Mistletoe Extracts - National Cancer Institute

Table 1. Use of Iscador in Cancer Treatment: Clinical Reports Describing Therapeutic Endpoints^a

Reference Citation(s) Type of Study Type(s) of Cancer No. of Patients: Enrolled; Treated; Control^b Strongest Benefit Reported^c Concurrent Therapy^d Level of Evidence Score^e

[28] Randomized trial Breast, stages I–III Unknown; 76; 79 Improved 14-y survival Unknown 1iiA

[28] Randomized trial Bronchial, operable 50; 12, stage I only; 14, stage I only Improved median survival No 1iiA

[21] Randomized trial Lung, non-small cell, inoperable 408; 105; 107^f Subjective improvement in quality of life Yes^g 1iiA

[30] Randomized trial Lung, non-small cell, stages I–IV 218; 87; 96 Improved median survival, LN+ patients only No 1iiA

[24] Randomized trial Melanoma, stages II–III 830; 102; 102 None No None

[15,27,29] Randomized trial Stomach, stages I–IV 359; 62, stages II–III only; 75, stages II–III only Improved median survival No 1iiA

[10] Nonrandomized controlled trial Various types, no stage information Unknown; 72; 52 Improved 2-y survival, uterus and breast cancer Unknown 2A

[7] Prospective randomized matched-pair study Breast, stage III 8,475^h; 17ⁱ; 17ⁱ Improved mean survival Yes 1iiA

[7] Prospective randomized matched-pair study Various types, stages I–IV 8,475^h; 39ⁱ; 39ⁱ Improved mean survival Yes 1iiA

[9] Phase II trial Kidney, renal cell, stage IV 14; 14; None None Yes 3iiiA

[7] Retrospective matched-pair, case-control study Various types, stages I–IV 10,226^h; 396ⁱ; 396ⁱ Improved mean survival Yes 3iiiA

[13] Nonconsecutive case series Breast, stages I–IV 1,314; 319, stages I–II only; 228, historical controls Improved 10-y survival Yes 3iiiA

[28] Nonconsecutive case series Bronchial, inoperable 36; 36; 42, chemotherapy-treated historical controls Comparable survival No None

[26] Nonconsecutive case series Bronchial, operable Unknown; unknown; unknown, historical controls Improved 5-y survival Unknown None

[8,11] Nonconsecutive case series Cervical, stages I–III 81; 81; 800, historical controls Improved 5-y survival No 3iiiA

[28] Nonconsecutive case series Colon, stages I–IV 138; 47; 91 Improved 5-y survival No 3iiiA

[14] Nonconsecutive case series Lung, stages I–III 77; 37; 40, historical controls Improved 6-y survival No 3iiiA

[23] Nonconsecutive case series Pancreas 292; 292; Various historical controls Improved median survival Yes 3iiiA

[28] Nonconsecutive case series Rectal, operable Unknown; 37; 34, historical controls Improved 5-y survival, LN+ patients only No None

[16,28] Nonconsecutive case series Unknown metastatic (pleura carcinosis) 168; 168; None Partial tumor response (number not specified) Yes None

[12] Nonconsecutive case series Various female genital, stages I–IV 87; 87; None Improved 5-y survival, stage III cervical, stages II–III vaginal, stage II ovarian Yes None

[20] Case report Lung, small cell, stage IV 1; 1; None Partial response Yes None

LN+ = lymph node-positive disease; No. = number; y = year.

^aSee text and the NCI Dictionary for additional information and definition of terms.

^bNumber of patients treated plus number of patients controlled may not equal number of patients enrolled; number of patients enrolled = number of patients initially recruited/considered by the researchers who conducted a study; number of patients treated = number of enrolled patients who were administered the treatment being studied AND for whom results were reported; historical control subjects are not included in number of patients enrolled.

^cStrongest evidence reported that the treatment under study has anticancer activity or otherwise improves the well-being of cancer patients.

^dChemotherapy, radiation therapy, hormonal therapy, or cytokine therapy administered/allowed at the same time as mistletoe therapy.

^eFor information about levels of evidence analysis and an explanation of the level of evidence scores, see Levels of Evidence for Human Studies of Cancer Complementary and Alternative Medicine.

^fControl patients were treated with a vitamin B mixture as a placebo; 100 additional evaluable patients were treated with Polyerga Neu, a sheep spleen glycopeptide reported to be an immunostimulant and an inhibitor of tumor cell glycolysis; treatment with Polyerga Neu was not found to be beneficial.

^gRadiation therapy for metastases distant from the site of the primary tumor was permitted; radiation therapy to the primary tumor site or use of other anticancer treatment was not permitted.

