A Systematic Review and Meta-Analysis on the Survival of Cancer Patients Treated with a Fermented <b><i>Viscum album</i></b> L. Extract (Iscador): An Update of Findings

Abstract

Purpose: We aimed at updating the evidence found in controlled studies addressing general and event-free survival of cancer patients treated with the fermented mistletoe extract Iscador. Methods: The databases Embase, PubMed, CAMbase, Scopus, AMED and Cochrane were searched for clinical studies on cancer patients treated with Iscador. Quality of studies and risk of bias were evaluated according to the Cochrane guidelines and the Newcastle Ottawa Scale. Outcome data were expressed as hazard ratios (HR) and the respective 95% confidence intervals (CI). Meta-analysis was carried out using a random-effects model. Results: Eightytwo controlled studies met the inclusion criteria, of which 32 with 55 strata provided data for extracting HR and CI. The overall HR was 0.59 (95% CI: [0.53; 0.65], p < 0.0001) in favour of Iscador treatment. Heterogeneity of study results was moderate (I 2 = 50.9%; p < 0.0001, τ 2 = 0.053). Meta-regression did not reveal significant effects of sample size or study design. However, significant differences were found between cancer entities (p < 0.01), with most pronounced effects in cervical (HR = 0.43) and less pronounced effects in lung cancer (HR = 0.84). Conclusions: We found almost identical effects on cancer survival based on a broader database of higher quality. However, none of the studies was blinded and, therefore, there might be risk of performance bias. Implications for cancer survivors are as follows: findings indicate that adjuvant treatment of cancer patients with Iscador can be associated with a better survival.

Cost-effectiveness of real-world administration of chemotherapy and add-on Viscum album L. therapy compared to chemotherapy in the treatment of stage IV NSCLC patients

“…In a recent published real-world data study on patients with stage IV NSCLC we already demonstrated that patients receiving combinatorial CTx plus add-on VA had a longer mean OS and that this combinatorial treatment was significantly associated with a reduced risk of death compared to patient’s only receiving CTx [ 21 ]. These results are consistent with other published data on the clinical effects of combinatorial VA therapy in cancer patients [ 22 – 25 ].…”

Cost-effectiveness of real-world administration of chemotherapy and add-on Viscum album L. therapy compared to chemotherapy alone in the treatment of stage IV NSCLC patients

“…The survival analyses demonstrated that patients in the V-group showed longer survival than those receiving standard of care (a 5.7 month longer adjusted overall mean survival [20][21][22][23]. The relevant negative association of the male gender with survival was observed in our patients and correlated with other published data [24].…”

Overall Survival of Nonmetastasized NSCLC Patients Treated With Add-On Viscum album L: A Multicenter Real-World Study

“…For survival analysis including Kaplan-Meier curves and right-censored time-to-event analyses the R-package 34 “survival” was applied, version 2.41-3, published by Terry M. Therneau and Thomas Lumley on April 4, 2017 ( https://CRAN.R-project.org/package=survival ). To draw survival curves the package “survminer” was used, version 0.4.0, by Alboukadel Kassambara, Marcin Kosinski, and Przemyslaw Biecek published on June 7, 2017 ( https://CRAN.R-project.org/package=survminer ).…”