Overall survival of stage IV non-small cell lung cancer patients treated with Viscum album L. in addition to chemotherapy, a real-world observational multicenter analysis

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dc.contributor.authorSchad, Friedemann
dc.contributor.authorThronicke, Anja
dc.contributor.authorSteele, Megan L.
dc.contributor.authorMerkle, Antje
dc.contributor.authorMatthes, Burkhard
dc.contributor.authorGrah, Christian
dc.contributor.authorMatthes, Harald
dc.date.accessioned2024-05-23T18:54:03Z
dc.date.available2024-05-23T18:54:03Z
dc.date.digitized2020-10-31 21:49:07
dc.date.issued2018
dc.description.abstract<p><strong>Background: </strong>Stage IV non-small cell lung cancer (NSCLC) is associated with a five-year survival rate of around 1%. Treatment with Viscum album L. (VA) extracts has been shown to reduce chemotherapy (CTx)-related adverse events, decrease CTx dose reductions and improve quality of life in a number of cancers. Recent data suggest a beneficial effect of add-on treatment with Viscum album L. (VA, European mistletoe) on survival in cancer patients. The objective of this study was to evaluate the effect of VA in addition to chemotherapy on survival in stage IV NSCLC patients.</p> <p><strong>Methods: </strong>The observational study was conducted using data from the Network Oncology clinical registry which is an accredited conjoint clinical registry of German oncological hospitals, practitioners and out-patient centers.Patients were included if they had stage IV NSCLC at diagnosis, lived at least for four weeks post-diagnosis and received chemotherapeutic treatment. Patients with EGFR mutations as well as patients receiving tyrosine kinase inhibitors or immune checkpoint inhibitors were not included. Overall survival and impact on hazard in patients with chemotherapy (CTx) to patients receiving CTx plus VA were compared. To identify factors associated with survival and to address potential sources of bias a multivariate analyses using Cox proportional hazard model was performed.</p> <p><strong>Results: </strong>The median age of the population was 64.1 years with 55.7% male patients. The highest proportion of patients had adenocarcinoma (72.2%) and most of the patients were current or past smokers (70.9%). Of 158 stage IV NSCLC patients, 108 received CTx only and 50 additional VA. Median survival was 17.0 months in the CTx plus VA group (95%CI: 11.0–40.0) and was 8.0 months (95%CI: 7.0–11.0) in the CTx only group (?2 = 7.2, p = .007). Overall survival was significantly prolonged in the VA group (HR 0.44, 95%CI: 0.26–0.74, p = .002). One-year and three-year overall survival rates were greater with CTx plus VA compared to CTX alone (1y: 60.2% vs. 35.5%; 3y: 25.7% vs. 14.2%).</p> <p><strong>Conclusion: </strong>Our findings suggest that concomitant VA is positively associated with survival in stage IV NSCLC patients treated with standard CTx. These findings complement pre-existing knowldedge of add-on VA’s clinical impact, however, results should be interpreted with caution in light of the study’s observational character. </p> <p><strong>Citation</strong>: Schad, F., Thronicke, A., Steele, M. L., Merkle, A., Matthes, B., Grah, C., &amp; Matthes, H. (2018). Overall survival of stage IV non-small cell lung cancer patients treated with Viscum album L. in addition to chemotherapy, a real-world observational multicenter analysis. <em>PLOS ONE</em>, <em>13</em>(8), e0203058. <a href="https://doi.org/10.1371/journal.pone.0203058" target="_blank">https://doi.org/10.1371/journal.pone.0203058</a></p>
dc.description.notesfixed
dc.identifier.citationSchad, F., Thronicke, A., Steele, M. L., Merkle, A., Matthes, B., Grah, C., & Matthes, H. (2018). Overall survival of stage IV non-small cell lung cancer patients treated with Viscum album L. in addition to chemotherapy, a real-world observational multicenter analysis. PLOS ONE, 13(8), e0203058. https://doi.org/10.1371/journal.pone.0203058
dc.identifier.doihttps://doi.org/10.1371/journal.pone.0203058
dc.identifier.externalUrl/library/2020/6/25/overall-survival-of-stage-iv-non-small-cell-lung-cancer-patients-treated-with-viscum-album-l-in-addition-to-chemotherapy-a-real-world-observational-multicenter-analysis
dc.identifier.issn1932-6203
dc.identifier.urihttps://hdl.handle.net/20.500.14430/425
dc.subject.otherCancer treatment studies
dc.subject.otherNon-small cell lung cancer
dc.subject.otherCancer
dc.subject.otherMultiple oncology centers
dc.subject.otherMistletoe Therapy with Chemotherapy
dc.titleOverall survival of stage IV non-small cell lung cancer patients treated with Viscum album L. in addition to chemotherapy, a real-world observational multicenter analysis
dspace.entity.typePublication
oaire.citation.titlePLOS ONE
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