Iscador, maretakpreparaat tegen kanker
Ondersteunende behandelingsvormen bij kanker krijgen de laatste jaren meer aandacht dan voorheen, omdat met de reguliere oncologische interventies helaas nog steeds zelden volledige genezing kan worden bereikt. Naast de “cure” wordt dan ook naar “care” gekeken, omdat steeds meer kankerpatiënten realistisch voor kwaliteit van hun resterende leven kiezen. In het Medisch centrum Berg en Bosch te Bilthoven bestaat al langere tijd ruime ervaring in het behandelen van patiënten met kanker met maretakpreparaten (Latijn: Viscum Album, of Mistletoe in het Engels). Deze behandeling wordt gegeven door een internist die ruime ervaring met behandeling van kanker met maretakpreparaten.
De behandeling van patiënten met immuunstimulerende preparaten, zoals Viscum album, waarvan ook bekend is dat het positieve immuunmoderende werkingen heeft, kan potentieel een brede positieve werkzaamheid hebben bij symptoombestrijding bij patiënten die lijden aan maligniteiten.
Veiligheid
Iscador is vele jaren als antroposofisch middel gebruikt als adjuvante behandeling bij kanker, en in Zwitserland heeft men alle gemelde bijwerkingen vast gelegd. Het komt erop meer dat dit middel vergeleken met gewone anti-kanker middelen veilig is en niet veel bijwerkingen heeft. De meest bekende bijwerking bestaat uit allergische reacties tegen de bestanddelen van Iscador.
Voor zover ons bekend zijn er geen negatieve interacties bekend met andere middelen die regulier bij kanker behandeling ingezet worden.
Verdere gegevens
Het preparaat is op de markt onder diverse namen: Iscador, Iscador QuFrF, Helixor, Iscucin, Isorel.
Beoordeling
Er is echter nog niet een sluitend bewijs geleverd dat de preparaten inderdaad duidelijke effectiviteit hebben bij patiënten met kanker, dat onderzoek loopt nog. Wel is aannemelijk gemaakt dat Iscador waarschijnlijk een positieve bijdrage kan leveren aan de kwaliteit van leven van kankerpatiënten, waardoor IOCOB deze therapie een oranjegroen stoplicht geeft. Zodra het definitieve bewijs van de effectiviteit is geleverd, zal dat een groen stoplicht kunnen worden.
Literatuur
1] Stein GM, Henn W, von Laue HB, Berg PA. Modulation of the cellular and humoral immune responses of tumor patients by mistletoe therapy. Eur. J. Med. Res. 1998; 3: 194-202.
[2] Beuth J, Ko HL, Tunggal L et al. Effect of mistletoe lectin in standardized extracts on the in vitro proliferation of malignant and non-malignant cells. Dtsch. Ztsch. Onkol. 1994; 26: 1-6.
[3] Dietrich J.B., G. Ribereau-Gayon, M.L. Jung et al. Identity of the N-terminal sequences of the three A chains of mistletoe (Viscum album) lectins: homology with ricin-like plant toxins and single chain ribosome-inhibiting proteins. Anti Cancer Drugs 1992/3, 507-511.
[4] J. Konopa, J.M. Woynarowski, M. Lewandowska-Gumienak. “Identification of viscotoxins. Cytotoxic basic polypeptides from Viscum album”; Z. Physiol. Chem. 1980/361, 1525-1533.
[5] G. Ribereau, M.L. Jung, M. Franz, R. Anton, “Modulation of cytotoxicity and enhancement of cytokine release induced by Viscum album extracts or mistletoe lectins”; Anti-Cancer Drugs 1997/8, 3-8.
[6] Cazacu M, Oniu T, Lungoci C, Mihailov A, Cipak A, Klinger R, Weiss T, Zarkovic N. The influence of isorel on the advanced colorectal cancer. Cancer Biother. Radiopharm. 2003 Feb;18(1):27-34.
