Proteolytic enzymes beneficial for multiple myeloma - Literature Review & Commentary

Townsend Letter for Doctors and Patients,  June, 2003  by Alan R. Gaby

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Two hundred sixty-five patients with multiple myeloma stages I-Ill were treated with standard chemotherapy. One hundred sixty-six of these patients also received oral enzymes for more than six months, while 99 patients either did not receive enzymes or received them for less than six months (control group). Treatment allocation was not randomized, but was assigned on the basis of the availability of the enzymes on the first day of chemotherapy. The enteric-coated enzyme preparation (Wobe-Mugos) contained 100 mg of papain, 40 mg of trypsin, and 40 mg of chymotrypsin per tablet. The dose was 2 tablets 3 times per day for 1 year, starting on the first day of chemotherapy; in most cases the dose was reduced to 1 tablet 3 times per day after the first year, and was continued indefinitely. The proportion of patients achieving complete remission, partial remission, or stable disease was significantly higher in the enzyme group than in the control group (97.6% vs. 69.7%; p = 0.001). In stage III patients, the proport ion of non-responders was 3.7% in the enzyme group and 38.9% in the control group (p < 0.001). The median survival time in stage III patients was 47 months in the control group and 83 months in the enzyme group (77% increase; p < 0.002), corresponding to a 3-year increase in survival time. The observation period was not long enough to estimate the survival times for patients in stages I and II.

Comment: Proteolytic enzymes have been used for many years in the treatment of various types of cancer, but there is only a small amount of published research supporting its use. The present study has a potential flaw, in that patients who discontinued enzyme treatment (perhaps because they were too sick to continue) were counted as not having received the treatment. In addition, the non-random selection of patients may have biased the results. Nevertheless, the outcome was markedly better in the enzyme group than in the control group, suggesting that enzyme treatment increases the response rate and prolongs survival in patients with multiple myeloma. Although the mechanism of action is not known, it has been suggested that proteolytic enzymes help break through a protective coating produced by cancer cells, thereby giving the immune system a better chance to attack the tumor cells.

Sakalova A, et al. Retrolective cohort study of on additive therapy with on oral enzyme preparation in patients with multiple myeloma. Cancer Chemother Pharmacol 2001;47(Suppl):S38-S44.

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