LONG-TIME SURVIVAL (48 MONTHS) IN A PATIENT WITH METASTATIC MYXOFIBROSARCOMA UNDER INTEGRATIVE CANCER CARE: SYSTEMIC THERAPY ALONG WITH MISTLETOE (VISCUM ALBUM) EXTRACTS AND HIGH-DOSE VITAMIN C – A CASE REPORT
DOI:
https://doi.org/10.52340/jecm.2023.06.07Ключевые слова:
myxofibrosarcoma, integral oncology, viscum album, vitamin CАннотация
Myxofibrosarcoma (MFS) is a rare cancer starting in the connective tissue and growing in arm or leg. High grade MFS spreads quickly and has a poor prognosis. Management of inoperable, advanced or metastatic sarcomas of the pelvis and extremities remains challenging with a median survival time of 12 to 24 months. Viscum album extracts (VAE) have strong immune stimulatory properties, cytotoxic effects, can downregulate cancer genes and inhibit angiogenesis. VAE are often used as an adjunct treatment in cancer patients but have rarely been investigated in MFS. High-dose intravenous vitamin C (IVC) has been used as a potent anti-cancer drug over the past decades. In addition, there is some clinical evidence for IVC’s ability to reduce chemotherapy-related side effects and to improve quality of life also in the palliative care setting. We present a case of a 59-year old man with high-grade MFS of the right buttock with pelvis bone infiltration and vertebral bone metastases (T3N0M1, stage IV). Along with the recommended chemo-radiotherapy, an integrative treatment approach was offered and he was treated with subcutaneous and intravenous VAE and IVC. The most positive (stable disease) effect was achieved on doxorubicin and liposomal doxorubicin combined with VAE and IVC. Despite disease progression, the patient showed an extraordinary long survival (48 months) and ECOG performance status 1-2 except for the last 3 months. We presume that integrative treatment approach might had an impact on this clinically relevant outcome and therefore should be further investigated in MFS.
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Sambri A, Tuzzato G, Spinnato P, et al. Grading in myxofibrosarcoma of the extremities can predict survival and local control. Oncol Res Treat 2020; 43: 189–195.
Mutter RW, Singer S, Zhang Z, et al. The enigma of myxofibrosarcoma of the extremity. Cancer 2012; 118: 518–527.
Vanni S, De Vita A, Gurrieri L, Fausti V, Miserocchi G, Spadazzi C, Liverani C, Cocchi C, Calabrese C, Bongiovanni A, Riva N, Mercatali L, Pieri F, Casadei R, Lucarelli E, Ibrahim T. Myxofibrosarcoma landscape: diagnostic pitfalls, clinical management and future perspectives. Ther Adv Med Oncol. 2022 Jun 28;14:17588359221093973. doi: 10.1177/17588359221093973.
Charlotte Castronovo, Jorge E. Arrese, Pascale Quatresooz, Arjen F. Nikkels. Myxofibrosarcoma: A Diagnostic Pitfall. Rare Tumors. 2013 Apr 15; 5(2): 60–61. doi: 10.4081/rt.2013.e15
Gilg MM, Sunitsch S, Leitner L, Bergovec M, Szkandera J, Leithner A, Liegl-Atzwanger B. Tumor-associated mortality and prognostic factors in myxofibrosarcoma - A retrospective review of 109 patients. Orthop Traumatol Surg Res. 2020 Oct;106(6):1059-1065. doi: 10.1016/j.otsr.2020.04.017.
van der Horst CAJ, Bongers SLM, et al. Overall Survival of Patients with Myxofibrosarcomas: An Epidemiological Study. Cancers (Basel). 2022 Feb 22;14(5):1102. doi: 10.3390/cancers14051102.
Verschoor, A.J., Litière, S., Marréaud, S. et al. Survival of soft tissue sarcoma patients after completing six cycles of first-line anthracycline containing treatment: an EORTC-STBSG database study. Clin Sarcoma Res 10, 18 (2020). https://doi.org/10.1186/s13569-020-00137-5
Nakamura T, Asanuma K, Hagi T, Sudo A. Clinical Outcome of Systemic Treatment for Advanced Soft Tissue Sarcoma: Real-Life Perspective in Japan. Drug Des Devel Ther. 2020 Oct 12;14:4215-4220. doi: 10.2147/DDDT.S275526.
Nagar SP, Mytelka DS, Candrilli SD, et al. Treatment Patterns and Survival among Adult Patients with Advanced Soft Tissue Sarcoma: A Retrospective Medical Record Review in the United Kingdom, Spain, Germany, and France. Sarcoma. 2018 May 24;2018:5467057. doi: 10.1155/2018/5467057.
Blay JY, van Glabbeke M, Verweij J, van Oosterom AT, Le Cesne A, Oosterhuis JW, Judson I, Nielsen OS. Advanced soft-tissue sarcoma: a disease that is potentially curable for a subset of patients treated with chemotherapy. Eur J Cancer. 2003 Jan;39(1):64-9. doi: 10.1016/s0959-8049(02)00480-x.
Lochner J, Menge F, Vassos N, Hohenberger P, Kasper B: Prognosis of Patients with Metastatic Soft Tissue Sarcoma: Advances in Recent Years. Oncol Res Treat 2020;43:613-619. doi: 10.1159/000509519
Kienle GS, Kiene H. Review Article: Influence of Viscum album L (European Mistletoe) Extracts on Quality of Life in Cancer Patients: A Systematic Review of Controlled Clinical Studies. Integrative Cancer Therapies. 2010;9(2):142-157. doi:10.1177/1534735410369673
Horneber M, Bueschel G, et al. Mistletoe therapy in oncology. Cochrane Database of Systematic Reviews 2008, Issue 2. Art. No.: CD003297. DOI: 10.1002/14651858.CD003297.pub2.
