Can polysaccharide K improve therapeutic efficacy and safety in gastrointestinal cancer? a systematic review and network meta-analysis

Yan Ma, Xiaofen Wu, Jingwen Yu, Jinyan Zhu, Xia Pen and Xianjun Meng _

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Oncotarget. 2017; 8:89108-89118. https://doi.org/10.18632/oncotarget.19059

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Yan Ma2, Xiaofen Wu3, Jingwen Yu3, Jinyan Zhu4, Xia Pen2 and Xianjun Meng1

1College of Food Science, Shenyang Agriculture University, Shenyang 110866, P.R. China

2Center of Experiment Teaching, Shenyang Normal University, Shenyang 110034, P.R. China

3The Sixth People’s Hospital of Shenyang, Shenyang 110005, P.R. China

4Food Inspection Monitoring Center of Zhuanghe, Dalian 116400, P.R. China

Correspondence to:

Xianjun Meng, email: [email protected]

Keywords: polysaccharide K, PSK, immunochemotherapy, gastrointestinal cancer, network meta-analysis

Received: May 13, 2017     Accepted: June 19, 2017     Published: July 06, 2017


Objective: To assess the comparative efficacy and safety of polysaccharide K (PSK), with or without chemotherapy, for patients with gastrointestinal cancer (GIC) through a systematic review and network meta-analysis.

Materials and Methods: We performed a network meta-analysis to identify evidence from randomized controlled trials. We searched PubMed, Embase and the Cochrane Library for publications up to May 2017. The prespecified primary efficacy outcomes were 1–7 year overall survival (OS), while the secondary efficacy outcomes were 1–7 year disease-free survival (DFS); we performed subgroup analyses and meta-regressions according to the cancer type (colorectal, esophagus and gastric cancer) and treatment arms (with or without chemotherapy). Safety outcomes were side effects of PSK. We conducted pairwise meta-analyses using a random-effects model and then performed random-effects network meta-analyses.

Results: A total of 23 trials were eligible, involving 10684 patients and 13 intervention arms. PSK treatment significantly increased 1–5 year OS and resulted in positive trends in 6–7 year OS; significant increases were also found in 1–7 year DFS, while no increase in side effects was observed. Significant efficacy outcomes obvious in colorectal and gastric cancer groups, as well as PSK combined with chemotherapy groups (iv, po, iv+po). Network meta-analysis revealed that PSK combined with chemotherapy was superior, with significantly increased 3-year and 5-year OS. The study is registered with PROSPERO (CRD42017065193)

Conclusions: The adjuvant immunochemotherapy agent PSK is effective and safe for patients with GIC. PSK combined with chemotherapy appears to be the preferred application of PSK.

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