Fermented Wheat Germ Extract: Are you a health professional? - CancerChoices

This dietary supplement may improve survival and your response to chemotherapy or radiotherapy, notably among people with colon cancer.

Are you a health professional?

This section does not replicate the other information on this topic but provides additional details or context most relevant to professionals.

Modes of action

Fermented wheat germ extract lowers VEGF and Cox-2 protein and mRNA levels.1Imir NG, Aydemir E, Şimşek E. Mechanism of the anti-angiogenic effect of Avemar on tumor cells. Oncology Letters. 2018 Feb;15(2):2673-2678.

FWGE’s cytostatic and growth delay effects were linked to impaired glucose utilization which influenced the cell cycle, cellular ATP levels, and the NADH/NAD+ ratio. The growth delay effect in response to FWGE treatment led to induction of autophagy.2Otto C, Hahlbrock T et al. Antiproliferative and antimetabolic effects behind the anticancer property of fermented wheat germ extract. BMC Complementary and Alternative Medicine. 2016 Jun 1;16:160.

FWGE controls pancreas tumor propagation primarily by regulating glucose carbon redistribution between cell proliferation-related and cell differentiation-related macromolecules.3Boros LG, Lapis K et al. Wheat germ extract decreases glucose uptake and RNA ribose formation but increases fatty acid synthesis in MIA pancreatic adenocarcinoma cells. Pancreas. 2001 Aug;23(2):141-7. 

Preclinical evidence

Notable preclinical evidence is listed here; clinical evidence is in How can FWGE help you? What the research says ›

Improving treatment outcomes

FWGE enhanced the efficacy of several conventional treatments in preclinical studies.

Cancer as a whole
  • FWGE showed an additive to synergistic drug interaction with 5-fluorouracil (5-FU) or dacarbazine (DTIC), reducing tumor size and metastasis in mouse models.4Mueller T, Voigt W. Fermented wheat germ extract—nutritional supplement or anticancer drug? Nutrition Journal. 2011 Sep 5;10:89; Mueller T, Jordan K, Voigt W. Promising cytotoxic activity profile of fermented wheat germ extract (Avemar®) in human cancer cell lines. Journal of Experimental & Clinical Cancer Research. 2011 Apr 16;30(1):42.
  • FWGE showed antimetastatic effects in three metastasis models (3LL-HH, B16, and HCR-25). It also enhanced the antimetastatic effects and decreased the toxic side effects of 5-FU and DTIC in metastasis animal models.5Hidvégi M, Rásó E et al. MSC, a new benzoquinone-containing natural product with antimetastatic effect. Cancer Biotherapy & Radiopharmaceuticals. 1999 Aug;14(4):277-89. 
  • FWGE alone or combined with vitamin C inhibited metastasis formation in tumor models compared to vitamin C alone.6Hidvégi M, Ráso E et al. Effect of Avemar and Avemar + vitamin C on tumor growth and metastasis in experimental animals. Anticancer Research. 1998 Jul-Aug;18(4A):2353-8. 
Breast cancer
  • FWGE enhanced the efficacy of tamoxifen in promoting apoptosis and decreasing estrogen receptor activity in ER+ breast cancer cells7Marcsek Z, Kocsis Z, Jakab M, Szende B, Tompa A. The efficacy of tamoxifen in estrogen receptor-positive breast cancer cells is enhanced by a medical nutriment. Cancer Biotherapy &  Radiopharmaceuticals. 2004 Dec;19(6):746-53.
  • Combining FWGE with any of the endocrine treatments (tamoxifen, examestane, or anastrasol) enhanced the efficacy compared to endocrine monotherapy and showed greater effects (50% inhibition) when used alone than any of the other monotherapies.8Tejeda M, Gaál D, Szűcs I, Telekes A. Avemar inhibits the growth of mouse and human xenograft mammary carcinomas comparable to endocrine treatments. Journal of Clinical Oncology 2007 Jun;25(18_suppl): 21132.
Gastric cancer
  • 2,6-Dimethoxy-1,4-benzoquinone (2,6-DMBQ), the major bioactive compound found in fermented wheat germ extract, significantly reduced cell growth and induced G1 phase cell cycle arrest and apoptosis in gastric cancer cells.9Zu X, Ma X et al. 2,6-DMBQ is a novel mTOR inhibitor that reduces gastric cancer growth in vitro and in vivo. Journal of Experimental and Clinical Cancer Research. 2020 Jun 9;39(1):107.
Liver cancer
Lung cancer
  • Fermented wheat germ protein showed cytotoxicity against non-small cell lung cancer cells and inhibited growth of A549 xenografts in mice.13Levis DJ, Meckler JF, O’Donnell RT, Tuscano JM. A fermented wheat germ extract contains protein components active against NSCLC xenografts in vivo. Current Issues in Molecular Biology. 2023 Aug 25;45(9):7087-7096.
  • 2,6-DMBQ, the major bioactive compound found in fermented wheat germ extract, suppressed cell growth and migration in non-small cell lung cancer cells.14Xie X, Zu X, Laster K, Dong Z, Kim DJ. 2,6-DMBQ suppresses cell proliferation and migration via inhibiting mTOR/AKT and p38 MAPK signaling pathways in NSCLC cells. Journal of Pharmacological Sciences. 2021 Mar;145(3):279-288.
Oral cancer
  • High concentration of FWGE reduced the viability of oral tongue squamous cell carcinoma cells and enhanced the effects of cisplatin and 5-fluorouracil on viability.18Zhurakivska K, Risteli M et al. Effects of fermented wheat germ extract on oral cancer cells: an in vitro study. Nutrition and Cancer. 2022;74(6):2133-2141.
  • FWGE inhibited viability and induced cell apoptosis in human oral squamous carcinoma SCC-4 cells and inhibited the migration and invasion of metastatic SCC-4 cells.19Yang MD, Chang WS et al. Inhibitory effects of AVEMAR on proliferation and metastasis of oral cancer cells. Nutrition and Cancer. 2016;68(3):473-80.
Ovarian cancer

