Atlas chapter 26 · Oncology (adjunctive)

Taiwanofungus camphoratus

Taiwanofungus camphoratus (historical names: Antrodia camphorata, A. cinnamomea)

Cancer E3Ø; liver-related programme E3±, proposition-dependent; narrow selected controlled outcomes E3+ where a valid preparation-specific between-group signal is demonstratedØ — Does not support under tested conditionsR1-2

Proposition / claim: No significant survival/disease-control benefit in the audited randomized advanced-cancer trial
Evidence owner: Specific audited preparations in the randomized advanced-cancer trial
Dominant uncertainty: Wild-versus-cultivated clinical relevance

Organism: Taiwanofungus camphoratus
Tested intervention: Multiple proposition-specific Taiwanofungus-related interventions, which must not be merged: (1) the specific defined preparation tested in the randomized advanced-cancer trial; (2) defined cultivated or manufactured preparations used in separate controlled liver-related studies; (3) wild Taiwanofungus material as the subject of an UNTESTED wild-superiority/equivalence proposition.
Evidence target: MULTI_PROPOSITION_INTERVENTION: defined randomized-trial cancer preparation / separate cultivated or manufactured liver-study preparations / wild-versus-cultivated equivalence and superiority proposition. A single standardized-preparation target would falsely collapse the controlled cancer null, the mixed liver programme, and the untested wild-superiority proposition.
Intervention description: Cancer: a defined Taiwanofungus-related preparation administered in a randomized advanced/metastatic cancer setting alongside conventional treatment. Liver: separate defined cultivated or manufactured preparations studied in controlled human liver-related programmes. Wildness proposition: rare wild material associated with the traditional host Cinnamomum kanehirae is commercially and culturally prestigious, but current human evidence does not establish clinical superiority over cultivated material. Wildness becomes part of the intervention definition only when therapeutic superiority is claimed.
Population: Cancer: people with advanced or metastatic cancer receiving conventional treatment in the audited randomized trial. Liver: proposition-specific populations in separate controlled studies, including a small randomized study in people with non-alcoholic steatohepatitis and a later placebo-controlled liver-enzyme programme. These populations must not be merged into one generic clinical population.
Comparator: Cancer: the comparator/control condition in the audited randomized advanced-cancer trial alongside conventional treatment. Liver: placebo/control conditions belonging to the individual controlled liver-related studies. Wild-superiority proposition: no qualifying direct wild-versus-cultivated clinical comparator has established wild superiority. Exact comparator composition is not further specified in FA-053.
Outcome: CANCER: the audited randomized advanced-cancer trial did not demonstrate a significant improvement in overall survival or disease-control outcomes, supporting E3Ø for the tested cancer proposition under the tested conditions. This controlled null is not erased by post-hoc rescue hypotheses about wrong preparation, wrong cancer, advanced disease, dose, or cultivated-versus-wild material; those are future hypotheses, not corrections to the trial. LIVER: the programme is mixed and outcome-specific. One small randomized controlled study in non-alcoholic steatohepatitis reported favourable between-group findings on selected composite liver-related measures, supporting a narrow E3+ only for the particular preparation/outcomes that earned a valid between-group signal. A later randomized placebo-controlled study examining ALT and AST did not demonstrate significant overall treatment-versus-placebo differences on the prespecified primary liver-enzyme outcomes; a favourable ALT finding in regular alcohol drinkers is subgroup evidence and remains exploratory. Programme-level position: E3±, proposition-dependent. Biomarker/composite findings are not converted into liver-disease prevention, fibrosis reversal, cirrhosis prevention, general hepatoprotection, or long-term patient-important benefit. WILD SUPERIORITY: no current evidence establishes that rare wild material is clinically superior to cultivated alternatives.
Evidence maturity (E): Cancer E3Ø; liver-related programme E3±, proposition-dependent; narrow selected controlled outcomes E3+ where a valid preparation-specific between-group signal is demonstrated
Direction: Ø — Does not support under tested conditions
Historical flag (H): Not specified at dossier level
Replication (R): R1-2
Claim Gap (CG): CG1 for preparation- and outcome-specific summaries
Evidence Transfer Vector: I / O / C / R / D — for the expanded claim "Wild Taiwanofungus camphoratus is a superior anticancer medicine." I: cultivated/manufactured preparation → wild material. O: preclinical or liver-related outcomes → cancer treatment. C: selected clinical contexts → advanced cancer broadly. R: limited preparation-specific evidence → superiority claim. D: studied standardized product → variable wild material. The strongest direct cancer trial points Ø.
