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Successful Outcome of Elderly Patients with Advanced Malignant Melanoma by Standardized Allergen-removed Rhus verniciflua Stokes Extract and Bojungikki-tang: Two Cases

  • Jung, Hyunsik (Department of Medical Consilience, Graduate School, Dankook University) ;
  • Lee, Sanghun (Department of Medical Consilience, Graduate School, Dankook University)
  • Received : 2014.07.22
  • Accepted : 2014.10.24
  • Published : 2014.12.30

Abstract

Objectives: Advanced malignant melanoma (MM) has a poor prognosis, with an expected 2-year survival rate of 10 to 20%. It has long been recognized as an immunogenic tumor, and is worse for elderly patients. Many studies have suggested that herbal treatments improve immune functions, but few clinical studies have reported on this topic. Patients and History: We present two cases of female patients (72 and 77 years old, respectively) with advanced MM. The 72-year-old female patient was, at first, diagnosed with MM with multiple bone metastases. She received resection of the primary lesion, but refused further chemotherapy. The 77-year-old female patient was diagnosed with cutaneous MM of the left heel, with suspicion of sentinel node lymphadenopathy; however, she also refused any conventional treatment due to old age. Course of Therapy and Results: Both patients were exclusively treated with standardized allergen-removed Rhus verniciflua stokes (aRVS) extract combined with Bojungikki-tang (BT, Bu-Zhong-Yi-Qi-Tang in Chinese or Hochu-ekki-to in Japanese). Both patients are still alive and doing well (Feb. 2014), demonstrating that the 72-year-old patient has lived for 27 months and the 77-year-old patient has lived for 31 months without disease progression since the aRVS and BT administration. Conclusion: We suggest that the combination of aRVS extract and BT could be a candidate for overcoming the cancer's immunoediting process especially for elderly MM patients intolerant of conventional treatment.

