Synopsis

Source of validity: Scientific
Rating (out of 5): 2

Proteolytic enzymes, such as bromelain, papain, and trypsin, have been studied as adjuncts to chemotherapy, primarily for their potential to reduce treatment-related side effects like mucositis, inflammation, and edema. Some clinical trials, mainly from Europe and particularly Germany, have suggested that proteolytic enzyme supplements may help decrease the severity of chemotherapy-induced side effects, including oral mucositis and gastrointestinal discomfort. One of the most studied preparations is a combination called Wobenzym, which has been evaluated in small-scale clinical trials. These studies report modest improvements in quality of life and reductions in certain symptoms, but they often suffer from methodological limitations such as small sample sizes, lack of blinding, or inadequate control groups. Meta-analyses and systematic reviews indicate that while there is some supportive evidence, it is generally of low to moderate quality and remains inconclusive.

Mechanistically, proteolytic enzymes are proposed to modulate inflammatory pathways and support tissue repair, but these effects have not been robustly demonstrated in large, well-designed trials. Major oncology guidelines do not currently recommend proteolytic enzymes as a standard adjunct for chemotherapy side effect management. In summary, while there is some scientific investigation and limited evidence supporting their use, the overall quality and strength of evidence is modest, warranting further research.

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