Vollständige Metastasenremission und Langzeitüberleben bei einer Melanompatientin unter hochdosierter, fieberinduzierender Viscum-album-Extrakt-Therapie

Paul Werthmann, Alexander Hintze, Gunver S. Kienle
Artikel-ID: DMS-21048-DE
DOI: https://doi.org/10.14271/DMS-21048-DE

Hintergrund: Das metastasierte maligne Melanom (MCM) – ein stark immunogener Krebs – hat in der Regel eine sehr schlechte Prognose. Viscum-album-Extrakte (VAE) zeigen starke immunstimulierende, apoptogene und zytotoxische Wirkungen.

Fallbericht: Eine 66-jährige MCM-Patientin mit neu diagnostizierten Lymphknotenmetastasen entschied sich für eine alleinige VAE-Therapie. VAE wurden zunächst subkutan, später in ungewöhnlich hohen, fieberinduzierenden Dosierungen auch intravenös und intraläsional gegeben. Die Metastasen verkleinerten sich über die nächsten Monate und nach 2 Jahren waren alle Läsionen vollständig zurückgebildet (regionale und hiläre Lymphknotenmetastasen). Die Patientin ist zum Zeitpunkt der Publikation 3 ½ Jahre tumorfrei (5 Jahre seit Beginn der intensivierten VAE-Therapie). Neben Fieber und grippeähnlichen Symptomen zeigten sich keine Nebenwirkungen.

Diskussion: Wir nehmen an, dass die Therapie mit VAE eine vermehrte Ausschüttung von Tumorantigenen, eine vermehrte Immunprozessierung der Tumorantigene und damit eine verstärkte Immunantwort gegen das Tumorgewebe bewirkte, die zur vollständigen Remission geführt haben.

Complete remission and long-term survival of a patient with melanoma metastases treated with high-dose fever-inducing Viscum album extract: A case report

Introduction: Metastatic malignant cutaneous melanoma (MCM) – a highly immunogenic cancer – typically has a poor prognosis. Viscum album extracts (VAEs) have strong immune-stimulating, apoptogenic, and cytotoxic effects.

Case presentation: A 66-year-old MCM patient with newly diagnosed lymph node metastases opted for sole VAE treatment. VAEs were initially applied subcutaneously, and then later in exceptionally high, fever-inducing doses, both intravenously and intralesionally. The metastases shrunk over the following months, and after 2 years, all lesions had completely remitted (regional and hilar lymph nodes). The patient has been tumor free for 3.5 years at the time of publication (and for 5 years since initiation of intensified VAE treatment). Besides fever and flu-like symptoms, no side effects occurred.

Discussion: We presume that VAE triggered an increased release of tumor-associated antigens, enhanced immunologic recognition, and increased immune response against the tumor tissue and induced tumor remission.

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