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. 2017 Sep;7(3):359-366.
doi: 10.3892/mco.2017.1346. Epub 2017 Jul 25.

Lentinula edodes Mycelia Extract Plus Adjuvant Chemotherapy for Breast Cancer Patients: Results of a Randomized Study on Host Quality of Life and Immune Function Improvement

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Free PMC article

Lentinula edodes Mycelia Extract Plus Adjuvant Chemotherapy for Breast Cancer Patients: Results of a Randomized Study on Host Quality of Life and Immune Function Improvement

Yukiko Nagashima et al. Mol Clin Oncol. .
Free PMC article

Abstract

Anthracycline-based chemotherapies for breast cancer are known to adversely affect patients' quality of life (QOL) and immune function. For that reason, adjuvants that improve those impairments are required. A randomized double-blind study was conducted to evaluate the effectiveness of Lentinula edodes mycelia extract (LEM), which is an oral biological response modifier (BRM) medicine for cancer patients as such an adjuvant. A total of 47 breast cancer patients who were scheduled to receive postoperative adjuvant anthracycline-based chemotherapy, i.e., 5-fluorouracil (5-FU) + cyclophosphamide + epirubicin (FEC regimen), 5-FU + cyclophosphamide + doxorubicin/pirarubicin (FAC regimen), cyclophosphamide + doxorubicin/pirarubicin (AC regimen) and cyclophosphamide + epirubicin (EC regimen), were entered in the study. The patients were randomly divided into either an LEM or a placebo tablet group; the tablets were orally ingested daily over 2 courses of each therapy. In the placebo group, the total scores for QOL were lower on day 8 of the second course of chemotherapy compared with the baseline scores, whereas in the LEM group the scores had not decreased. In the placebo group, the QOL functional well-being score was lower on day 8 after both the first and second courses of chemotherapy compared with the baseline score, but it had not decreased in the LEM group. Evaluation of immunological parameters indicated that an increase in the proportion of regulatory T cells to peripheral blood CD4+ cells tended to be inhibited in the LEM group compared with the placebo group. Oral LEM that was coadministered with anthracycline-based chemotherapies was useful for maintaining patients' QOL and immune function. Thus, LEM appears to be a useful oral adjuvant for patients receiving anthracycline-based chemotherapy.

Keywords: Lentinula edodes; anthracycline; breast cancer; quality of life; randomized clinical study; regulatory T cell.

Figures

Figure 1.
Figure 1.
QOL scores over the course of the study. QOL was measured by the Functional Assessment of Cancer Therapy for patients receiving Biological Response Modifiers (FACT-BRM) version 4, and was evaluated from scores on the questionnaire. The measurement values shown are means ± standard error. Variation within each group was assayed by the Kruskal-Wallis test with the Steel test vs. day 1 of the first course. *P<0.05; **P<0.01. (A) Total scores, (B) FACT-G total scores, (C) PWB scores, (D) FWB scores. QOL, quality of life; LEM, Lentinula edodes mycelia extract; PWB, physical well-being; FWB, functional well-being; FACT-G, Functional Assessment of Cancer Therapy general scale.
Figure 2.
Figure 2.
Regulatory T cells (Tregs) in CD4-positive cells in peripheral blood over the course of the study. The proportion of CD25-positive FoxP3-positive cells in CD4-positive cells was measured using flow cytometry. The figure shows the change in the value from the baseline (first course, day 1, prior to drug administration). The measurement values are shown as means ± standard error. Black bars, LEM group; white bars, placebo group. Variation within each group was assayed by repeated one-way analysis of variance with Bonferroni's correction vs. day 1 of the first course. *P<0.05; **P<0.01. Variation between the two groups was assayed by an unpaired t-test. LEM, Lentinula edodes mycelia extract; FoxP3, forkhead box p3.

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