Twardziok M, Kleinsimon S, Rolff J, Jäger S, Eggert A, et al. (2016) Multiple Active Compounds from Viscum album L. Synergistically Converge to Promote Apoptosis in Ewing Sarcoma. PLOS ONE 11(9): e0159749. https://doi.org/10.1371/journal.pone.0159749
Hunziker-Basler N, Zuzak TJ, Eggenschwiler J, et al. Prolonged cytotoxic effect of aqueous extracts from dried viscum album on bladder cancer cells. Pharmazie. 2007 Mar;62(3):237-8.
Zuzak TJ, Rist L, Eggenschwiler J, Grotzer MA, Viviani A. Paediatric medulloblastoma cells are susceptible to Viscum album (Mistletoe) preparations. Anticancer Res. 2006 Sep-Oct;26(5A):3485-92. PMID: 17094471.
Cameron E, Pauling L. Supplemental ascorbate in the supportive treatment of cancer: reevaluation of prolongation of survival times in terminal human cancer. Proc Natl Acad Sci U S A. 1978 Sep;75(9):4538-42.
Böttger, F., Vallés-Martí, A., Cahn, L. et al. High-dose intravenous vitamin C, a promising multi-targeting agent in the treatment of cancer. J Exp Clin Cancer Res 40, 343 (2021). https://doi.org/10.1186/s13046-021-02134-y
Mussa A, Mohd Idris RA, Ahmed N, Ahmad S, et al. High-Dose Vitamin C for Cancer Therapy. Pharmaceuticals (Basel). 2022 Jun 3;15(6):711. doi: 10.3390/ph15060711.
White R, Nonis M, Pearson JF, Burgess E, Morrin HR, Pullar JM, Spencer E, Vissers MCM, Robinson BA, Dachs GU. Low Vitamin C Status in Patients with Cancer Is Associated with Patient and Tumor Characteristics. Nutrients. 2020 Aug 5;12(8):2338. doi:10.3390/nu12082338.
Roa FJ, Peña E, Gatica M, Escobar-Acuña K, et al. Therapeutic Use of Vitamin C in Cancer: Physiological Considerations. Front Pharmacol. 2020 Mar 3;11:211. doi: 10.3389/fphar.2020.00211.
Bazzan AJ, Zabrecky G, et al. Retrospective Evaluation of Clinical Experience With Intravenous Ascorbic Acid in Patients With Cancer. Integr Cancer Ther.2018Sep;17(3):912-20
IVC Protocol Vitamin C Research: The Riordan IVC Protocol for Adjunctive Cancer Care Intravenous Ascorbate as a Chemotherapeutic and Biological Response Modifying Agent
https://riordanclinic.org/research-study/vitamin-c-research-ivc-protocol/
Kirsch A, Hajto T. Case reports of sarcoma patients with optimized lectin-oriented mistletoe extract therapy. J Altern Complement Med. 2011 Oct;17(10):973-9. doi: 10.1089/acm.2010.0596.
Reynel M, Villegas Y, Werthmann PG, Kiene H, Kienle GS. Long-Term Survival of a Patient with Recurrent Dedifferentiated High-Grade Liposarcoma of the Retroperitoneum Under Adjuvant Treatment with Viscum album L. Extract: A Case Report. Integr Cancer Ther. 2021 Jan-Dec; 20:1534735421995258. doi: 10.1177/1534735421995258.
Kenny Yong Yean Sirn, Intratumoral injections of viscum album mistletoe in malignant left inguinal large sarcoma; Med Aromat Plants 2016, 5:5(Suppl) http://dx.doi.org/10.4172/2167-0412.C1.005
Schad F, Thronicke A, et al. Immune-related and adverse drug reactions to low versus high initial doses of Viscum album L. in cancer patients. Phytomedicine. 2017 Dec 1; 36:54-58.
Friedel WE, Matthes H, Bock PR, Zänker KS. Systematic evaluation of the clinical effects of supportive mistletoe treatment within chemo- and/or radiotherapy protocols and long-term mistletoe application in nonmetastatic colorectal carcinoma: multicenter, controlled, observational cohort study. J Soc Integr Oncol. 2009 Fall;7(4):137-45. PMID: 19883529.
Thronicke A, Oei SL, Merkle A, Matthes H, Schad F. Clinical Safety of Combined Targeted and Viscum album L. Therapy in Oncological Patients. Medicines (Basel). 2018 Sep 6;5(3):100.
Thronicke, A., Steele, M.L., Grah, C. et al. Clinical safety of combined therapy of immune checkpoint inhibitors and Viscum album L. therapy in patients with advanced or metastatic cancer. BMC Complement Altern Med 17, 534 (2017). https://doi.org/10.1186/s12906-017-2045-0
Paller CJ, Wang L, Fu W, Kumar R, et al. Phase I Trial of Intravenous Mistletoe Extract in Advanced Cancer. Cancer Res Commun. 2023 Feb 28;3(2):338-346.
Oei SL, Thronicke A, Schad F. Mistletoe and Immunomodulation: Insights and Implications for Anticancer Therapies. Evid Based Complement Alternat Med. 2019 Apr 17; 2019:5893017. doi: 10.1155/2019/5893017.
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