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)

  • Samir G. Sukkar
  • Franca Cella
  • Giuseppe M. Rovera
  • Michele Nichelatti
  • Giuseppe Ragni
  • Giovanni Chiavenna
  • Antonello Giannoni
  • Giovanni Ronzani
  • Claudia Ferrari


Background and aim

Anorexia/cachexia syndrome is frequently correlated with increased oxidative stress (OS). A fermented wheat-germ extract with a standardized benzoquinone content (brand name Avemar) has been shown to exert an intense antioxidant activity with no side effects. The aim of this study was to investigate the effects of Avemar in patients affected by head and neck cancer, correlating the variations with OS with the quality of life as assessed by the Spitzer’s index

Patients and methods

A cohort of 60 patients affected by head and neck tumours (stage IIIa, IIIb, IV) were enrolled in the study following an open-label protocol. The patients were assigned to two subgroups, A or B. Group A was treated with conventional oncological therapy alone, and group B was treated with Avemar in addition to standard therapy. After 2 months only 55 patients survived and could be evaluated (29 in the control group and 26 in the Avemar group). Each patient was checked for circulating concentrations of hydroperoxides using the FRAS III test


The levels of OS significantly decreased after 2 months in the group receiving Avemar (group). The value of Spitzer’s index was significantly higher in group B, attesting to an improved quality of life


Although the specific active substance in Avemar has not yet been identified, the reduction in free oxygen radicals induced by it is correlated with a clinically significant improvement in the quality of life in patients with advanced cancer


Fermented wheat germ extract Head and neck cancer Quality of life Oxidative stress D-ROMs test 


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Copyright information

© Springer-Verlag Italia 2008

Authors and Affiliations

  • Samir G. Sukkar
    • 1
  • Franca Cella
    • 1
  • Giuseppe M. Rovera
    • 2
  • Michele Nichelatti
    • 3
  • Giuseppe Ragni
    • 1
  • Giovanni Chiavenna
    • 4
  • Antonello Giannoni
    • 5
  • Giovanni Ronzani
    • 6
  • Claudia Ferrari
    • 1
  1. 1.Clinical Nutrition UnitAzienda Ospedaliera Universitaria San MartinoGenoaItaly
  2. 2.Clinical Nutrition UnitOspedale EvangelicoTurinItaly
  3. 3.Clinical Epidemiology and Biostatistics, Haematology DepartmentOspedale NiguardaMilanItaly
  4. 4.Clinical Nutrition UnitOspedale di LeccoLeccoItaly
  5. 5.Artificial Nutrition UnitASL1CarraraItaly
  6. 6.Clinical Nutrition UnitOspedale di Montecchio MaggioreVicenzaItaly

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