Mistletoe in Cancer Cell Biology: Recent Advances.

Area of Science:

• Integrative oncology and complementary cancer therapy.
• Immunology and molecular mechanisms of cancer treatment.

Background:

• Mistletoe (Viscum album) has a long history in complementary cancer therapy.
• Its precise anticancer mechanisms were previously poorly understood.

Purpose of the Study:

• To review recent advances (2020-2025) in mistletoe cancer research.
• Focus on molecular mechanisms, immunomodulation, and clinical applications.

Main Methods:

• Comprehensive analysis of controlled studies, mechanistic investigations, and real-world evidence (2020-2025).
• Evaluation of mistletoe's effect on immunogenic cell death (ICD), macrophage reprogramming, and clinical outcomes.
• Review of safety data from Phase I clinical trials.

Main Results:

• Mistletoe induces ICD via endoplasmic reticulum stress, increasing calreticulin exposure and ATP release.
• Enhanced macrophage reprogramming observed, increasing IL-6 and decreasing IL-10.
• Combination therapy with PD-1/PD-L1 inhibitors doubled median overall survival in non-small-cell lung cancer patients.
• Intravenous administration safety established at 600 mg thrice weekly.

Conclusions:

• Mistletoe is a scientifically validated agent in integrative oncology.
• Its mechanisms involve ICD and immunomodulation, supporting its use in evidence-based cancer care.
• Precision medicine applications are emerging through advanced analytical techniques.