Observational studyBMC complementary and alternative medicine2017
Clinical safety of combined therapy of immune checkpoint inhibitors and Viscum album L. therapy in patients with advanced or metastatic cancer.
Observational study in BMC complementary and alternative medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
23 citing papers in PubMed, 2 syntheses or guidelines pooled it, 48 citations in OpenAlex.
- Systematic analysis of mistletoe prescriptions in clinical studies.Journal of cancer research and clinical oncology · 2023Pooled it
- Mistletoe in oncological treatment: a systematic review : Part 1: survival and safety.Journal of cancer research and clinical oncology · 2019Pooled it
- Mistletoe in Cancer Cell Biology: Recent Advances.Current issues in molecular biology · 2025Review
- Combined Immune Checkpoint Blockade and HelixorInternational journal of molecular sciences · 2025Article
- Immune Checkpoint Blockade Combined with AbnobaViscumPharmaceuticals (Basel, Switzerland) · 2024Article
- Article
- Integrative Oncology Approaches to Supporting Immune Checkpoint Inhibitor Treatment of Solid Tumours.Current oncology reports · 2024Review
- The Antioxidant Activity of Mistletoes (Plants (Basel, Switzerland) · 2023Review
- The Anti-Inflammatory Activity ofPlants (Basel, Switzerland) · 2023Review
- Safety of Combined Targeted and HelixorInternational journal of environmental research and public health · 2023Observational
- Real-world Evidence of the Herb-drug Interactions.Journal of food and drug analysis · 2022Review
- HDI Highlighter, The First Intelligent Tool to Screen the Literature on Herb-Drug Interactions.Clinical pharmacokinetics · 2022Review
- Herb-Drug Interactions: Worlds Intersect with the Patient at the Center.Medicines (Basel, Switzerland) · 2021Review
- [Complementary medicine in uro-oncology].Der Urologe. Ausg. A · 2021Article
- Analysis of intrahepatic sarcomatoid cholangiocarcinoma: Experience from 11 cases within 17 years.World journal of gastroenterology · 2019Article
- Mistletoe and Immunomodulation: Insights and Implications for Anticancer Therapies.Evidence-based complementary and alternative medicine : eCAM · 2019Review
- Contributing to Global Health: Development of a Consensus-Based Whole Systems Research Strategy for Anthroposophic Medicine.Evidence-based complementary and alternative medicine : eCAM · 2019Article
- Chemoimmunotherapy in Advanced Renal Cell Carcinoma: A Case Report of a Long-Term Survivor Adjunctly Treated with Viscum album Extracts.Complementary medicine research · 2019Article
- Clinical Safety of Combined Targeted andMedicines (Basel, Switzerland) · 2018Article
- Current Clinical Progress of PD-1/PD-L1 Immunotherapy and Potential Combination Treatment in Non-Small Cell Lung Cancer.Integrative cancer therapiesReview
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDespite improvement of tumour response rates in patients with progressive and metastatic cancer, immune checkpoint inhibitors (ICM) induce toxicities in cancer patients. Viscum album L. (VA, mistletoe) extracts are applied as add-on cancer therapy especially in German speaking countries and within integrative and anthroposophical concepts with the goal to improve quality of life. The primary objective of this pilot observational cohort study was to determine the rate of adverse events (AE) related to ICM therapy with and without VA in patients with advanced or metastatic cancer in a certified Cancer Center.
methodsICM or combined ICM/VA therapies were applied in patients with progressive or metastatic cancer. AE rates of both therapy groups were compared.
resultsA total of sixteen cancer patients were treated with ICM: nivolumab (75%), ipilimumab (19%) or pembrolizumab (6%). The median age of the study population was 64 years (IQR 57.8; 69.3); 44% were male. Of the sixteen patients receiving ICM, nine patients received additional VA (56%; ICM/VA group) and seven did not (44%; ICM group). No statistically significant differences were seen between groups with respect to AE-rates (67% ICM/VA versus 71% ICM). Adjusted multivariate regression analysis revealed that concomitant application of VA did not alter the AE rate in ICM treated patients. 85% of AEs were expected ICM reactions. No AEs of grade 3 or greater were documented for the total study cohort.
conclusionsThis is the first study evaluating the clinical safety profile of ICM in combination with VA in patients with advanced or metastatic cancer. The overall AE rate of the study cohort is comparable to AE rates of ICM treatment in the literature. Our data indicate a first impression that concomitant VA application may not alter ICM-induced AE rates. However, the nature of this study does not allow excluding possible immunological interactions between ICM and VA. Further prospective trials in larger study cohorts should focus on the assessment of safety aspects, clinical efficacy and health related quality of life in patients with combined ICM/VA therapy.
trial registrationDRKS00013335 , retrospectively registered (November 27th, 2017) at the German Clinical Trials Register ( www.drks.de ).
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.