Trial shows mistletoe extract does not increase survival in advanced pancreatic cancer

The MISTRAL study, involving 290 patients with advanced pancreatic cancer, has investigated whether treatment with mistletoe extract (ME) in addition to standard treatment could help patients live longer. The result is that the treatment did not make any difference compared to placebo in how long the patients lived. The study is published in Deutsches Ärzteblatt international.

This national multicenter study ran between 2016 and 2022.

"We saw no difference in how long the patients lived or in terms of their overall quality of life when we added the ME treatment," says the leader of the study Kathrin Wode, specialist in oncology and palliative medicine, Department of Diagnostics and Intervention, Umeå University.

Previous studies have shown that ME treatment could help patients with pancreatic cancer live longer and improve their quality of life. But the results of the MISTRAL study were different.

"We were surprised that our results differed so much from previous studies. Of course, it would have been good news to find a positive result for survival in this disease.

An important difference compared to previous studies is that MISTRAL was a randomized double-blind study, i.e. with random sampling where neither the patients nor the doctors knew who was given ME treatment or placebo. Despite this, some patients could have guessed that they were receiving the ME treatment due to reactions at the injection site, but this does not seem to have affected the results.

"Our results will be important for those caring for patients with advanced pancreatic cancer. Although we did not see any effect of the ME treatment in this study, the study did not show any risks associated with using it. Our study does not answer the question of whether ME treatment is effective for other tumors," says Kathrin Wode.