[7] Beuth J, Ko HL, Tunggal L, Pulverer G. Mistletoe lectin as an immunomodulator in adjuvant therapy. Dtsch Ztsch. Onkol. 1993; 25: 73-76.
[8] Stein G, Berg PA. Evaluation of the stimulatory activity of a fermented mistletoe lectin-1 free mistletoe extract on T-helper cells and monocytes in healthy individuals. Arzneim. Forsch. Drug Res. 1996; 46: 635-639.
[9] Hajto T, Hostanska K, Fischer J, Saller R. Immunomodulatory effects of Viscum album agglutinin-1 on natural immunity. Anti-Cancer Drugs 1997; 8 suppl: S43-S46.
[10] Büssing A, Suzart K, Bergmann J, et al. Induction of apoptosis in human lymphocytes treated with Viscum album L is mediated by the mistletoe lectins. Cancer Lett. 1996; 99: 59-72.
[11] Lyu SY, Choi SH, Park WB. Korean mistletoe lectin-induced apoptosis in hepatocarcinoma cells is associated with inhibition of telomerase via mitochondrial controlled pathway independent of p53. Arch. Pharm. Res. 2002 Feb;25(1):93-101.
[12] Van Huyen JP, Bayry J, Delignat S, Gaston AT, Michel O, Bruneval P, Kazatchkine MD, Nicoletti A, Kaveri SV. Induction of Apoptosis of Endothelial Cells by Viscum album: A Role for Anti-Tumoral Properties of Mistletoe Lectins. Mol. Med. 2002 Oct;8(10):600-6.
[13] Kovacs E, Kühn JJ, Werner M, et al. Effect of Iscador on DNA-repair after radiation or cyclophosphamide; correlation with IFN-production. Onkologie 1995;18 (suppl 2): 186.
[14] Kovacs E, Haijto T, Hostanska K. Improvement of DNA-repair in lymphocytes of breast cancer patients treated with Viscum album extracts (Iscador). Eur. J. Cancer 1991; 27 (12): 1672-1676.
Abstracts
Bron: Altern Ther Health Med. 2001 May-Jun;7(3):57-66, 68-72, 74-6 passim.
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.
Grossarth-Maticek R, Kiene H, Baumgartner SM, Ziegler R.
Institute for Preventive Medicine, European Center for Peace and Development, United Nations, Heidelberg, Germany.
CONTEXT: In anthroposophical medicine, total extracts of Viscum album (mistletoe) have been developed to treat cancer patients. The oldest such product is Iscador. Although Iscador is regarded as a complementary cancer therapy, it is the most commonly used oncological drug in Germany.
CONCLUSION: Iscador treatment can achieve a clinically relevant prolongation of survival time of cancer patients and appears to stimulate self-regulation.
Bron: Altern Ther Health Med. 2001 May-Jun;7(3):57-66, 68-72, 74-6 passim.
Efficacy and safety of long-term complementary treatment with standardized European mistletoe extract (Viscum album L.) in addition to the conventional adjuvant oncologic therapy in patients with primary non-metastasized mammary carcinoma.
Results of a multi-center, comparative, epidemiological cohort study in Germany and Switzerland
Bock PR, Friedel WE, Hanisch J, Karasmann M, Schneider B.
Institut fur Angewandte Gesundheitsforschung, IFAG Basel AG, Basel, Schweiz.
OBJECTIVES: The purpose of the study was to evaluate the therapeutic efficacy and safety of long-term complementary therapy in primary, non-metastatic mammary carcinoma patients in UICC stage I-III with a standardized European mistletoe extract (Viscum album L., Iscador, "mistletoe extract") given in addition to conventional adjuvant oncologic therapy (i.e. chemo-, radio-, and hormonal therapy; "conventional therapy").
CONCLUSIONS: The results of the present study confirmed the safety of the complementary therapy of patients with primary, non-metastatic mammary carcinoma with a standardized mistletoe extract and showed considerably fewer ADRs attributed to concurrent conventional therapy, as well as reduced disease and treatment-associated symptoms, and suggested a prolonged overall survival in the mistletoe extract group as compared with controls.
