Die Mistelgabe in der Tumortherapie: Was gibt’s Neues?

Zusammenfassung

Krebspatienten nutzen komplementäre Verfahren wie die Misteltherapie mit unterschiedlichen Zielen. In Studien wurde die Mistelwirkung hinsichtlich einer Verbesserung der Lebensqualität, der Reduktion von Begleiterscheinungen konventioneller Tumortherapien, des krankheitsfreien Intervalls und weiteren Parametern untersucht. Neuere Daten zeigen unterschiedliche Effekte unter Mistelgabe: Lektinreiche Präparate scheinen die Angiogenese zu hemmen. Beim NSCLC waren Dosisreduktionen oder nichthämatologische Toxizität Grad 3–4 deutlich seltener. Eine Verbesserung der Lebensqualität konnte in verschiedenen neueren Studien belegt werden.

Summary

Mistletoe in cancer therapy: An update
Cancer patients use complementary methods such as mistletoe therapy with different objectives. In several studies, the effect of mistletoe was investigated in terms of improvement of quality of life, reduction of side effects of conventional cancer therapy, the disease-free interval, and other parameters. According to recent data, different effects are attributed to mistletoe. For example, preparations rich in lectins appear to inhibit angiogenesis. Regarding NSCLC, dose reductions or non-haematological toxicity grade 3-4 were significantly less frequent. Moreover several recent studies have demonstrated improvement in quality of life through mistletoe therapy.

Schlüsselwörter

Mistel - Viscum album L - Onkologie - klinische Studien - Onkologie - Lebensqualität - Übersicht

Key words

Mistletoe - Viscum album L - oncology - clinical studies - quality of life - review

