Efficacy and safety of astragalus polysaccharides in patients with malignant tumors: A systematic review and meta-analysis.

Current evidence suggests that Astragalus membranaceus is one of the most commonly used herbal medicines for cancer treatment, with its primary component, Astragalus polysaccharide (APS), demonstrating immunomodulatory effects. However, the reliability of the available evidence remains elusive. Therefore, this systematic review and meta-analysis of studies intended to evaluate the therapeutic effects and safety of APS supplementation in malignant tumor patients. We searched eight databases for articles published from January 2010 to August 2024. Uilizing the ROB2 tool for bias risk. Meta-analysis of the objective response rate (ORR), immune function, and adverse reactions was performed using Stata 15.1 software. This study is registered with PROSPERO (ID: CRD42021272595). A total of 31 randomized controlled trials (RCTs) involving 2,648 participants were incorporated. The meta-analysis results unraveled that the treatment group outperformed the control group in terms of treatment efficacy [RR = 1.30, 95% CI (1.21, 1.39), P < 0.01], CD3 + T cell count [MD = 8.79, 95% CI (6.15, 11.43), P < 0.01], CD4 + T cell count [MD = 7.94, 95% CI (5.27, 10.61), P < 0.01], and the CD4 + /CD8 + ratio [MD = 0.40, 95% CI (0.28, 0.52), P < 0.01]. No substantial distinctions were noted between the two groups in terms of CD8 + T cell count [MD = -1.74, 95% CI (-4.66, 1.17), P = 0.242]. Regarding adverse reactions, the incidence of symptoms such as hand-foot numbness and weakness was low, indicating a high safety profile. Supplementation with APS can improve treatment outcomes, enhance immune function, and demonstrate a high level of safety in malignant tumor patients, making it a promising option for clinical use. However, given the variety of cancer types included in the studies, future research should focus on specific cancer types.