In a further study of Iscador (ISC) as part of supportive care, the mistletoe extract demonstrated strong benefits as compared with conventional supportive care among patients with pancreatic carcinoma receiving adjuvant chemotherapy (with or without radiotherapy). "Adjuvant" signifies treatment given in addition to primary treatment (usually surgery). Chemotherapy among 400 patients treated at 17 German and Swiss centers was mostly gemcitabine.

Study author P. Heusser, MD, Institute of Complementary Medicine (KIKOM), University of Bern, Bern, Switzerland, noted that mistletoe therapy is often used in Europe as supportive treatment among cancer patients, mainly to reduce adverse drug reactions (ADRs) of conventional chemo- and/or radiotherapy and to improve quality of life. Dr. Heusser's study was designed to evaluate the effectiveness and safety of ISC

given as a subcutaneous injection two or three times per week in 205 patients, at any stage of pancreatic carcinoma, receiving adjuvant chemotherapy and/or radiotherapy, or passive aftercare. A control group of 195 patients received conventional therapy only. The primary outcome measure was rate of ADRs. Results were adjusted to compensate for differences in baseline differences.

Patients in the ISC group had a significantly lower ADR rate than controls (13.7% versus 48.9%).'Persistent therapy-related symptoms after the first therapy course, especially gastrointestinal symptoms, central nervous system (CNS) symptoms or back pain, were consistently better in the ISC group. Karnofsky index improved in the ISC group and deteriorated in the conventional treatment group, with a significant 4.5% difference (mean values 79.1% versus 74.7%). Mean hospitalization duration was shorter in the ISC group (39.5 days versus 53.6 days), and overall survival (mortality hazard ratio) was better in the ISC group (42% lower mortality risk than controls). The mortality benefit was more pronounced in those with metastatic disease.

Dr. Heusser underscored that this study is the largest systematic comparative clinical data evaluation ever performed concerning supportive mistletoe treatment in pancreatic carcinoma. Aside from the positive findings in reduced ADRs and symptoms, the longer overall survival suggests an independent beneficial effect in all pancreatic carcinoma tumor stages.