Mechanisms of Traditional Chinese Medicine in Advanced Gastric Cancer: Insights from Meta-Analysis and Network Pharmacology

BACKGROUND: Traditional Chinese medicine (TCM) is widely used as an adjuvant therapy for advanced gastric cancer (AGC), yet its underlying mechanisms and targets remain inadequately characterized. METHODS: This study integrated meta-analysis and network pharmacology to evaluate the therapeutic effects of TCM, identify core-effective prescriptions (CEPs), and predict potential molecular targets. RESULTS: Seventeen studies comparing TCM combined with chemotherapy versus chemotherapy alone for AGC were identified through a search of seven databases. Meta-analysis showed that TCM significantly improved overall survival (OS) (hazard ratio: 1.65, 95% confidence interval: 1.23-2.22, p < 0.001, I2 = 0%). CEPs and their chemical constituents were identified. A component-target (C-T) network was constructed, revealing the top 10 core genes were TP53, AKT1, CASP3, MYC, IL6, ESR1, EGFR, TNF, PTEN, and HIF1A. CONCLUSION: This meta-analysis demonstrates that TCM combined with chemotherapy improves OS in AGC patients more effectively than chemotherapy alone. Network pharmacology offered complementary mechanistic insights, laying a foundation for future experimental research.