Optimizing your body terrain

Immune function
  • FWGE was linked to an altered immune response 21Mueller T, Voigt W. Fermented wheat germ extract—nutritional supplement or anticancer drug? Nutrition Journal. 2011 Sep 5;10:89. and enhanced immune activity, resulting in death of tumor cells in animal studies 22Mueller T, Voigt W. Fermented wheat germ extract—nutritional supplement or anticancer drug? Nutrition Journal. 2011 Sep 5;10:89; Telekes A, Hegedus M, Chae CH, Vékey K. Avemar (wheat germ extract) in cancer prevention and treatment. Nutrition and Cancer. 2009;61(6):891-9.
  • FWGE showed activity toward restoring the immune function of blastic transformation of peripheral blood lymphocytes of mice.23Hidvégi M, Rásó E, Tömösközi Farkas R, Lapis K, Szende B. Effect of MSC on the immune response of mice. Immunopharmacology. 1999 Apr;41(3):183-6.
  • FWGE lowered the inflammatory response especially related to oxidative stress and lowered LPS-triggered partial disruption of epithelial integrity in porcine intestinal epithelial cells.24Karancsi Z, Móritz AV et al. Beneficial effect of a fermented wheat germ extract in intestinal epithelial cells in case of lipopolysaccharide-evoked inflammation. Oxidative Medicine and Cellular Longevity. 2020 Aug 5;2020:1482482.
  • FWGE synergized with lipopolysaccharide and PMA in the induction of the transcription of cytokine genes and release of inflammatory cytokines.25Telekes A, Kiss-Tóth E et al. Synergistic effect of Avemar on proinflammatory cytokine production and Ras-mediated cell activation. Annals of the New York Academy of Sciences. 2005 Jun;1051:515-28.
  • FWGE inhibited the activity of the inflammatory enzymes cyclooxygenase-1 and -2 in HT-29 human colon carcinoma cells.26Illmer C, Madlener S et al. Immunologic and biochemical effects of the fermented wheat germ extract Avemar. Experimental Biology and Medicine (Maywood, NJ). 2005 Feb;230(2):144-9.
Oxidative stress
  • FWGE lowered a marker of oxidative stress (intracellular reactive oxygen species) in IPEC-J2 cells exposed to mycotoxins.28Pomothy JM, Pászti-Gere E, Barna RF, Prokoly D, Jerzsele Á. The impact of fermented wheat germ extract on porcine epithelial cell line exposed to deoxynivalenol and T-2 mycotoxins. Oxidative Medicine and Cellular Longevity. 2020 Dec 8;2020:3854247.
  • FWGE at low dose (0.1%) efficiently decreased cellular ROS production and the lipid peroxidation rate in primary hepatocyte cell cultures of rat origin with LPS-induced inflammatory response, although higher concentration of FWGE (1%) increased the rate of both ROS and malondialdehyde synthesis.29Mackei M, Vörösházi J, Sebők C, Neogrády Z, Mátis G, Jerzsele Á. Fermented wheat germ extract as a redox modulator: alleviating endotoxin-triggered oxidative stress in primary cultured rat hepatocytes. Oxidative Medicine and Cellular Longevity. 2020 Dec 8;2020:3181202.
  • FWGE lowered the level of intracellular ROS in LPS-treated porcine intestinal epithelial cells.30Karancsi Z, Móritz AV et al. Beneficial effect of a fermented wheat germ extract in intestinal epithelial cells in case of lipopolysaccharide-evoked inflammation. Oxidative Medicine and Cellular Longevity. 2020 Aug 5;2020:1482482.
  • FWGE induced oxidative stress that promoted cytotoxicity in human cancer cell lines.31Otto C, Hahlbrock T et al. Antiproliferative and antimetabolic effects behind the anticancer property of fermented wheat germ extract. BMC Complementary and Alternative Medicine. 2016 Jun 1;16:160.

