The effects of adjuvant Fermented Wheat Germ Extract on oral and gastrointestinal cancer cells. A systematic review.

• ¹ Department of Clinical and Experimental Medicine, University of Foggia, Italy
• ² University of Palermo, Dipartimento di Scienze Orali, Chirurgiche e Oncologiche, Italy
• ³ Department of Clinical Sciences and Odontostomatology, Marche Polytechnic University, Italy

Aim. Fermented wheat germ extract (FWGE) (trade name AVEMAR) is a natural compound, deriving from industrial fermentation of wheat germ. From recent studies its potential anticancer properties emerged. The aim of this systematic review is to summarize the data available in the scientific literature concerning the “in vitro” and “in vivo” activity of FWGE on malignant cells of oral and gastrointestinal carcinoma. Materials and Methods. A systematic review of English articles on electronic databases was performed. The primary outcomes of the review regarded the types of cancer cell lines subjected to the investigation and the main results concerning cell viability, proliferation, and apoptosis observed in the in vitro studies after the treatment with FWGE. The growth inhibition capacity, anticarcinogenic and antimetastatic activities in vivo studies were also evaluated. Results. six articles were included in the final qualitative analysis. The in vitro treatment with FWGE of various types of cancer cells of head and neck district and digestive tract resulted in cytotoxic effects, alteration of the cell cycle, anti-proliferative effects and induction of apoptosis. From in vivo studies an enhancing of apoptosis and growth inhibition effects on the tumor mass emerged, in addition to a promising antimetastatic effect. No toxicity seems to be revealed after FWGE treatment. Discussion: FWGE is a nutraceutical that has been reported to possess unique “cancer-fighting” characteristics. Its antiproliferative and cytotoxic activity, as well as the induction of apoptosis in human cancer cells has been estabilished by several studies included in the present review. Moreover, some of the studies included in this review suggested that Avemar could potentially inhibit cancer cells migration and their invasion capacities [1, 2]. Such actions can be important especially for some types of tumors, for which the highest mortality is due to the ability of lymph node metastasis or those to the distant organs, such as the oral squamous cell carcinoma. Such results suggest that FWGE can be a promising drug component in cancer treatment, however, further in vitro and in vivo studies are necessary to prove its effectiveness and safety in human.