Taxonomic Transfer Confidence: HIGH for well-authenticated modern material
Intervention Transfer Confidence: Wild ↔ cultivated: LOW-UNKNOWN until equivalence is tested
Safety: S1-2
Conservation: Wild material C3; cultivated/manufactured alternatives C+
Resolution zone: RZ-1 → RZ-2: begin analytically with authenticated identity and wild/cultivated chemical equivalence; progress to exposure/bioavailability comparison only if meaningful differences justify it; clinical head-to-head comparison comes later only if earlier stages show clinically plausible differences.
Next best experiment: Wild-versus-Cultivated Equivalence Programme. Stage 1: authenticated taxonomic identity. Stage 2: metabolomics and targeted chemistry. Stage 3: batch-variability analysis. Stage 4: bioavailability/exposure comparison. Stage 5: clinical head-to-head only if earlier stages justify the cost and ecological burden.
Primary references: Tsai MY, Hung YC, Chen YH, Chen YH, Huang YC, Kao CW, Su YL, Chiu HHE, Rau KM. A preliminary randomised controlled study of short-term Antrodia cinnamomea treatment combined with chemotherapy for patients with advanced cancer. BMC Complementary and Alternative Medicine. 2016;16(1):322. DOI: 10.1186/s12906-016-1312-9. PMID: 27565426. PMCID: PMC5002173. [ROLE: PRIMARY CONTROLLED CANCER EVIDENCE OWNER / E3Ø / CONTROLLED NULL — 37 patients (17 intervention, 20 placebo); mean overall survival 5.4 vs 5.0 months, p = .340; disease-control rate 41.2% vs 55%, p = .33. No significant survival or disease-control benefit. Result belongs to the tested preparation and advanced-cancer setting only; the favourable secondary sleep-quality finding does not rescue the cancer proposition.]
Chiou YL, Chyau CC, Li TJ, Kuo CF, Kang YY, Chen CC, Ko WS. Hepatoprotective Effect of Antrodia cinnamomea Mycelium in Patients with Nonalcoholic Steatohepatitis: A Randomized, Double-Blind, Placebo-Controlled Trial. Journal of the American College of Nutrition. 2021;40(4):349-357. DOI: 10.1080/07315724.2020.1779850. PMID: 32657670. [ROLE: CONTROLLED NASH LIVER PROGRAMME / OUTCOME-SPECIFIC HUMAN SIGNAL / BETWEEN-GROUP DISCIPLINE ANCHOR — 28 participants; 420 mg A. cinnamomea mycelium vs 420 mg starch placebo, 6 months; favourable findings on selected liver-related measures including SteatoTest and ActiTest. Quoted numerical values are reported as within-group pre/post changes and are not converted into between-group treatment effects; broad E3+ is not assigned from within-group significance. Liver programme remains E3±, proposition-dependent.]
Ho CY, Kuan CM, Hsu PK. Hepatoprotective effect of Antrodia Cinnamomea mycelia extract in subhealth Japanese adults: a randomized, double-blind, placebo-controlled clinical study. Journal of Dietary Supplements. 2023;20(6):939-949. DOI: 10.1080/19390211.2022.2152147. PMID: 36476310. [ROLE: LATER CONTROLLED LIVER PROGRAMME / MIXED-EVIDENCE CONTEXT / REPLICATION BOUNDARY — 44 Japanese adults with marginally elevated ALT; 250 mg/day mycelial extract vs placebo, 12 weeks. Different preparation, population and proposition from the NASH programme; not counted as direct replication. Subgroup findings remain exploratory. Replication R1-2 preserved.]
Wu SH, Kirk PM, Redhead SA, Stalpers JA, Dai YC, Norvell LL, Yang ZL, Ryvarden L, Su CH, Li Y, Zhuang WY, Yao YJ, Chen CJ, Chen LC, Yu ZH, Wang XC. Resolution of the nomenclature for niu-chang-chih (Taiwanofungus camphoratus), an important medicinal polypore. Taxon. 2012;61(6):1305-1310. DOI: 10.1002/tax.616011. [ROLE: PRIMARY NOMENCLATURE / IDENTITY CROSSWALK / TTC / HOST-ECOLOGY CONTEXT — addresses the competing names Antrodia camphorata, Antrodia cinnamomea and Taiwanofungus camphoratus, and describes the polypore as restricted to Taiwan on the endemic host Cinnamomum kanehirae. Supports TTC HIGH for well-authenticated modern material; historical clinical intervention names are retained, not silently rewritten.]
Tee PYE, Krishnan T, Cheong XT, Maniam SAP, Looi CY, Ooi YY, Chua CLL, Fung SY, Chia AYY. A review on the cultivation, bioactive compounds, health-promoting factors and clinical trials of medicinal mushrooms Taiwanofungus camphoratus, Inonotus obliquus and Tropicoporus linteus. Fungal Biology and Biotechnology. 2024. DOI: 10.1186/s40694-024-00176-3. [ROLE: ECOLOGY / HOST ASSOCIATION / WILD-RESOURCE PRESSURE / CULTIVATION-CONSERVATION CONTEXT — describes natural occurrence in Taiwan mountainous habitat with Cinnamomum kanehirae as primary natural host/nutrient source, historical unsustainable pressure from high wild demand and C. kanehirae wood exploitation, and artificial cultivation as a route away from scarce wild resources. Supports the ecological basis of wild C3 vs cultivated/manufactured C+ only; does not establish therapeutic equivalence or wild superiority, and does not make rarity a pharmacological variable.]
Source chapter: Chapter 26, The Fungal Evidence Atlas