Written by Edzard Ernst and the CAM-Cancer Consortium.
Updated November 1, 2011

Shark cartilage

Does it work?

Controlled trials

AE-941/Neovastat was administered in a randomised phase III trial of BeneFin including 331 patients with advanced solid tumours (including lung, prostate, breast, and kidney tumours).3 They were randomly assigned to receive either 30 to 240 mL/day cartilage or a placebo divided into three to four oral doses a day. Survival was the principal endpoint measured in this trial, but quality of life was also assessed. The results of these trials, however, have not been fully reported. A retrospective analysis involving a subgroup of patients with advanced non-small cell lung cancer suggests that AE-941/Neovastat is able to lengthen the survival of patients with this disease.

Two randomized phase III trials of AE-941/Neovastat in patients with advanced cancer have been approved by the United States Food and Drug Administration (FDA). In one trial in patients with stage III non-small cell lung cancer, treatment with oral AE-941/Neovastat plus chemotherapy and radiation therapy was compared to treatment with placebo plus the same chemotherapy and radiation therapy. Overall survival was not improved in patients taking the shark cartilage preparation 20 In the second trial, treatment with oral AE-941/Neovastat was compared to treatment with placebo in patients with metastatic renal cell carcinoma.21 Results from this second phase III trial have not been reported in the peer-reviewed literature.

Loprinzi published a double-blind, placebo-controlled randomised clinical trial of adjuvant therapy with shark cartilage administered three to four times daily to 83 patients with incurable breast or colorectal cancers.22 The primary endpoint, survival, showed no difference between the patients receiving shark cartilage and those receiving placebo in addition to standard care. Similarly, quality of life showed no inter-group differences.

Another randomised trial suggested an anti-angiogenic effects of shark cartilage in healthy volunteers.23

Uncontrolled trials

Several uncontrolled clinical studies have been published, which suggest anti-cancer effects of shark cartilage.24-31 The results of these studies tend to imply that shark cartilage is effective in changing the natural history of various types of cancer or positively influencing related variables. Yet, due to their uncontrolled nature, these investigations cannot establish cause and effect.

Pre-clinical studies

Some basic research studies have suggested direct toxicity against tumour cells. The inhibition of tumour angiogenesis has been relatively well documented in in-vitro studies One study, for instance, found that tamoxifen has significant anti-angiogenic activity that can be potentiated by shark cartilage.32

Another laboratory study suggested that the development of papillary and solid tumours in mice can be significantly delayed.25

Citation

Edzard Ernst, CAM-Cancer Consortium. Shark cartilage [online document]. http://www.cam-cancer.org/layout/set/print/CAM-Summaries/Dietary-approaches/Shark-cartilage. November 1, 2011.

Document history

Most recent update and revision in November 2011 by Edzard Ernst.
Fully revised and updated in April 2010 by Edzard Ernst.
Summary first published in September 2005, authored by Edzard Ernst.