^hAmong 10,226 cancer patients enrolled in a retrospective matched-pair, case-control study, 1,751 had been treated with Iscador or another mistletoe product and 8,475 had not been treated with mistletoe; from the 8,475 untreated patients, two sets of matched pairs were formed for prospective studies; in the prospective studies, one member of each pair was randomly assigned to be treated with Iscador and the other member served as a control subject.

ⁱPatients were strictly matched according to gender, year of birth ±3 years, year of diagnosis ±3 years, type of tumor, stage of disease, and conventional therapy received.

References

Grossarth-Maticek R, Kiene H, Baumgartner SM, et al.: Use of Iscador, an extract of European mistletoe (Viscum album), in cancer treatment: prospective nonrandomized and randomized matched-pair studies nested within a cohort study. Altern Ther Health Med 7 (3): 57-66, 68-72, 74-6 passim, 2001 May-Jun. [PUBMED Abstract]
Fellmer KE: A clinical trial of Iscador: follow-up treatment of irradiated genital carcinomata for the prevention of recurrences. Br Homeopath J 57: 43-7, 1968.
Kjaer M: Misteltoe (Iscador) therapy in stage IV renal adenocarcinoma. A phase II study in patients with measurable lung metastases. Acta Oncol 28 (4): 489-94, 1989. [PUBMED Abstract]
Majewski A, Bentele W: [Adjunct treatment in female genital carcinoma]. Zentralbl Gynakol 20: 696-700, 1963.
Fellmer Ch, Fellmer KE: [Follow-up treatment of irradiated genital carcinoma with the Viscum album preparation "Iscador"]. Krebsarzt 2: 175-85, 1966.
Leroi R: [Studies on additional Iscador therapy in the management of women with surgically and radiotherapeutically treated genital carcinoma] Gynaecologia 167 (3): 158-70, 1969. [PUBMED Abstract]
Leroi R: [Postoperative Viscum album therapy after surgery of breast neoplasms] Helv Chir Acta 44 (3): 403-14, 1977. [PUBMED Abstract]
Salzer G, Havelec L: [Prevention of recurrence of bronchial carcinomas after surgery by means of the mistletoe extract Iscador. Results of a clinical study from 1969-1971] Onkologie 1 (6): 264-7, 1978. [PUBMED Abstract]
Salzer G, Denck H: [Randomized study on medicamentous recurrence prophylaxis with 5-fluorouracil and Iscador in resectioned stomach cancer. Results of an intermediate assessment]. Dtsch Z Onkol 11 (5): 130-1, 1979.
Salzer G: Pleura carcinosis. Cytomorphological findings with the mistletoe preparation iscador and other pharmaceuticals. Oncology 43 (Suppl 1): 66-70, 1986. [PUBMED Abstract]
Bradley GW, Clover A: Apparent response of small cell lung cancer to an extract of mistletoe and homoeopathic treatment. Thorax 44 (12): 1047-8, 1989. [PUBMED Abstract]
Dold U, Edler L, Mäurer HCh, et al., eds.: [Adjuvant Cancer Therapy in Advanced Non-Small Cell Bronchial Cancer: Multicentric Controlled Studies To Test the Efficacy of Iscador and Polyerga]. Stuttgart, Germany: Georg Thieme Verlag, 1991.
Schaefermeyer G, Schaefermeyer H: Treatment of pancreatic cancer with Viscum album (Iscador): a retrospective study of 292 patients 1986-1996. Complementary Therapy and Medicine 6: 172-7, 1998.
Kleeberg UR, Suciu S, Bröcker EB, et al.: Final results of the EORTC 18871/DKG 80-1 randomised phase III trial. rIFN-alpha2b versus rIFN-gamma versus ISCADOR M versus observation after surgery in melanoma patients with either high-risk primary (thickness >3 mm) or regional lymph node metastasis. Eur J Cancer 40 (3): 390-402, 2004. [PUBMED Abstract]
Krause F, Erkan F: [Adjuvant Iscador treatment of resectioned bronchial carcinomas]. [Abstract] Onkol Symp Ludwig Boltzmann Inst (6): 158, 1983.
Salzer G, Havelec L: [Adjuvant Iscador treatment after operated stomach cancer. Results of a randomized study]. Dtsch Z Onkol 15 (4): 106-10, 1983.
Salzer G: [30 years of experience with mistletoe therapy in public health facilities]. In: Leroi R, ed.: [Mistletoe Therapy: A Response to the Challenge of Cancer]. Stuttgart, Germany: Freies Geistesleben, 1987, pp. 173-215.
Salzer G: [Prospective randomized study: operated stomach cancer. Adjuvant treatment with Iscador--an unconventional consideration]. Dtsch Z Onkol 20 (4): 90-3, 1988.
Salzer G, Danmayr E, Wutzholfer F, et al.: [Adjuvant Iscador® treatment of non-small cell bronchial carcinoma. Results of a randomized study]. Dtsch Z Onkol 23 (4): 93-8, 1991.