Mistletoe therapy in the AGO guideline on breast cancer in Germany

The AGO guideline on diagnostics and therapy of early and advanced breast cancer [245] is published by the “Arbeitsgemeinschaft Gynäkologische Onkologie e.V.” in the German Society for Gynaecology and Obstetrics and the German Cancer Society..

In its updated guideline Complementary Therapy Version 2025.1D, the AGO gives mistletoe therapy a “+/-” recommendation, which means that mistletoe therapy can be used to reduce the therapy-associated side effects caused by ongoing standard oncological therapy (Oxford evidence level 2a, Oxford recommendation grade B). As a number of studies have recently been conducted on the safety of mistletoe therapy in non-advanced breast cancer, the AGO also recommends that mistletoe therapy can be used in early breast cancer to reduce therapy-associated side effects in addition to standard oncological therapy (AGO +/-, Oxford evidence level 3a, Oxford recommendation grade B). According to the AGO, mistletoe therapy can also be used in breast cancer in combination with PARP inhibitors, checkpoint inhibitors or CDK4/6 inhibitors (Oxford evidence level 4, recommendation grade C).

The English version of the guidelines of the AGO Breast Committee can be found here [246].