Mistletoe Therapy Shows Promise in Lung Cancer Treatment

Lung cancer is a serious disease and the main cause of cancer deaths worldwide. Unfortunately, only about 10% of patients who have advanced non-small cell lung cancer (NSCLC) live for five years or more after diagnosis. Recent medical improvements have led to better treatments, particularly those that target specific proteins in the body known as PD-1 and PD-L1. These treatments help the immune system fight cancer more effectively.

#Immune Checkpoint Blockade (ICB)

The treatments that target PD-1 or PD-L1 proteins are called immune checkpoint inhibitors. Two common drugs used are pembrolizumab and nivolumab, which are PD-1 inhibitors, and durvalumab and atezolizumab, which are PD-L1 inhibitors. Doctors are constantly testing how to best use these drugs in terms of combinations, timing, and duration to improve Survival rates for patients.

#Mistletoe Extracts in Cancer Treatment

Another area of interest in cancer treatment is the use of extracts from European mistletoe, known as Viscum album L. or VA. Studies suggest that adding VA to PD-1/PD-L1 therapy for patients with advanced lung cancer may lead to improved overall survival. Research has shown no significant safety issues when combining VA with immune checkpoint inhibitors. Moreover, national guidelines have indicated that using VA along with these cancer treatments does not increase the risk of serious side effects.

#Study Goals

A study was conducted to assess how well patients with advanced or metastatic NSCLC do with standard ICB therapy, both with and without mistletoe therapy. The researchers used real-world data from a cancer registry in Germany, which offers insights into actual treatment practices and patient outcomes.

#Research Methods

The study included patients enrolled from July 2015 to May 2023. Patients could receive VA therapy based on their doctor's recommendation. The main goal was to compare overall survival rates between two groups: one receiving PD-1/PD-L1 inhibitors alone (the CTRL group) and another receiving these inhibitors along with VA therapy (the COMB group).

#Patient Selection

Patients were included if they were at least 18 years old and had provided consent. Data gathered included demographic details, tumor information, treatments received, and survival outcomes. Follow-ups were regularly scheduled to monitor patient progress.

#Team Composition

A multidisciplinary team of experts from various fields was involved in the study to ensure all aspects were thoroughly considered. This diversity was key to successfully carrying out the research.

#Ethical Considerations

All procedures followed the ethical guidelines set forth in the Declaration of Helsinki. Written informed consent was required from all participants, and the study was approved by an ethics committee.

#Group Classification

Patients were divided into two groups based on their treatment type. The CTRL group received only PD-1/PD-L1 inhibitors, while the COMB group received these inhibitors plus mistletoe therapy. The treatment group assignment was made by the doctor after discussing the options with the patient.

#Sample Size and Statistical Analysis

To ensure the study could find meaningful differences, a specific number of patients was chosen for analysis. Statistical methods were used to compare outcomes between the two groups, looking at factors like age, gender, tumor stage, and treatment methods.

#Patient Characteristics

In total, 300 patients participated in the study. Of these, 222 patients were in the CTRL group, and 78 were in the COMB group. The median age of all participants was 68 years. Other characteristics, such as tumor type and stage, were similar in both groups, which helps make the comparison fair.

#Differences in Molecular Markers

The study looked at various markers to better understand patient conditions. Notably, a higher percentage of patients in the CTRL group had a positive PD-L1 status. This difference was significant and points to the heterogeneity among patients that could affect treatment outcomes.

#Treatment Approaches

Almost 60% of patients in the study received first-line therapy with PD-1/PD-L1 inhibitors. The majority were treated with PD-1 inhibitors. The study found no major differences in initial treatments between the two groups.

#Mistletoe Therapy Details

In the COMB group, the mistletoe therapy lasted longer on average compared to the PD-1/PD-L1 treatment. The most common forms of VA therapy used included intravenous, subcutaneous, and intratumoral applications.

#Survival Analysis

A survival analysis revealed that patients receiving the combination treatment had a significant survival advantage over those receiving only PD-1/PD-L1 inhibitors. On average, patients in the COMB group lived 13.8 months, which was longer than the 6.8 months in the CTRL group.

#Three-Year Survival Rates

The three-year survival rate was also significantly better for the COMB group at 16.5%, compared to only 8% in the CTRL group. This indicates that patients benefiting from the addition of mistletoe therapy had better long-term outcomes.

#Impact on PD-L1 Positive Patients

Among patients with a positive PD-L1 status, those receiving mistletoe therapy had a 75% lower risk of death after adjusting for other factors. This suggests that the combination of therapies particularly helps certain patient groups.

#Summary of Findings

The study highlights the potential benefits of combining mistletoe therapy with standard cancer treatments in improving survival for advanced non-small cell lung cancer patients. While the results are promising, further studies are necessary to confirm these findings and understand the underlying mechanisms better.

#Limitations of the Study

It is worth noting that the study's non-randomized design poses limitations. However, the researchers balanced the groups to reduce variability and potential biases.

#Future Research Directions

To strengthen these findings, more research is needed involving larger patient populations and randomized controlled trials. Findings would contribute to developing better treatments for lung cancer and improving patient care.

#Conclusion

Overall, the addition of mistletoe therapy appears to provide significant benefits for patients receiving standard PD-1/PD-L1 inhibitors for advanced or metastatic non-small cell lung cancer. The improvements in survival rates provide a hopeful avenue for better treatment outcomes in the future.