How can FWGE help you? What the research says

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

How can FWGE help you? What the research says

We summarize the clinical evidence for each medical benefit here. We begin with our assessment of the strength of evidence within each category, followed by a brief summary of individual studies or reviews of several studies. In assessing the strength of evidence, we consider the study design, number of participants, and the size of the treatment effect (how much outcomes changed with treatment).

To see more details, click the plus sign to the right of any section.

Our assessments of evidence for each medical benefit fall into one of these categories:

Strong evidence: consistent, significant effects in several large (or at least one very large) well designed clinical studies or at least two meta-analysesa statistical analysis that combines the results of two or more research studies; the results of smaller research studies addressing the same or similar questions can be analyzed as though they are one bigger, more powerful study of clinical studies of moderate or better quality (or one large meta-analysis) finding similar results
Good evidence: significant effects in one large or several mid-sized and well-designed clinical studies ( randomized controlled trialsa study design in which people are randomly assigned to either an experimental group or a control group to compare the outcomes from different treatments; an RCT is considered a strong design for determining a therapy’s effects with an appropriate placebo or other strong comparison control or observational studies that control for confounds)
Modest evidence: significant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observationala type of study in which individuals are observed or certain outcomes are measured, but no attempt is made to affect the outcome (for example, no treatment is given); an example is a study that records people’s diets, but doesn’t try to alter their diets, and looks for patterns of disease or other outcomes related to different foods studies), or several small studies aggregated into a meta-analysis
Preliminary evidence: significant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect
Weak evidence: one or more case studies, supported by animal evidence OR small treatment effects of limited clinical significance OR studies with no controls OR weak trends of effects
Insufficient evidence: preclinical evidence only OR clinical studies with such poor or unclear methodology that no conclusion can be drawn OR conflicting findings across clinical studies with no preponderance of evidence in one direction; conflicting evidence occurs when studies find conflicting effects (positive effect vs no effect or negative effect) with the same treatment and the same general study population (same cancer type, for example)

Learn more about how we research and rate therapies and practices in How We Rate Therapies ›

Preclinical evidence is summarized in Are you a health professional? ›

Improving treatment outcomes

Is FWGE linked to improved survival? Is it linked to less cancer growth or metastasis? Does it enhance the anticancer action of other treatments or therapies? We present the evidence.

Colorectal cancer

Modest evidencesignificant effects in at least three small but well-designed randomized controlled trials (RCTs), or one or more well-designed, mid-sized clinical studies of reasonably good quality (RCTs or observational studies), or several small studies aggregated into a meta-analysis (this is the CancerChoices definition; other researchers and studies may define this differently) of better survival and less metastasis and progression of colorectal cancer among people treated with FWGE with standard treatment

Head, neck, and oral cancers

Preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of substantially less disease progression among people treated with standard treatment and FWGE

Melanoma

Preliminary evidence of substantially better survival among people treated with standard treatment and FWGE

Optimizing your body terrain

Does FWGE promote an environment within your body that is less supportive of cancer development, growth, or spread? We present the evidence.

See Optimizing Your Body Terrain ›

Find medical professionals who specialize in managing body terrain factors: Finding Integrative Oncologists and Other Practitioners ›

We also recommend that you share with your doctor the information here about how FWGE might affect oxidative stress.

Oxidative stress

Preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence in one direction (this is the CancerChoices definition; other researchers and studies may define this differently) of less oxidative stressan imbalance between free radicals and antioxidants in your body; this imbalance can cause harmful oxidation reactions in your body chemistry among people with head and neck cancer treated with FWGE

Managing side effects and promoting wellness

Is FWGE linked to fewer or less severe side effects or symptoms? Is it linked to less toxicity from cancer treatment? Does it support your quality of life or promote general well-being? We present the evidence.

