora and its diarrhea-reducing potential have also been studied at preclinical and network pharmacology levels. However, an oral nanoformulation of curcumin did not show a significant effect in preventing chemotherapy-induced diarrhea in a randomized trial. Before using any herbal remedy or dietary supplement, consultation with an oncologist is essential to avoid potential drug interactions.
The Xiao-Chai-Hu-Tang (XCHT) multi-herbal formulation was evaluated in a pilot phase human clinical trial in advanced colorectal cancer patients receiving irinotecan-based (FOLFIRI) chemotherapy; during treatment, no grade 3–4 severe diarrhea occurred, and the pharmacokinetic profile showed no unfavorable changes in the metabolism of irinotecan.
A randomized, double-blind, placebo-controlled clinical trial with the TiaoPi AnChang decoction (TPACD) demonstrated a reduction in CAPOX-associated side effects and gastrointestinal symptoms in colorectal cancer patients diagnosed with spleen deficiency syndrome.
In contrast, according to a randomized trial in patients with metastatic colorectal cancer, orally administered nano-curcumin (3 × 40 mg daily) did not prove effective in preventing diarrhea induced by chemotherapy (XELOX/FOLFOX-6) compared to placebo.
References
- A preliminary exploratory clinical study of Xiao-Chai-Hu-Tang co-administered with irinotecan-based chemotherapy in advanced colorectal cancer. PMID 42002120
- Evaluation of nano-curcumin oral formulation efficacy in prevention of chemotherapy-induced adverse reactions in metastatic colorectal cancer patients. PMID 42011355
- Efficacy and safety of TiaoPi AnChang decoction to reduce CAPOX-Induced adverse reactions in Chinese patients with colorectal cancer: a randomized, double-blind, placebo-controlled trial. PMID 42292820