Sustained Partial Remission of Metastatic Pancreatic Cancer Following Systemic Chemotherapy with Gemcitabine and Oxaliplatin plus Adjunctive Treatment with Mistletoe Extract

Abstract

Background: The clinical prognosis of metastatic pancreatic cancer is very poor, with a median survival time of such patients ranging from 3 to 6 months. Current chemotherapy regimens include the combination of oxaliplatin and gemcitabine. Case Report: A 43-year-old woman was diagnosed with pancreatic adenocarcinoma spreading into the regional lymph nodes and into multiple liver segments (pT3, pN1, pM1). Upon diagnosis, she underwent a pylorus-preserving pancreatic head resection, including dissection of regional lymph nodes and atypical resection of a single liver segment, followed by 9 cycles of palliative chemotherapy with gemcitabine and oxaliplatin. 37 weeks after surgery, the patient demonstrated a sustained partial remission, and the chemotherapy was stopped. Surprisingly, 10 months later, she still showed no evidence of tumor progression. Since the time of pancreatic surgery, the patient had taken mistletoe extracts and this adjunctive treatment has been continued until now. Conclusions: Cases of sustained long-term remission of metastatic pancreatic cancer are extremely rare. Although this single case observation does not allow for firm conclusions regarding potential mechanisms, the adjunctive therapy with mistletoe extracts might have played a role. Therefore, the clinical effects of such treatment in patients with pancreatic cancer warrant further investigation.

Use and Safety of Intratumoral Application of European Mistletoe (Viscum album L) Preparations in Oncology

“…25,26,28,29 As for clinical use, several groups have published case studies describing partial or complete tumor remission by IT mistletoe therapy alone or in combination with conventional therapies. [30][31][32][33] A recent retrospective study by Schad et al, 34 which included 39 pancreatic patients who received a total of 223 IT mistletoe injections in addition to conventional therapies, suggests that IT applied mistletoe might have contributed to an improved overall survival. Prospective clinical studies designed to confirm efficacy for IT or multimodal mistletoe therapy are therefore required.…”

Herbals and Plants in the Treatment of Pancreatic Cancer: A Systematic Review of Experimental and Clinical Studies

“…Ritter et al described the case of a woman aged 43 who had undergone a pancreatic head resection plus nine cycles of palliative treatment with gemcitabine plus oxaliplatin, and concomitant treatment with mistletoe. Ten months later, the patient was free of any evidence of tumor progression [21].…”

Emerging roles of mistletoes in malignancy management

“…Oxaliplatin and gemcitabine are the standard chemotherapy to combat the cancer. Ritter et al (2010) investigated the adjunct therapy possibilities with mistletoe extract. In a case study, 37 weeks after surgery, the patient demonstrated a sustained partial remission, and the chemotherapy was stopped.…”