- Fermented wheat germ extract
- MSC (Code Name)
For Patients & Caregivers
Bottom Line: Fermented wheat germ was shown to improve quality of life in cancer patients. More studies are needed.
Fermented wheat germ extract (WGE) was developed by Mate Hidvegi, a Hungarian chemist, in the 1990s. It should not be confused with wheat germ oil. WGE is used as a dietary supplement by cancer patients in Hungary to improve quality of life. Laboratory studies show that WGE may have anticancer properties. Results from some clinical trials suggest WGE improves quality of life, but cancer patients should consult their physicians before taking WGE.
- Cancer treatment
WGE was shown to improve quality of life in cancer patients. More data are needed to establish its use.
- Autoimmune disorders
Animal studies show that WGE is beneficial, but human data are lacking.
Data from test tube and observation studies show that WGE can regulate the immune system.
In a small study of 22 children with different cancers, 11 were given WGE during cancer treatments and 11 received only cancer treatments (control group). Researchers found certain white blood cell counts were close to normal in the WGE group compared with the control group.
In a study that looked at whether WGE could benefit patients with colorectal cancer, 66 patients were given WGE daily along with cancer treatments, and 104 patients received only cancer treatments (control group). Results showed that WGE improved overall survival for those taking WGE compared with the control group.
Another study in 52 patients with malignant skin cancer also used either WGE with cancer treatments or cancer treatments alone. After long-term followup of 7 years, an improvement in survival was noted.
- You are pregnant or nursing.
- You had an organ or tissue transplant.
- You have bleeding, ulcers of the stomach and intestine, or severe absorption problems.
- You have sensitivity to gluten.
- You are fructose intolerant.
- You are having barium X-ray contrast tests. Discontinue 2 days before and after test.
For Healthcare Professionals
Fermented wheat germ extract (WGE) was developed in the 1990s by Hungarian chemist Mate Hidvegi. It should not be confused with wheat germ oil. WGE is used as a dietary supplement by cancer patients in Hungary to improve quality of life (QoL).
Results from in vitro studies show that WGE has anticancer (1)(2)(3)(4)(5)(19), antimetastatic (6), and immunomodulatory (2)(7) effects. Although it appears to increase estrogen receptor (ER) activity, WGE enhanced efficacy of tamoxifen, an ER antagonist, in ER+ breast cancer cells (8) as well as cisplatin in ovarian cancer cell lines (5). Animal models suggest WGE can reduce cardiovascular symptoms due to chronic hypertension, diabetes, and obesity (9), mitigate symptoms associated with lupus (10), and that its antitumor effect is comparable to other endocrine treatments (11).
Data from pilot studies indicate a beneficial role for WGE in patients with colorectal cancer (12) and in reducing treatment-associated febrile neutropenia in pediatric cancer patients (13). It also prolonged survival of patients with melanoma when used with chemotherapy (14)(15). However, these effects must be confirmed by large-scale, well-designed clinical trials.
Because it potentiates estrogen receptor activity, patients with hormone-sensitive cancers should use WGE with caution.
Benzoquinone compounds are thought to be the active components of WGE (5). In vitro, WGE attenuates cell cycle progression from G2-M to G0-G1 phase, reduces ribonucleotide reductase activity (3)(4), and stimulates immune function via increased natural killer (NK) cell activity and intercellular adhesion molecule 1 (ICAM-1) expression (16)(17). It also increases tumor necrosis factor (TNF) and cytokine production by activating metabolic pathways involved in tumor cell death (14). WGE demonstrated cytotoxic effects on human lymphoma cells by inducing apoptosis (4) and against ovarian cancer cells via poly(ADP-ribose) polymerase (PARP)-1 and PARP-12 expression (5). It was also shown to regulate tumor cell proliferation by inhibiting glycolysis and pentose cycle enzymes (19), and induce apoptosis through caspase-3-mediated PARP cleavage (7).
- Pregnant and nursing women.
- Patients with hormone-sensitive cancers, as it may have estrogen-receptor activity.
- Patients with organ or tissue transplants.
- Patients with bleeding gastric or duodenal ulcers, enteritis/colitis, or malabsorption syndrome.
- Patients with sensitivity to gluten and those with fructose intolerance.
- The manufacturer recommends discontinuing Avemar usage 2 days before barium X-ray contrast examinations and resume 2 days after procedure.
Demidov LV, et al. Adjuvant fermented wheat germ extract (Avemar) nutraceutical improves survival of high-risk skin melanoma patients: a randomized, pilot, phase II clinical study with a 7-year follow-up. Cancer Biother Radiopharm. 2008 Aug;23(4):477-82.
This study included 52 patients with malignant skin melanoma who underwent radical surgery for tumor removal and complete resection of the regional nodes involved. Patients were randomized to receive dacarbazine (DTIC)-based adjuvant chemotherapy alone or supplemented with fermented wheat germ extract (FWGE) for 1 year. At 7-year follow-up, researchers observed significant differences in progression-free survival (mean PFS, 55.8 mo vs control group, 29.9 mo; P= .0137) and overall survival (mean OS, 66.2 mo vs control group, 44.7 mo; P=.0298) with FWGE supplementation. Investigators determined FWGE may be a useful adjuvant therapy in high-risk patients for skin melanoma. Larger studies are warranted.
Garami M, et al. Fermented wheat germ extract reduces chemotherapy-induced febrile neutropenia in pediatric cancer patients. J Pediatr Hematol Oncol 2004; 26(10): 631-635.
In this pilot study, 22 pediatric patients with different malignant tumors were given either WGE 12 g/m2 daily during cancer treatments or cancer treatments only (n=11 each). Researchers found no recognizable disease progression during the follow-up period, but there were significant between-group differences in frequency of febrile neutropenic events. The overall white blood cell and lymphocyte counts during such events were close to normal values in the WGE group compared with those in the control group. Since this is a preliminary study, randomized controlled trials are warranted with larger sample sizes to verify these effects.
Jakab F, et al. A medical nutriment has supportive value in the treatment of colorectal cancer. Br J Cancer 2003; 89:465-469.
This study was done to determine if WGE supplementation was beneficial for patients with colorectal cancer. A total of 66 patients were given WGE 9g once daily in addition to anticancer treatments, and 104 patients received only anticancer treatments. Data analysis revealed that patients who took WGE had fewer disease progression-related events compared with the control group. There was also an improvement in OS of patients on WGE, but more trials are needed with equal numbers of patients in the experimental and control groups.