Bron: Arzneimittelforschung. 2004;54(8):456-66
Mistletoe treatment induces GM-CSF- and IL-5 production by PBMC and increases blood granulocyte- and eosinophil counts: a placebo controlled randomized study in healthy subjects.
Huber R, Rostock M, Goedl R, Ludtke R, Urech K, Buck S, Klein R.
Center for Complementary Medicine, University Hospital Freiburg, Breisacher Str. 60, D-79106 Freiburg, Germany. rhuber@medizin.ukl.uni-freiburg.de
OBJECTIVE: Various immunological effects have been reported during application of mistletoe preparations. Because these data are heterogeneous, we performed a placebo controlled study to investigate (1) effects on peripheral granulocyte and eosinophil counts, (2) related cytokine levels and (3) whether effects are related to mistletoe lectin (ML).
METHODS: 43 volunteers were randomized to receive the mistletoe plant extract Iscador Quercus spezial (IQ), purified ML, IQ which was depleted from ML, or placebo subcutaneously twice per week for 8 weeks. Weekly, differential blood count and every four weeks spontaneous and IQ- and ML-induced cytokine production by peripheral blood mononuclear cells (PBMC) were analyzed.
RESULTS: Leukocyte-, granulocyte-, and eosinophil counts were significantly higher during treatment in the IQ- and ML-groups than in the placebo group. Furthermore, a significant increase of antigen-induced production of GM-CSF, IL-5 and IFNgamma by PBMC was observed in the IQ- and ML-group but not in the groups receiving ML-depleted IQ or placebo. Severe side effects did not occur in any of the subjects.
CONCLUSIONS: Treatment with IQ or ML stimulates the production of GM-CSF, IL-5 and IFNgamma by PBMC, and this is accompanied by an increase of eosinophil- and granulocyte-counts. These observations may, therefore, open rational therapeutic indications for mistletoe extracts.
Bron: Eur J Med Res. 2005 Oct 18;10(10):411-8
Retrolective, comparative, epidemiological cohort study with parallel groups design for evaluation of efficacy and safety of drugs with "well-established use".
Bock PR, Friedel WE, Hanisch J, Karasmann M, Schneider B.
Institute for Applied Medical Research, IFAG Basel AG, Hohenrainweg 105, CH-4444 Rumlingen, Switzerland. paulrbock@aol.com
The randomized controlled clinical trial (RCT) is accepted as the "golden standard" for the evaluation of efficacy and safety of new drugs. In contrast, to demonstrate efficacy and safety of drugs with "well-established use" that have been on the European Community market for long time, observational comparative epidemiological studies can be used according to the European drug regulation directive. However, because comparative epidemiological cohort studies can share some risk of bias with other nonrandomized observational study designs, there is a need for an approach that could effectively reduce the bias risk in this type of studies.
STUDY OBJECTIVES: The purpose of the study was to evaluate the therapeutic efficacy and safety of a long-term complementary therapy of primary, non-metastatic breast carcinoma patients treated with standardized European mistletoe extract Iscador("mistletoe") in addition to the conventional adjuvant oncologic therapy, and compared to the control group treated with the conventional therapy alone.
CONCLUSIONS: Complementary therapy of patients with primary, non-metastatic breast carcinoma with the mistletoe extract Iscador was safe and in comparison to the control group within the same study cohort showed considerably fewer ADRs attributed to concurrent conventional therapy, reduced disease symptoms, and suggested a significant improvement of survival. Despite some methodical limitations that require careful study planning and conduction as well as critical interpretation, the applied study design seems suitable to evaluate the efficacy and safety of drugs with "well-established use", particularly in oncology. Copyright 2004 S. Karger GmbH, Freiburg
Bron: Forsch Komplementarmed Klass Naturheilkd. 2004 Aug;11 Suppl 1:23-9.