Mistletoe preparations

A distinction is made between mistletoe preparations used in oncology, which are always injected, and mistletoe preparations in the form of drops or coated tablets, see Visci herba.

The preparations used in oncology are an aqueous extract of Viscum album, mistletoe. In the preparation of one preparation (^Iscador®), this is mixed with mistletoe's own lactic acid bacteria and thus fermented, after which it is further processed; in other preparations (^Helixor®, ^Iscucin®) without fermentation. These aqueous extracts are injected intracutaneously or subcutaneously.

Host trees are apple, pine, oak, elm and fir.

Mistletoe extracts for cancer originally come from anthroposophy, which is why approval in Germany is based on the exemption regulations for anthroposophy.

There is currently no recognized scientific evidence for the efficacy of mistletoe extracts in human medicine. An extension of the overall survival time could not be sufficiently proven in the data available.

The TIM study (Therapeutic Instillation of Mistletoe Extract) for the treatment of superficial bladder cancer with a small number of test subjects shows an effect comparable to mitomycin in the prevention of recurrence (Rexer H 2016).

Preclinical studies have shown that the lectins contained in mistletoe can kill cell cultures and stimulate immune cells.

Mistletoe extracts are available as approved medicinal products in German-speaking countries (based on the monographs of Commission C and Commission E. The costs of mistletoe therapy are only covered by health insurance companies (statutory and private) in exceptional cases, usually only for palliative therapy to improve quality of life.

Immunostimulant in malignant diseases, stimulation of bone marrow activity. Mistletoe extracts are still used today in high-risk malignant melanoma. A prospective randomized study of the EORTC melanoma group showed that treatment with the mistletoe lectin Iscador M has no influence on the prognosis compared to a non-treated control group.

see also Visci herba, use in degenerative-inflammatory joint diseases

Protein hypersensitivity, acute and chronic progressive infections, fever. Lactation, pregnancy and childhood.

Depending on the manufacturer, different warnings are given, e.g. for thyroid problems, intracranial pressure in the case of metastases or tumors in the brain.

Some preparations warn patients with leukemia, lymphoma, renal cell carcinoma or melanoma.

^Helixor®, ^Iscador®, Iscucin®^{, abnobaVISCUM®} , ^Isorel®

1. Kähler KC et al (2011) Adjuvant systemic therapy of melanoma. Dermatologist 62: 414-422
2. https://www.krebsinformationsdienst.de/mistel#c7463
3. https://www.leitlinienprogramm-onkologie.de/fileadmin/user_upload/Downloads/Leitlinien/Komplement%C3%A4r/Version_2/LL_Komplement%C3%A4rmedizin_Langversion_2.0.pdf
4. https://www.krebsinformationsdienst.de/mistel#c7463

5. Rexer H (2o16) Studie zur Therapie beim nicht-muskelinvasiven Urblasenkarzinom: Eine Phase-III-Wirksamkeitsstudie zur intravesikalen Instillation von Mistelextrakt bei oberflächlichem Blasenkarzinom (TIM) - AB 40/11 der AUO [Study for the treatment of nonmuscle invasive bladder cancer: A phase III efficacy trial for intravesical instillation of mistletoe extract in superficial bladder cancer (TIM) - AB 40/11 of the AUO]. Urologist A. 55(7):963-5. German. doi: 10.1007/s00120-016-0135-0. PMID: 27272001.