Turkey Tail Mushroom

• Slightly better overall survival after 5 years among people with cancer treated with conventional treatment and turkey tail compared to conventional treatment alone in a systematic review and meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 13 RCTsrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects of low or moderate quality¹Eliza WL, Fai CK, Chung LP. Efficacy of Yun Zhi (Coriolus versicolor) on survival in cancer patients: systematic review and meta-analysis. Recent Patents on Inflammation & Allergy Drug Discovery. 2012 Jan;6(1):78-87.

• Slightly better 5-year survival among people with breast cancer treated with chemotherapy and turkey tail mushroom compared to chemotherapy alone in a meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 3 RCTsrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects of low quality²Eliza WL, Fai CK, Chung LP. Efficacy of Yun Zhi (Coriolus versicolor) on survival in cancer patients: systematic review and meta-analysis. Recent Patents on Inflammation & Allergy Drug Discovery. 2012 Jan;6(1):78-87.

Use with chemotherapy

Colorectal or colon cancer

Modest evidence of better survival among people with colorectal cancer as a whole or colon cancer specifically treated with turkey tail or PSK added to chemotherapy

Preliminary evidence of better survival among people with colorectal cancer treated with PSK alone

Also see evidence of worse survival among people with colorectal cancer treated with PSK used in place of leucovorin with tegafur/uracil in Safety and precautions ›

• Better survival at 3 and 5 years among people with colorectal cancer treated with PSK compared to placebo in 2 RCTsrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects, or when PSK was used with oral chemotherapy compared to oral chemotherapy alone in 14 RCTs, with a weak trendan apparent change due to a therapy, close to but not achieving full statistical significance (this is the CancerChoices definition; other researchers and studies may define this differently) toward better survival when PSK was used with intravenous chemotherapy, in a network analysis of studies of moderate to high quality³Ma Y, Wu X, Yu J, Zhu J, Pen X, Meng X. Can polysaccharide K improve therapeutic efficacy and safety in gastrointestinal cancer? A systematic review and network meta-analysis. Oncotarget. 2017 Jul 6;8(51):89108-89118.
• Better 5-year survival among people with colorectal cancer treated with chemotherapy and turkey tail mushroom compared to chemotherapy alone in a meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 3 RCTs of low quality⁴Eliza WL, Fai CK, Chung LP. Efficacy of Yun Zhi (Coriolus versicolor) on survival in cancer patients: systematic review and meta-analysis. Recent Patents on Inflammation & Allergy Drug Discovery. 2012 Jan;6(1):78-87.
• A weak trend toward better 5-year survival after curative resection among people with stage 2 or 3 colorectal cancer  with detectable serum immunosuppressive acidic protein (IAP) who were treated with a therapy connected or added to a main treatment or therapy, not used alone tegafur/uracil and PSK compared to tegafur/uracil alone, with a larger effect in people with stage 3 cancer in a mid-sized RCT⁵Ohwada S, Ikeya T et al. Adjuvant immunochemotherapy with oral tegafur/uracil plus PSK in patients with stage II or III colorectal cancer: a randomised controlled study. British Journal of Cancer. 2004 Mar 8;90(5):1003-10.
• Better 5-year survival after curative resection among people with colorectal cancer treated with adjuvanttreatment applied after initial treatment for cancer, especially to suppress secondary tumor formation chemotherapy plus PSK compared to adjuvant chemotherapy alone in a meta-analysis of 3 RCTs of indeterminate quality⁶Sakamoto J, Morita S et al; Meta-Analysis Group of the Japanese Society for Cancer of the Colon Rectum. Efficacy of adjuvant immunochemotherapy with polysaccharide K for patients with curatively resected colorectal cancer: a meta-analysis of centrally randomized controlled clinical trials. Cancer Immunology, Immunotherapy. 2006 Apr;55(4):404-11.
• Better recurrence-free survival, cancer-specific survival, and overall survival rates among people with colon cancer exhibiting a diffuse nuclear accumulation-type beta-catenin activation and treated with chemotherapy plus PSK compared to chemotherapy alone in a mid-sized observationala type of study in which individuals are observed or certain outcomes are measured, but no attempt is made to affect the outcome (for example, no treatment is given); an example is a study that records people’s diets, but doesn’t try to alter their diets, and looks for patterns of disease or other outcomes related to different foods study⁷Yamashita K, Ougolkov AV et al. Adjuvant immunochemotherapy with protein-bound polysaccharide K for colon cancer in relation to oncogenic beta-catenin activation. Diseases of the Colon and Rectum. 2007 Aug;50(8):1169-81.
• Better 7-year survival among people with colorectal cancer and a carcinoembryonic antigen (CEA) level of 3ng/mL or greater or a purified protein derivative reaction (PPD) of less than 19mm and treated with a therapy connected or added to a main treatment or therapy, not used alone chemotherapy plus PSK compared to chemotherapy alone in a subgroup analysis of a small, separate RCT⁸Takahashi Y, Mai M, Nakazato H. Preoperative CEA and PPD values as prognostic factors for immunochemotherapy using PSK and 5-FU. Anticancer Research. 2005 Mar-Apr;25(2B):1377-84.

