The Commonly Used Antitumor and Liver-Protecting Chinese Patent Medicine Ganfule Tablets (Capsules)

Ganfule tablets (capsules) are a modern Chinese patent medicine. Its ingredients include: Codonopsis (Dangshen), turtle shell (Biejia, vinegar-processed), Paris rhizome (Chonglou), white atractylodes (Baizhu, stir-fried), Astragalus (Huangqi), tangerine peel (Chenpi), ground beetle (Tubiechong), rhubarb (Dahuang), peach kernel (Taoren), Scutellaria barbata (Banzhilian), Patrinia (Baijiangcao), Poria (Fuling), Coix seed (Yiyiren), Curcuma turmeric (Yujin), Sappan wood (Sumu), oyster shell (Muli), Artemisia capillaris (Yinchen), Akebia (Mutong), Cyperus (Xiangfu, processed), Aquilaria (Chenxiang), and Bupleurum (Chaihu). It is both an antitumor drug with adjunctive effects on liver and breast cancer, prolonging survival in those conditions, and a liver-protecting drug with some therapeutic effect on liver injury and fibrosis, lowering serum ALT and AST.

In vivo animal experiments show Ganfule markedly suppresses solid liver cancer in mice, with an inhibition rate of 35.2%–43.62%; its inhibition rate for breast cancer is 38.0%; it prolongs survival by 39.5% in H22 ascites tumor and by 74.0% in EAC ascites tumor. In vitro, Ganfule is cytotoxic to both H22 ascites cells and Lewis lung carcinoma cells. Its anticancer mechanism mainly blocks DNA synthesis in cancer cells; modern pharmacology shows its anticancer action derives mainly from the stasis-resolving, hardness-softening herbs in the formula.

This formula is a modification of Dahuang Zhechong Wan, with some components similar to Biejia Jian Wan. It also incorporates herbs shown by modern pharmacology to have some anticancer effect—Scutellaria barbata, Patrinia, and Coix seed—together forming a formula that activates blood and resolves stasis, softens hardness and disperses nodules, stops pain and reduces swelling, and promotes diuresis and reduces jaundice. Cyperus, Bupleurum, and Curcuma turmeric in the formula additionally soothe the liver and relieve stagnation, suving constraint. The formula is indicated for an upper abdominal mass, hypochondriac pain, fatigue and lassitude, poor appetite and reduced eating, epigastric distension, irritability, and a bitter mouth with dry throat. These symptoms are common in cancers such as liver and breast cancer, and also in liver diseases such as hepatitis B, fatty liver, liver fibrosis, drug-induced liver injury, and cirrhosis; Ganfule can therefore also relieve the symptoms of the above liver conditions.

But Ganfule has certain side effects. First, it can cause diarrhea: the rhubarb in the formula is purgative, and long-term rhubarb use easily causes habitual constipation. Second, this is a fairly strong blood-activating, stasis-resolving formula; the ground beetle, Curcuma turmeric, rhubarb, peach kernel, and Sappan wood are all blood-activating herbs and may cause bleeding. Patients with a bleeding tendency should not use it, and pregnant women are contraindicated.