Association of Spatholobus littoralis Hassk Supplementation with Nutritional Indices and Survival Outcomes in EGFR Wild-Type Lung Adenocarcinoma

Fidya Rahmadhany Arganita; Haryati Haryati; Ali Assagaf; Mohamad Isa; Ira Nurrasyidah

doi:10.31557/APJCC.2026.11.4.521

Authors

Fidya Rahmadhany Arganita Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Lambung Mangkurat University/Ulin General Hospital, Banjarmasin, Indonesia. https://orcid.org/0000-0002-0409-7263
Haryati Haryati Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Lambung Mangkurat University/Ulin General Hospital, Banjarmasin, Indonesia. https://orcid.org/0000-0001-8605-9991
Ali Assagaf Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Lambung Mangkurat University/Ulin General Hospital, Banjarmasin, Indonesia. https://orcid.org/0009-0005-3019-5085
Mohamad Isa Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Lambung Mangkurat University/Ulin General Hospital, Banjarmasin, Indonesia. https://orcid.org/0009-0006-7565-641X
Ira Nurrasyidah Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Lambung Mangkurat University/Ulin General Hospital, Banjarmasin, Indonesia. https://orcid.org/0000-0001-6327-3186

DOI:

https://doi.org/10.31557/APJCC.2026.11.4.521

Keywords:

lung adenocarcinoma, Spatholobus littoralis Hassk, Prognostic Nutritional Index, Controlling Nutritional Status, Progression-free survival

Abstract

Introduction: Spatholobus littoralis Hassk. is a natural antioxidant that may help support clinical outcomes in cancer patients. In EGFR wild-type lung adenocarcinoma, where therapeutic options and prognosis remain limited, nutritional status may play an important prognostic role, yet clinical evidence in this setting is scarce. This study evaluated the association of adjunctive S. littoralis supplementation with nutritional indices and survival outcomes.

Materials and Methods: A prospective cohort study was conducted at Ulin General Hospital, Banjarmasin, Indonesia, from May 2023 to May 2024, with follow-up through May 2025. Eligible patients with stage IIIB or higher EGFR wild-type adenocarcinoma received platinum–pemetrexed chemotherapy, with or without S. littoralis extract (1000 mg three times daily). Nutritional indices the Prognostic Nutritional Index (PNI) and Controlling Nutritional Status (CONUT) were evaluated before and after three chemotherapy cycles. Comparative analyses were performed using appropriate parametric and non-parametric tests. Primary outcomes were ΔPNI, ΔCONUT, and progression-free survival (PFS), while overall survival (OS) was treated as a secondary outcome. Survival analyses were conducted using Kaplan–Meier curves with log-rank tests.

Results: A total of 21 patients with EGFR wild-type lung adenocarcinoma were included. Patients receiving S. littoralis supplementation showed non-significant improvements in PNI (42.93 ± 7.93 to 46.74 ± 7.51; p = 0.128) and reductions in CONUT scores (1 [0–5] to 1 [0–3]; p = 0.358) after chemotherapy. However, between-group analysis revealed significantly greater improvement in the S. littoralis group, reflected by higher ΔPNI (+3.81 vs. –2.21; p = 0.043) and lower ΔCONUT (–1.36 vs. +0.6; p = 0.042). Median PFS was significantly longer in the treatment group (7 vs. 3 months; p = 0.012), while OS did not differ (7 vs. 7 months; p = 0.542).

Conclusion: Spatholobus littoralis Hassk. supplementation was associated with improved ΔPNI, ΔCONUT and longer PFS. These findings support its potential as a natural immunonutritional adjuvant in lung cancer care. Larger multicenter trials are required to confirm these findings.