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Mistletoe extract in patients with advanced pancreatic cancer: Health-related quality of life in a double-blind, randomized, placebo-controlled trial (MISTRAL).

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Mistletoe Extract in Patients With Advanced Pancreatic Cancer: a Double-Blind, Randomized, Placebo-Controlled Tial

Kathrin Wode1, Gunver S Kienle, Ove Björ

  • 1Department of Radiation Sciences/Oncology, Umeå University, Umeå, Sweden; Department of Neurobiology, Caring Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Regional Cancer Centre Stockholm Gotland, Stockholm, Sweden; Center for Complementary Medicine, Department of Medicine II, Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany; Institute for Applied Epistemology and Medical Methodology at Witten/Herdecke University (IFAEMM), Freiburg, Germany; Department of Nursing, Umeå University, Umeå, Sweden; Department of Biomedical and Clinical Sciences, Linköping University, Sweden; Department of Oncology, Västmanlands Hospital, Västerås, Schweden; Department of Oncology, Ryhov County Hospital, Jönköping, Schweden; Palliative Care Unit Västerås, Schweden.

Deutsches Arzteblatt International
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Mistletoe extract (ME) did not improve survival or quality of life for advanced pancreatic cancer patients. Further research is needed to explore potential benefits of ME in oncology care.

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Area of Science:

  • Oncology
  • Integrative Medicine
  • Clinical Trials

Background:

  • Advanced pancreatic cancer presents significant survival challenges and limited therapeutic avenues.
  • Mistletoe extract (ME) is explored as an adjunct therapy to standard oncological treatment and palliative care.

Purpose of the Study:

  • To evaluate the efficacy of mistletoe extract (ME) in prolonging overall survival (OS) in patients with advanced pancreatic cancer.
  • To assess the impact of ME on health-related quality of life (HRQoL) in this patient population.

Main Methods:

  • A double-blind, placebo-controlled randomized trial (MISTRAL) involving patients with advanced pancreatic cancer (ECOG performance status 0-2).
  • Participants received either ME or placebo subcutaneously three times weekly for nine months, alongside standard care.
  • Primary endpoint was overall survival (OS); secondary endpoint included the HRQoL global health/QoL dimension.

Main Results:

  • No statistically significant difference in overall survival (OS) was observed between the ME and placebo groups (median survival: 7.8 vs. 8.3 months).
  • Health-related quality of life (HRQoL) scores remained comparable between groups (p=0.86).
  • Adverse events were similar, with a higher incidence of local skin reactions in the ME group.

Conclusions:

  • Mistletoe extract (ME) is unlikely to provide a clinically significant benefit for overall survival or quality of life in advanced pancreatic cancer patients receiving comprehensive care.
  • The findings suggest ME does not enhance standard treatment outcomes for this indication.