Safety of Combined Treatment With Monoclonal Antibodies and Viscum album L Preparations.
Combination strategies involving chemotherapy and monoclonal antibodies (mAb) are commonly used in attempts to produce better clinical outcomes. This practice has led to new and ongoing toxicities that may lead to reductions in dose or noncompliance, limiting the effectiveness of treatment. Viscum album L (VA) preparations are widely used in Europe as additive therapy and have been associated with reduced chemotherapy-related adverse reactions and increased health-related quality of life. Concomitant VA therapy might also reduce toxicity related to mAb. This retrospective study investigated the safety of combined treatment with VA and mAb in cancer patients. A total of 43 patients had combined therapy (474 exposures); 12 had VA without mAb (129 exposures), and 8 had mAb without VA (68 exposures). Most patients (89.3%) received concomitant chemotherapy or supportive therapies. A total of 34 patients (60.7%) experienced 142 adverse events (AEs). Leucopenia (14.1% of all events), acneiform rash (8.5%), and stomatitis (6.3%) occurred most frequently. Longitudinal logistic regression analysis suggested a nearly 5 times higher odds of experiencing an AE following treatment with mAb compared with mAb plus VA (95% CI = 1.53-16.14). Our results, together with theoretical consideration of potential botanical-drug interactions, suggest that combined treatment with VA and mAb is safe.
['Schad|Friedemann|F|', 'Axtner|Jan|J|', 'Kröz|Matthias|M|', 'Matthes|Harald|H|', 'Steele|Megan L|ML|']
D000368:Aged D000911:Antibodies, Monoclonal D000970:Antineoplastic Agents D000074322:Antineoplastic Agents, Immunological D000972:Antineoplastic Agents, Phytogenic D003131:Combined Modality Therapy D003602:Cytotoxicity, Immunologic D005260:Female D005858:Germany D006801:Humans D007262:Infusions, Intravenous D008297:Male D008875:Middle Aged D009369:Neoplasms D008517:Phytotherapy D010936:Plant Extracts D012042:Registries D012189:Retrospective Studies D028182:Viscum album
safety Viscum album L combination therapy adverse events Helixor integrative oncology mistletoe targeted therapy