{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T06:36:24Z","timestamp":1792132584867,"version":"4.4.0"},"reference-count":24,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T00:00:00Z","timestamp":1757376000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate the efficacy, safety, and quality of evidence for commercial Chinese polyherbal preparations (CCPPs) in combination with oxaliplatin-based chemotherapy (OX) for gastric cancer (GC).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We searched six databases for randomized controlled trials (RCTs) comparing CCPPs plus OX to other active treatments for GC. The risk of bias was assessed using a modified version of Cochrane risk of bias tool. A frequentist network meta-analysis using a random-effects model was performed to estimate the relative effectiveness between treatments. We used GRADE to assess the certainty of evidence, to categories the interventions, and to present the findings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One-hundred-and-eighty-nine RCTs involving 15,320 participants that reported 27 CCPPs were identified. Moderate to high certainty evidence showed that Compound Mylabris preparations (Disease Control Rate (DCR): 1.51, 1.13\u20132.03) is among the most effective CCPPs for improving DCR, while Kangai Injection (objective response rate (ORR): 1.40, 1.28 to 1.77; quality of life (QoL): 1.46, 1.11\u20131.94), Huachansu preparations (ORR: 1.28, 1.15\u20131.43), Ya Dan Zi Oil Emulsion Injection (QoL: RR 1.26, 1.06\u20131.51), Aidi Injection (QoL: 1.30, 1.13\u20131.50), Lentinan (QoL: 1.27, 1.05\u20131.54), and Yangzheng Xiaoji Capsules (ORR: 1.36, 1.05\u20131.77) showed intermediate efficacy for ORR and QoL. Regarding immune function improvement, with moderate to high certainty evidence, Shenmai Injection (CD3<jats:sup>+<\/jats:sup>: 10.03, 1.69 to 18.37; CD4<jats:sup>+<\/jats:sup>: 8.33, 0.64\u201316.02), Ginseng Polysaccharide Injection (CD3<jats:sup>+<\/jats:sup>: 10.55, 1.89\u201319.21), Huachansu preparations (CD3<jats:sup>+<\/jats:sup>: 7.42, 2.51\u201312.34), Kangai Injection (CD3<jats:sup>+<\/jats:sup>: 11.65, 6.81 to 16.50; CD4<jats:sup>+<\/jats:sup>\/CD8<jats:sup>+<\/jats:sup>: 0.25, 0.02\u20130.47), Lentinan (CD4<jats:sup>+<\/jats:sup>: 9.43, 3.78\u201315.08), Shenqi Fuzheng Injection (CD4<jats:sup>+<\/jats:sup>: 5.72, 3.68\u20137.76), and Yangzheng Xiaoji Capsules (CD3<jats:sup>+<\/jats:sup>: 9.32, 0.84\u201317.80) showed improvements in specific immune parameters.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>No CCPP was optimal for all endpoints, Compound Mylabris showed superior tumor response, and Kangai Injection offered the most favorable risk-benefit profile, providing broad efficacy and statistically significantly reducing AEs. The choice of adjuvant CCPP should be individualized based on specific therapeutic priorities, balancing efficacy and safety.<\/jats:p><\/jats:sec><jats:sec><jats:title>Systematic Review Registration<\/jats:title><jats:p><jats:ext-link>https:\/\/www.crd.york.ac.uk\/PROSPERO\/view\/CRD42025646173<\/jats:ext-link>.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fphar.2025.1645079","type":"journal-article","created":{"date-parts":[[2025,9,9]],"date-time":"2025-09-09T09:08:43Z","timestamp":1757408923000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Efficacy and safety of commercial Chinese polyherbal preparation combined with oxaliplatin-based chemotherapy for gastric cancer: a systematic review and network meta-analysis"],"prefix":"10.3389","volume":"16","author":[{"given":"Bei","family":"Pan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Honghao","family":"Lai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ning","family":"Ma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaowei","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiyuan","family":"Deng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinhui","family":"Tian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Long","family":"Ge","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kehu","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,9,9]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"167","DOI":"10.6004\/jnccn.2022.0008","article-title":"Gastric cancer, version 2.2022, NCCN clinical practice guidelines in oncology","volume":"20","author":"Ajani","year":"2022","journal-title":"J. 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