Keywords

References

  1. Houghton AN, Polsky D. Focus on melanoma. Cancer Cell. 2002;2(4):275-8. https://doi.org/10.1016/S1535-6108(02)00161-7
  2. Soengas MS, Lowe SW. Apoptosis and melanoma chemoresistance. Oncogene. 2003;22(20):3138-51. https://doi.org/10.1038/sj.onc.1206454
  3. Macdonald JB, Dueck AC, Gray RJ, Wasif N, Swanson DL, Sekulic A, et al., Malignant melanoma in the elderly: different regional disease and poorer prognosis. Journal of Cancer. 2011;2:538-43. https://doi.org/10.7150/jca.2.538
  4. Hegde UP, Grant-Kels JM, Metastatic melanoma in the older patient: special considerations. Clinics in Dermatology. 2013;31(3):311-6. https://doi.org/10.1016/j.clindermatol.2012.08.011
  5. Kang CH,, Shin HK, Shim BS, Kim SH, Choi SH, et al. Experimental Studies on the Anti-angiogenesis and Anti-metastasis Effects of Ekong-san. Journal of Korean Traditional Oncology. 2006;11(1):41-54.
  6. Lee SG, Ha JH. Antitumor and immunomodulatory effects of Ikongsan on murine melanoma-induced lung metastasis. Korean Journal of Oriental Medical Pathology. 1997;11(1):21-30.
  7. Kwon SJ, Lee JH, Moon KD, Jeong IY, Ahn DU, Lee MK, et al. Induction of apoptosis by isoegomaketone from Perilla frutescens L. in B16 melanoma cells is mediated through ROS generation and mitochondrial-dependent, -independent pathway. Food Chem Toxicol. 2013.
  8. Nabeshima S, Murata M, Hamada M, Chong Y, Yamaji K, Hayashi J. Maturation of monocyte -derived dendritic cells by Hochu-ekki-to, a traditional Japanese herbal medicine. Int Immunopharmacol. 2004;4(1):37-45. https://doi.org/10.1016/j.intimp.2003.10.002
  9. Cho S, Hong T, Kaneko A, Yoshino G, Sato N, Kikuchi K, et al. Evaluation of immunological effects of hochu-ekki-to (TJ-41) prophylactic administration in mice. Am J Chin Med. 2004;32(2):235-43. https://doi.org/10.1142/S0192415X04001898
  10. Chae SY, Shin SH, Ha MH, Jo SK, Kim SH, Byun MW, et al. Effect of Bu - Zhong - Yi - Qi - Tang on Proliferation of T Cells. Journal of the Korean Society of Food Science and Nutrition. 2004;33(7):1085-91. https://doi.org/10.3746/jkfn.2004.33.7.1085
  11. Jeong JS, Ryu BH, Kim JS, Park JW, Choi WC, Yoon SW. Bojungikki-tang for cancer-related fatigue: a pilot randomized clinical trial. Integr Cancer Ther. 2010;9(4):331-8. https://doi.org/10.1177/1534735410383170
  12. Choi W, Jung H, Kim K, Lee S, Yoon S, Park J, et al. Rhus verniciflua Stokes against Advanced Cancer: A Perspective from the Korean Integrative Cancer Center. Journal of Biomedicine & Biotechnology. 2012;2012:874276.
  13. Lee S, Kim K, Jung H, Cheon S, Kim S, Eo W, et al. Efficacy and Safety of Standardized Allergen-Removed Rhus verniciflua Stokes Extract in Patients with Advanced or Metastatic Pancreatic Cancer: A Korean Single-Center Experience. Oncology. 2011;81(5-6):312-8. https://doi.org/10.1159/000334695
  14. Choi W, An S, Kwon E, Eo W, Lee S. Impact of Standardized Allergen-Removed Rhus verniciflua Stokes Extract on Advanced Adenocarcinoma of the Ampulla of Vater: A Case Series. Evidence-based Complementary and Alternative Medicine : eCAM. 2013;2013:203168.
  15. Satoh N, Sakai S, Kogure T, Tahara E, Origasa H, Shimada Y, et al. A randomized double blind placebo-controlled clinical trial of Hochuekkito, a traditional herbal medicine, in the treatment of elderly patients with weakness N of one and responder restricted design. Phytomedicine. 2005;12(8):549-54. https://doi.org/10.1016/j.phymed.2004.06.014
  16. Kuroiwa A, Liou S, Yan H, Eshita A, Naitoh S, Nagayama A. Effect of a traditional Japanese herbal medicine, hochu-ekki-to (Bu-Zhong-Yi-Qi Tang), on immunity in elderly persons. Int Immunopharmacol. 2004;4(2):317-24. https://doi.org/10.1016/j.intimp.2003.12.004
  17. Yamaoka Y, Kawakita T, Nomoto K. Protective effect of a traditional Japanese medicine Hochu-ekki-to (Chinese name: Bu-zhong-yiqi-tang), on the susceptibility against Listeria monocytogenes in infant mice. Int Immunopharmacol. 2001;1(9-10):1669-77. https://doi.org/10.1016/S1567-5769(01)00076-5
  18. Utsuyama M, Seidlar H, Kitagawa M, Hirokawa K. Immunological restoration and anti-tumor effect by Japanese herbal medicine in aged mice. Mechanisms of Ageing and Development. 2001;122(3):341-52. https://doi.org/10.1016/S0047-6374(00)00249-9
  19. Li T, Tamada K, Abe K, Tada H, Onoe Y, Tatsugami K, et al. The restoration of the antitumor T cell response from stress-induced suppression using a traditional Chinese herbal medicine Hochu-ekki-to (TJ-41:Bu-Zhong-Yi-Qi-Tang). Immunopharmacology. 1999;43(1):11-21. https://doi.org/10.1016/S0162-3109(99)00034-X
  20. Ahn KS, Lee KT, Jang SK, Jeong JC, Noh YS. Experimental Studies on the Immunomodulatory Effects of Ekong-san. Journal of the Institute of Oriental Medicine. 1999;2(-):15-29.
  21. Lee SK, Jung HS, Eo WK, Lee SY, Kim SH, Shim BS. Rhus verniciflua Stokes extract as a potential option for treatment of metastatic renal cell carcinoma: report of two cases. Ann Oncol. 2010;21(6):1383-5. https://doi.org/10.1093/annonc/mdq154
  22. Clemente CG, Mihm MC, Jr. Bufalino R, Zurrida S, Collini P, Cascinelli N. Prognostic value of tumor infiltrating lymphocytes in the vertical growth phase of primary cutaneous melanoma. Cancer. 1996;77(7):1303-10. https://doi.org/10.1002/(SICI)1097-0142(19960401)77:7<1303::AID-CNCR12>3.0.CO;2-5
  23. Quezada SA, Peggs KS. Exploiting CTLA-4, PD-1 and PD-L1 to reactivate the host immune response against cancer. British Journal of Cancer. 2013;108(8):1560-5. https://doi.org/10.1038/bjc.2013.117
  24. Maio M. Melanoma as a model tumour for immuno-oncology. Annals of Oncology. 2012;23:10-4. https://doi.org/10.1093/annonc/mdr117