Blood-related side effects

Preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence in one direction of fewer episodes of febrile neutropeniaan abnormally low number of neutrophils in the blood, leading to increased susceptibility to infection during chemotherapy among children treated with FWGE

Body composition or cachexia

Weak evidenceone or more case studies, supported by animal evidence OR small treatment effects of limited clinical significance OR studies with no controls OR weak trends of effects (this is the CancerChoices definition; other researchers and studies may define this differently) of less cachexia weakness and wasting of the body due to severe chronic illness during treatment for oral cancer among people treated with FWGE

Fatigue

Weak evidenceone or more case studies, supported by animal evidence OR small treatment effects of limited clinical significance OR studies with no controls OR weak trends of effects (this is the CancerChoices definition; other researchers and studies may define this differently) of less fatigue during cancer treatment among people with breast cancer or lung cancer undergoing

Gastrointestinal symptoms, including nausea and vomiting

Weak evidenceone or more case studies, supported by animal evidence OR small treatment effects of limited clinical significance OR studies with no controls OR weak trends of effects (this is the CancerChoices definition; other researchers and studies may define this differently) of fewer symptoms of nausea, vomiting, and constipation among people with breast cancer treated with FWGE

Quality of life

Sleep disruption

Weak evidenceone or more case studies, supported by animal evidence OR small treatment effects of limited clinical significance OR studies with no controls OR weak trends of effects (this is the CancerChoices definition; other researchers and studies may define this differently) of fewer symptoms of insomnia among people with breast cancer treated with FWGE

Reducing cancer risk

Is FWGE linked to lower risks of developing cancer or of recurrence? We present the evidence.

Colorectal cancer

Preliminary evidencesignificant effects in small or poorly designed clinical studies OR conflicting results in adequate studies but a preponderance of evidence of an effect (this is the CancerChoices definition; other researchers and studies may define this differently) of lower risk of recurrence among people treated with FWGE

Head, neck, and oral cancers

Preliminary evidence of substantially lower recurrence of oral cancer among people with oral cancer treated with FWGE

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Author

Nancy Hepp, MS

Lead Researcher

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Reviewers

Laura Pole, MSN, RN, OCNS

Senior Clinical Consultant

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Andrew Jackson, ND

Research Associate

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Last update: December 11, 2023

Last full literature review: April 2021

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.

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References[+]

1, 14	Jakab F, Shoenfeld Y et al. A medical nutriment has supportive value in the treatment of colorectal cancer. British Journal of Cancer. 2003 Aug 4;89(3):465-9.
2, 3, 11, 13, 15	Boros LG, Nichelatti M, Shoenfeld Y. Fermented wheat germ extract (Avemar) in the treatment of cancer and autoimmune diseases. Annals of the New York Academy of Sciences. 2005 Jun;1051:529-42.
4	Demidov LV, Manziuk LV, Kharkevitch GY, Pirogova NA, Artamonova EV. 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 Biotherapy & Radiopharmaceuticals. 2008 Aug;23(4):477-82.
5	Sukkar SG, Cella F et al. A multicentric prospective open trial on the quality of life and oxidative stress in patients affected by advanced head and neck cancer treated with a new benzoquinone-rich product derived from fermented wheat germ (Avemar). Mediterranean Journal of Nutrition and Metabolism. 2008;1:37–42.
6	Garami M, Schuler D et al. Fermented wheat germ extract reduces chemotherapy-induced febrile neutropenia in pediatric cancer patients. Journal of Pediatric Hematology/Oncology. 2004 Oct;26(10):631-5.
7	Boros LG, Nichelatti M, Shoenfeld Y. Fermented wheat germ extract (Avemar) in the treatment of cancer and autoimmune diseases. Annals of the New York Academy of Sciences. 2005 Jun;1051:529-42.
8, 9, 12	Boros LG, Nichelatti M, Shoenfeld Y. Fermented wheat germ extract (Avemar) in the treatment of cancer and autoimmune diseases. Annals of the New York Academy of Sciences. 2005 Jun;1051:529-42.
10	Sukkar SG, Cella F et al. A multicentric prospective open trial on the quality of life and oxidative stress in patients affected by advanced head and neck cancer treated with a new benzoquinone-rich product derived from fermented wheat germ (Avemar). Mediterranean Journal of Nutrition and Metabolism. 2008;1:37–42.