Rectal cancer: no evidence of an effect on survival among people with rectal cancer treated with tegafur/uracil (UFC) and PSK added to curative surgery in a preliminary study; also see evidence of lower survival and higher risk of recurrence among people with colorectal cancer when combining tegafur/uracil with PSK in Safety and precautions ›

• Comparable 3-year or 5-year overall survival after curative surgery among people with stage 2 rectal cancer treated with tegafur/uracil (UFC) plus PSK compared to surgery alone in a small RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects of reasonable quality⁹Okuno K, Aoyama T et al. Randomized phase III trial comparing surgery alone to UFT + PSK for stage II rectal cancer (JFMC38 trial). Cancer Chemotherapy Pharmacology. 2018 Jan;81(1):65-71.

Other conventional treatments: preliminary evidence of better 10-year overall survival after curative resection among people with colorectal cancer treated with fluoropyramidines and PSK

• Better 10-year overall survival after curative resection among people with colorectal cancer treated with fluoropyramidines plus PSK compared to fluoropyramidines alone in a small controlled triala study design in which people are assigned to either an experimental group or a control group to compare the outcomes from different treatment; assignment is not random, and so this is not as strong a study design as a randomized controlled trial, but still stronger than an uncontrolled trial¹⁰Sakai T, Yamashita Y et al. Immunochemotherapy with PSK and fluoropyrimidines improves long-term prognosis for curatively resected colorectal cancer. Cancer Biotherapy & Radiopharmaceuticals. 2008 Aug;23(4):461-7.

Esophageal cancer: no evidence of an effect on survival among people with esophageal cancer treated with turkey tail added to conventional treatment in a combined analysis of 2 studies

• No evidence of an effect on 5-year survival among people with esophageal cancer treated with conventional treatment and turkey tail mushroom compared to conventional treatment alone in a meta-analysisa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of 2 RCTsrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects of low quality¹¹Eliza WL, Fai CK, Chung LP. Efficacy of Yun Zhi (Coriolus versicolor) on survival in cancer patients: systematic review and meta-analysis. Recent Patents on Inflammation & Allergy Drug Discovery. 2012 Jan;6(1):78-87.

Liver cancer: no evidence of better survival among people with hepatocellular carcinoma and unable to receive standard treatment treated with PSP alone in a preliminary study

• No evidence of an effect on survival among people with hepatocellular carcinoma with poor liver function and deemed unfit for standard treatment who were treated with PSP compared to placebo in a small RCT¹²Chay WY, Tham CK et al. Coriolus versicolor (Yunzhi) use as therapy in advanced hepatocellular carcinoma patients with poor liver function or who are unfit for standard therapy. Journal of Alternative and Complementary Medicine. 2017 Aug;23(8):648-652.

Stomach cancer

Modest evidence of better survival among people with stomach cancer treated with turkey tail or PSK added to chemotherapy

Preliminary evidence of better survival among people with stomach cancer treated with PSK alone

• Better survival at 3 and 5 years among people with stomach cancer treated with PSK compared to placebo in 2 RCTs, or when PSK was used with oral chemotherapy compared to oral chemotherapy alone in 14 RCTs, with a weak trendan apparent change due to a therapy, close to but not achieving full statistical significance (this is the CancerChoices definition; other researchers and studies may define this differently) toward better survival when PSK was used with intravenous chemotherapy in a network analysis of studies of moderate to high quality¹³Ma Y, Wu X, Yu J, Zhu J, Pen X, Meng X. Can polysaccharide K improve therapeutic efficacy and safety in gastrointestinal cancer? A systematic review and network meta-analysis. Oncotarget. 2017 Jul 6;8(51):89108-89118.
• Moderately better 5-year survival among people with stomach cancer treated with chemotherapy and turkey tail mushroom compared to chemotherapy alone in a meta-analysis of 3 RCTs of low to moderate quality¹⁴Eliza WL, Fai CK, Chung LP. Efficacy of Yun Zhi (Coriolus versicolor) on survival in cancer patients: systematic review and meta-analysis. Recent Patents on Inflammation & Allergy Drug Discovery. 2012 Jan;6(1):78-87.
• Substantially better 3-year survival rates among people with stage 3 stomach cancer treated with PSK and tagafur/uracil (UFT) compared to UFT alone in a small RCT; the PSK survival benefit was found to be greatest in a subset of people whose CD57(+) T-cell ratio increased above 18% after surgery, and for whom survival was worse than among those with lower ratios¹⁵Akagi J, Baba H. PSK may suppress CD57(+) T cells to improve survival of advanced gastric cancer patients. International Journal of Clinical Oncology. 2010 Apr;15(2):145-52.
• Better 5-year survival rate only among people with granulocyte to lymphocyte (G/L) ratios less than 2.0, but no evidence of an effect on survival among people with G/L ratios greater than 2.0, treated with chemotherapy and PSK compared to chemotherapy alone in a mid-sized observationala type of study in which individuals are observed or certain outcomes are measured, but no attempt is made to affect the outcome (for example, no treatment is given); an example is a study that records people’s diets, but doesn’t try to alter their diets, and looks for patterns of disease or other outcomes related to different foods study¹⁶Toge T, Yamaguchi Y. Protein-bound polysaccharide increases survival in resected gastric cancer cases stratified with a preoperative granulocyte and lymphocyte count. Oncology Reports. 2000;7:1157–1161.

