Astragaloside IV, a bioactive saponin found in Astragalus membranaceus, has been studied for its potential to reduce chemotherapy-induced side effects, particularly in preclinical models. Several animal studies and a limited number of small clinical trials suggest that Astragaloside IV may mitigate side effects such as myelosuppression, nephrotoxicity, and gastrointestinal toxicity caused by chemotherapeutic agents like cisplatin and doxorubicin. The proposed mechanisms include anti-inflammatory, antioxidant, and immunomodulatory effects, such as reducing oxidative stress, modulating cytokine release, and promoting hematopoiesis.

For example, research published in Phytomedicine (2012) and Journal of Ethnopharmacology (2013) demonstrated that Astragaloside IV protected bone marrow cells from chemotherapy damage in mice and improved white blood cell counts. There are also reports of Astragalus-based preparations being used adjunctively in traditional Chinese medicine for cancer patients, but clinical evidence specific to Astragaloside IV remains sparse.

Overall, while there is preclinical and preliminary clinical evidence suggesting benefit, well-powered randomized controlled trials in humans are lacking. Thus, the evidence currently supports a possible, but not proven, benefit for reducing chemotherapy side effects, justifying a moderate evidence rating.