Changes to This Summary (03/03/2014)
Added text to state that the findings from more than 50 clinical trials of mistletoe extracts in patients with cancer have been published, and several systematic reviews and meta-analyses of the results of these studies have been performed; three of the most recent systematic reviews addressed quality of life (QOL), survival, and symptom relief in patients with various cancer types, although most studies reported an improvement in QOL.
Added text to state that in one systematic review that examined 26 randomized controlled trials (RCTs), 22 trials reported an improvement in QOL; all 10 of the nonrandomized controlled trials also reported the same benefit, with improvement in fatigue, nausea and vomiting, depression, emotional well-being, and concentration.
Added text to state that tumor response, QOL, and psychological distress were measured in a review of 21 RCTs of various cancers in which different mistletoe preparations were used either alone, with chemotherapy, or with radiation; most of the studies reported benefits for patients, although this review was limited by small sample size and methodological weaknesses.
Added text to state that the oldest of the three reviews investigated the results of 10 RCTs that used a variety of mistletoe extracts in patients with various malignancies; there was no difference in survival or other benefits for cancer patients who received mistletoe.
Added text to state that the use of additional adjuvant chemotherapy was more frequent in the Iscador-treated group, while the use of immunotherapy was more frequent in the control group; only mild to intermediate adverse drug reactions were seen in the treatment group.
Added text about a randomized phase II study of Iscador combined with carboplatin-containing regimens in chemotherapy-naïve patients with advanced non-small cell lung cancer and found that there were no differences in QOL observed between the two treatment groups (cited Bar-Sela et al. as reference 28).
Added Mansky et al. as reference 40.
Added text about one meta-analysis of Viscum album L. and isolated mistletoe lectins that included both animal and human studies and reported no immunosuppressive effects; another review reported adverse reactions that included local reactions at the injection site, fever, increased intracerebral pressure, headache, circulatory problems, thrombophlebitis, swelling of lymph nodes, and allergic reactions (cited Kienle et al. as reference 4 and Ernst et al. as reference 5).
This summary is written and maintained by the PDQ Cancer Complementary and Alternative Medicine Editorial Board, which is editorially independent of NCI. The summary reflects an independent review of the literature and does not represent a policy statement of NCI or NIH. More information about summary policies and the role of the PDQ Editorial Boards in maintaining the PDQ summaries can be found on the About This PDQ Summary and PDQ NCI's Comprehensive Cancer Database pages.