References

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  2. Batist G, Patenaude F, Champagne P, et al. Neovastat (AE-941) in refractory renal cell carcinoma patients: report of a phase II trial with two dose levels. Ann Oncol 2002;13:1259-63.
  3. Sauder DN, Dekoven J, Champagne P, et al. Neovastat (AE-941), an inhibitor of angiogenesis: Randomized phase I/II clinical trial results in patients with plaque psoriasis. J Am Acad Dermatol 2002;47:535-41.
  4. Hillman JD, Peng AT, Gilliam AC, Remick SC. Treatment of Kaposi Sarcoma with oral administration of shark cartilage in a Human Herpes virus 8-seropositive, Human Immunodeficiency Virus-Seronegative homosexual man. Arch Dermatol 2001;137:1149-52.
  5. Fetrow CW, Avila JR. Professional's Handbook of Complementary & Alternative Medicines. 1st ed. Springhouse, PA: Springhouse Corp., 1999.
  6. Folkman J, Long DM, Becker FF. Growth and metastasis of tumour organ culture. Cancer 1963;16:453-67.
  7. Lane IW. Comac L. Sharks don’t get cancer. How shark cartilage can save your life. New Your: Avery, 1992.
  8. Wellings SR. Neoplasia and primate vertebrate phylogeny: a review. Natl Cancer Inst Monograph 1969;31:59-128.
  9. Prieur DJ, Fenstermaher JD, Guarino AM. A choroids plexus papilloma in Elasmobranchs. J Natl Cancer Inst 1976;56:1207-9.
  10. Cassileth BR Shark and bovine cartilage therapies. In: Cassileth BR, ed.: The Alternative Medicine Handbook: The Complete Reference Guide to Alternative and Complementary Therapies. New York, NY: WW Norton & Company, 1998, pp 197-200.
  11. Prudden J. The clinical acceleration of healing with a cartilage preparation: a controlled study. JAMA 1965;192:252.
  12. Prudden JF, Balassa LL The biological activity of bovine cartilage preparations. Clinical demonstration of their potent anti-inflammatory capacity with supplementary notes on certain relevant fundamental supportive studies. Semin Arthritis Rheum 1974;3: 287-321.
  13. Lee A, Langer R Shark cartilage contains inhibitors of tumor angiogenesis. Science 1983;221:1185-7.
  14. Bargahi A, Rabbani-Chadegani A, Bargahi A et al. Angiogenic inhibitor protein fractions derived from shark cartilage. Biosci Rep 2008;28:15-21.
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  19. Dold C. Shark therapy. Discover 1996;4:51-7.
  20. Lu C, Lee JJ, Komaki R, Herbst RS, Feng L, Evans WK et al. Chemoradiotherapy with or without AE-941 in stage III non-small cell lung cancer: a randomized phase III trial. Journal of the National Cancer Institute 2010; 102(12):859-865.
  21. Batist G, Champagne P, Hariton C, et al. Dose-survival relationship in a phase II study of Neovastat in refractory renal cell carcinoma patients. [Abstract] Proceedings of the American Society of Clinical Oncology 2002;21:A-1907.
  22. Loprinzi CL, Levitt R, Barton DL, Sloan JA, Atherton PJ, Smith DJ, Dakhil SR, Moore DF Jr, Krook JE, Rowland KM Jr, Mazurczak MA, Berg AR, Kim GP; North Central Cancer Treatment Group. Evaluation of shark cartilage in patients with advanced cancer – a north central cancer treatments group trial . Cancer 2005;104:176-82.
  23. Berbari P, Thibodeau A, Germanin L, Saint-Cyr M, Gaudreau P, Elkhouri S, Dupont E, Garrel DR, Elkouri S. Antiangiogenic effects of the oral administration of liquid cartilage extracts in humans. J Surg Res 1999;87:108-13.
  24. Mathews J. Media feeds frenzy over shark cartilage as a cancer treatment. J Natl Cancer Inst 1993;85:1190-1191.
  25. Barber R, Delahunt B, Grebe SKG, Davis PF, Thornton A, Slim GC. Oral shark cartilage does not abolish carcinogenesis but delays tumor progression in a murine model. Anticancer Research 2001;21:1065-70.
  26. Yagita A. Role of angiogenesis inhibitor in novel immunotherapy for cancer (NITC). BiotherapyJapan 2000;14:973-82.
  27. Maruyama S, Yagita A, Sukegawa Y, Daido A, Takeuchi S. Effect of a new immunotherapy for advanced colorectal cancer. BiotherapyJapan 2000;14:460-3.
  28. Leitner SP, Rothkopf MM, Haverstick L, et al. Two phase II studies of oral dry shark cartilage powder (SCP) with either metastatic breast or prostate cancer refractory to standard treatment. [Abstract] Proceedings of the American Society of Clinical Oncology 1998;17:A-240.
  29. Rosenbluth RJ, Jennis AA, Cantwell S, et al. Oral shark cartilage in the treatment of patients with advanced primary brain tumors. [Abstract] Proceedings of the American Society of Clinical Oncology 1999;18:A-554.
  30. Champagne P, Aeterna Laboratories, Incorporated Phase II Study of AE-941 (Neovastat) in Patients With Early Relapse or Refractory Multiple Myeloma, AETERNA-AE-MM-00-02, Clinical trial, Closed.
  31. Miller DR. Phase I/II trial of the safety and efficacy of shark cartilage in the treatment of advanced cancer. J Clin Oncol 1998;16:3649-3655.
  32. McGuire TR et al. Tamoxifen and shark cartilage: potential anti-angiogenic combination (Abstract from American College of Clinical Pharmacy Annual Meeting St. Louis, 1994). Pharmacotherapy 1994;14:362.
  33. Ashar B, Vargo E. Shark cartilage-induced hepatitis. Ann Intern Med 1996;125:780-781.
  34. Simard B, Bouamrani A, Jourdes P, Pernod G, Dimitriadou V, Berger F et al. Induction of the fibrinolytic system by cartilage extract mediates its antiangiogenic effect in mouse glioma. Microvascular Research 2011; 82(1):6-17.
  35. Bargahi A, Hassan ZM, Rabbani A, Langroudi L, Noori SH, Safari E et al. Effect of shark cartilage derived protein on the NK cells activity. Immunopharmacology & Immunotoxicology 2011; 33(3):403-409.
  36. Habermann TM, Thompson CA, LaPlant BR, Bauer BA, Janney CA, Clark MM et al. Complementary and alternative medicine use among long-term lymphoma survivors: a pilot study. American Journal of Hematology 2009; 84(12):795-798.
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