Helpful link for professionals

KNOW Oncology ›

A subscription is required; access is free of charge for members of the Society for Integrative Oncology.

Keep reading about fermented wheat germ extract


Nancy Hepp, MS

Lead Researcher
View profile

Ms. Hepp is a researcher and communicator who has been writing and editing educational content on varied health topics for more than 20 years. She serves as lead researcher and writer for CancerChoices and also served as the first program manager. Her graduate work in research and cognitive psychology, her master’s degree in instructional design, and her certificate in web design have all guided her in writing and presenting information for a wide variety of audiences and uses. Nancy’s service as faculty development coordinator in the Department of Family Medicine at Wright State University also provided experience in medical research, plus insights into medical education and medical care from the professional’s perspective.

Nancy Hepp, MS Lead Researcher


Laura Pole, MSN, RN, OCNS

Senior Clinical Consultant
View profile

Laura Pole is senior clinical consultant for CancerChoices. Laura is an oncology clinical nurse specialist who has been providing integrative oncology clinical care, navigation, consultation, and education services for over 40 years. She is the co-creator and co-coordinator of the Integrative Oncology Navigation Training at Smith Center for Healing and the Arts in Washington, DC. Laura also manages the “Media Watch Cancer News That You Can Use” listserv for Smith Center/Commonweal. In her role as a palliative care educator and consultant, Laura has served as statewide Respecting Choices Faculty for the Virginia POST (Physician Orders for Scope of Treatment) Collaborative as well as provided statewide professional education on palliative and end-of-life care for the Virginia Association for Hospices and Palliative Care.

For CancerChoices, Laura curates content and research, networks with clinical and organizational partners, brings awareness and education of integrative oncology at professional and patient conferences and programs, and translates research into information relevant to the patient experience as well as clinical practice.

Laura sees her work with CancerChoices as a perfect alignment of all her passions, knowledge and skills in integrative oncology care. She is honored to serve you.

Laura Pole, MSN, RN, OCNS Senior Clinical Consultant

Andrew Jackson, ND

Research Associate
View profile

Andrew Jackson, ND, serves as a CancerChoices research associate. As a naturopathic physician practicing in Kirkland, Washington, he teaches critical evaluation of the medical literture at Bastyr University in Kenmore, Washington. His great appreciation of scientific inquiry and the scientific process has led him to view research with a critical eye.

Andrew Jackson, ND Research Associate

Last update: July 15, 2024

Last full literature review: June 2024

CancerChoices provides information about integrative in cancer care, a patient-centered approach combining the best of conventional care, self care and evidence-informed complementary care in an integrated plan cancer care. We review complementaryin cancer care, complementary care involves the use of therapies intended to enhance or add to standard conventional treatments; examples include supplements, mind-body approaches such as yoga or psychosocial therapy, and acupuncture therapies and self-care lifestyle actions and behaviors that may impact cancer outcomes; examples include eating health-promoting foods, limiting alcohol, increasing physical activity, and managing stress practices to help patients and professionals explore and integrate the best combination of conventionalthe cancer care offered by conventionally trained physicians and most hospitals; examples are chemotherapy, surgery, and radiotherapy and complementary therapies and practices for each person.

Our staff have no financial conflicts of interest to declare. We receive no funds from any manufacturers or retailers gaining financial profit by promoting or discouraging therapies mentioned on this site.

Learn more

Health professional comment

We invite health professionals to contribute expertise or send us questions.

"*" indicates required fields

Please share your thoughts about content on the CancerChoices website. If you have a correction for us to consider, or additional information to add, please include references and links if possible.