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Traditional Chinese Medicine Formula LC09 is an investigational topical herbal medicine developed for the treatment of hand-foot syndrome (HFS) and hand-foot skin reaction (HFSR), which are common and often dose-limiting side effects of certain chemotherapy agents (e.g., capecitabine) and molecularly targeted anti-cancer drugs (e.g., sorafenib, sunitinib). [5, 6, 7] The formula consists of a combination of five herbs: *Astragalus membranaceus*, *Carthamus tinctorius* (flowers carthami), *Lithospermum erythrorhizon*, *Geranium wilfordii*, and *Angelica sinensis*. [10] It is supplied as granules that are dissolved in water to create a lotion, in which patients soak their hands and feet. [5, 6, 7] Clinical studies, including a Phase II randomized trial, have been conducted by the China-Japan Friendship Hospital to evaluate its efficacy in reducing the severity and pain associated with HFS/HFSR, thereby improving patients' quality of life and ability to continue their primary cancer therapy. [7, 10]
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