Mistletoe: From Basic Research to Clinical Outcomes

By Mathias Kröz et al., May 2014

The importance of integrative medicine in oncological care is increasing in accordance with growth of its evidence base. In central Europe, white-berried mistletoe (Viscum album) preparations not only are among the most common types of treatments used in integrative medicine but also have been among of the most commonly prescribed cancer treatments in Germany per se in 2010.

By 2017, mistletoe preparations will have been used in the treatment of cancer patients for 100 years. The first recorded use in oncology was by the Dutch physician Ita Wegman who used a mistletoe extraction for the treatment of a breast cancer patient following a recommendation by Rudolf Steiner.

The PubMed database alone lists more than 1,200 citations for “mistletoe,” with approximately 50 new entries each year. There are a multitude of laboratory-based studies demonstrating immune stimulation, cytotoxicity, proapoptotic effects, antiangiogenesis, and DNA stabilisation; animal experiments have found tumor-reducing effects. Recent observations of a potent anti-inflammatory effect of Viscum album via selective inhibition of COX-2 protein expression provide a further rationale for an antitumor role of mistletoe in view of the close relationship between cancer and inflammation. More recent research focuses on new mistletoe extracts that contain lipophilic components, that is, triterpenes, shown to have strong cytotoxic effects in mouse models.

Recent years have seen growth in the number and quality of clinical research studies on mistletoe therapy reporting improved patient outcomes, including studies of its coadministration alongside chemotherapy to reduce adverse effects and to improve quality of life in breast cancer, ovarian cancer, and lung cancer patients. Its clinical efficacy regarding tumor control and survival has been contested; other systematic reviews have been more positive, particularly with regard to health-related quality of life outcomes. A 2013 randomised-controlled trial reported an increase in median survival time for patients with pancreatic cancer. Further similar well-designed clinical trials on other cancer types are warranted.

Original publication: Matthias Kröz, Gunver Sophia Kienle, Gene Feder, Srini Kaveri, and Steven Rosenzweig, “Mistletoe: From Basic Research to Clinical Outcomes in Cancer and Other Indications,” Evidence-Based Complementary and Alternative Medicine, vol. 2014, Article ID 987527, 2 pages, 2014. doi:10.1155/2014/987527

Read the full article: http://www.hindawi.com/journals/ecam/2014/987527/