• Literatur

• 1 Micke O, Buntzel J, Kisters K et al. Complementary and alternative medicine in lung cancer patients: a neglected phenomenon?. Front Radiat Ther Oncol 2010; 42: 198-205
• 2 Templeton A, Thürlimann B, Baumann M et al. Cross-sectional study of self-reported physical activity, eating habits and use of complementary medicine in breast cancer survivors. BMC Cancer 2013; 13: 153
• 3 Kienle GS, Berrino F, Büssing A et al. Mistletoe in cancer – a systematic review on controlled clinical trials. Eur J Med Res 2003; 8: 109-119
• 4 Kienle GS, Glockmann A, Schink M et al. Viscum album L. extracts in breast and gynaecological cancers: a systematic review of clinical and preclinical research. J Exp Clin Cancer Res 2009; 28: 79
• 5 Stumpf C, Rieger S, Fischer IU et al. Retrospektive Untersuchung zur Therapie mit Mistelextrakten bei Patienten mit kolorektalem Karzinom. Dtsch Ztsch Onkol 2007; 39: 12-22
• 6 Friedel WE, Matthes H, Bock PR et al. Systematic evaluation of the clinical effects of supportive mistletoe treatment within chemo- and/or radiotherapy protocols and long-term mistletoe application in nonmetastatic colorectal carcinoma: multicenter, controlled, observational cohort study. J Soc Integr Oncol 2009; 7: 137-145
• 7 Mabed M, El-Helw L, Sharma S. Phase II study of Viscum fraxini-2 in patients with advanced hepatocellular carcinoma. Br J Cancer 2004; 90: 65-69
• 8 Piao BK, Wang YX, Xie GR et al. Impact of complementary mistletoe extract treatment on quality of life in breast, ovarian and nonsmall cell lung cancer patients. A prospective randomized controlled clinical trial. Anticancer Res 2004; 24: 303-310
• 9 Vehmeyer K, Liersch T, Damenz W et al. Hemopoiesis protection by mistletoe extract during the therapy of head and neck tumors. J Cancer Res Clin Oncol 1990; 116: 697 (Abstract)
• 10 Augustin M, Bock PR, Hanisch J et al. Safety and efficacy of the long-term adjuvant treatment of primary intermediate- to high-risk malignant melanoma (UICC/AJCC stage II and III) with a standardized fermented European mistletoe (Viscum album L.) extract. Arzneimittelforschung 2005; 55: 38-49
• 11 Böhringer PA, Roeber G, Hintze B et al. Misteltherapie bei Myelodysplastischen Syndrom (MDS) und sekundären Akuten Myeloischen Leukämien (sAML). Der Merkurstab 1999; 52: 40-47
• 12 Stumpf C, Rosenberger A, Rieger S et al. Therapie mit Mistelextrakten bei malignen hämatologischen und lymphatischen Erkrankungen – eine monozentrische retrospektive Analyse über 16 Jahre. Forsch Komplementärmed 2000; 7: 139-146
• 13 Ibrahiem EI, Hekal IA. Mistletoe extract as an adjuvant therapy after resection of superficial bladder cancer: prospective clinical randomized study. J Urol 2009; 181(4) Abstract No. 1775
• 14 Mahfouz MM, Ghaleb HA, Zawawy A et al. Significant tumor reduction, improvement of pain and quality of life and normalization of sleeping patterns of cancer patients treated with a high dose of mistletoe. Ann Oncol 1998; 9: 129
• 15 Kienle G. Forschung zur Misteltherapie von Brustkrebs – ein Überblick. Der Frauenarzt 2013; 54: 260-226
• 16 Kessler T, Mesters RM, Berdel WE. Angiogenesehemmung in der Onkologie. Der Onkologe 2007; 13: 20-31
• 17 Elluru S, Duong Van Huyen JP, Delignat S et al. Molecular mechanisms underlying the immunomodulatory effects of mistletoe (Viscum album L.) extracts Iscador. Arzneimittelforschung 2006; 56: 461-466
• 18 Yance Jr DR, Sagar SM. Angiogenesis with integrative cancer therapies. Integr Cancer Ther 2006; 5: 9-29
• 19 Heidecke H, Meyer U. Iscucin^® –Wirkung auf die Angiogenese in vitro. Der Merkurstab 2005; 58: 302-304
• 20 Britsch M, Heidecke H, Meyer U. Angiogenesehemmung durch Iscucine^® – Ergebnisse aktueller Untersuchungen. Der Merkurstab 2010; 3: 218-222
• 21 Elluru SR, Duong Van Huyen JP, Delignat S et al. Antiangiogenetic properties of Viscum album extracts are associated with endothelial cytotoxicity. Anticancer Res 2009; 29: 2945-2950
• 22 Nabrotzki M, Penter R. Kasuistik über eine unkonventionelle Therapie und einen günstigen Verlauf eines fortgeschrittenen Mammakarzinoms. Dtsch Ztsch Onkol 2009; 41: 79-81
• 23 Bar-Sela G, Wollner M, Hammer L et al. Mistletoe as complementary treatment in patients with advanced non-small-cell lung cancer treated with carboplatin-based combinations: a randomised phase II study. Eur J Cancer 2013; 49: 1058-1064
• 24 Mansky PJ, Wallerstedt DB, Sannes T et al. NCCAM/NCI phase I study of mistletoe extract and gemcitabine in patients with advanced solid tumors. J Clin Oncol 2010; 15 (Suppl. 28): 2559
• 25 Galun D, Tröger W, Reif M et al. Mistletoe extract therapy versus no antineoplastic therapy in patients with locally advanced or metastatic pancreatic cancer: A randomized clinical phase III trial on overall survival. Ann Oncol 2012; 23 (Suppl. 9): 712P
• 26 Galun D, Tröger W, Reif M et al. Phase III trial on mistletoe extract versus no antineoplastic therapy in patients with locally advanced or metastatic pancreatic cancer. Eur J Integrat Med 2012; 4 (Suppl. 1): 11-12
• 27 Kim KC, Yook JH, Eisenbraun J et al. Quality of life, immunomodulation and safety of adjuvant mistletoe treatment in patients with gastric carcinoma – a randomized, controlled pilot study. BMC Complement Altern Med 2012; 12: 172
• 28 Brandenberger M, Simões-Wüst AP, Rostock M et al. An exploratory study on the quality of life and individual coping of cancer patients during mistletoe therapy. Integr Cancer Ther 2012; 11: 90-100