• Better 5-year survival and better median survival time by 10 months among people with nasopharyngeal cancer treated with radiotherapy with or without chemotherapy plus PSK compared to people treated with radiotherapy alone in a small controlled triala study design in which people are assigned to either an experimental group or a control group to compare the outcomes from different treatment; assignment is not random, and so this is not as strong a study design as a randomized controlled trial, but still stronger than an uncontrolled trial of low quality¹⁷Go P, Chung C-H. Adjuvant PSK immunotherapy in patients with carcinoma of the nasopharynx. Journal of International Medical Research. March 1989:141-149.

• Better overall survival among people with leukemia treated with chemotherapy plus Krestin (PSK) compared to chemotherapy alone in an RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects of unknown size or quality¹⁸Nagao T, Komatsuda M et al.  Chemoimmunotherapy with Krestin in acute leukemia. Tokai Journal of Experimental and Clinical Medicine. 1981 Apr;6(2):141-6.

• Moderately better 4-year survival after resection among people with lung cancer treated with adjuvanttreatment applied after initial treatment for cancer, especially to suppress secondary tumor formation chemotherapy and PSK compared to adjuvant chemotherapy alone in a mid-sized RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects¹⁹Ikeda T, Sakai T, Suito T, Kosaki G. [Evaluation of postoperative immunochemotherapy in lung cancer]. Gan To Kagaku Ryoho. 1986 Apr;13(4 Pt 1):1044-9. Japanese.
• A weak trendan apparent change due to a therapy, close to but not achieving full statistical significance (this is the CancerChoices definition; other researchers and studies may define this differently) toward longer mean survival time in people with stage 3 adenocarcinoma of the lung, but no evidence of an effect with stage 4, treated with chemotherapy and PSK compared to chemotherapy alone in a subgroup analysis of an RCT of unknown quality²⁰Nishiwaki Y, Furuse K  et al. [A randomized controlled study of PSK combined immuno-chemotherapy for adenocarcinoma of the lung. The Advanced Lung Cancer Immuno-chemotherapy Study Group]. Gan To Kagaku Ryoho. 1990 Jan;17(1):131-6. Japanese.

• Higher blood lymphocyte and neutrophil counts after completing conventional treatment among people with advanced non-small cell lung cancer treated with PSP compared to controls in a small RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects²¹Tsang KW, Lam CL et al. Coriolus versicolor polysaccharide peptide slows progression of advanced non-small cell lung cancer. Respiratory Medicine. 2003 Jun;97(6):618-24.
• Greater lymphocyte counts, natural killer (NK) cell activity and greater CD8+ T cell and CD19+ B cell counts with increasing doses after completing radiotherapy among people with breast cancer treated with 6 grams of turkey tail mushroom daily compared to baseline in a small uncontrolled triala study in which a therapy is used, but without a comparison group against which to judge outcomes; an uncontrolled trial is considered a weak study design²²Torkelson C J, Sweet E. Phase 1 Clinical trial of Trametes versicolor in women with breast cancer. International Scholarly Research Notices, vol. 2012, Article ID 251632, 7 pages, 2012.

• Better markers of immune function among healthy people treated with turkey tail capsules and Salvia miltiorrhiza for 4 months in a mid-sized RCTrandomized controlled trial, a study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects²³Wong CK, Tse PS, Wong EL, Leung PC, Fung KP, Lam CW. Immunomodulatory effects of yun zhi and danshen capsules in health subjects—a randomized, double-blind, placebo-controlled, crossover study. International Immunopharmacology. 2004 Feb;4(2):201-11.