Written by Alexander Kalisch, Markus Horneber and the CAM-Cancer Consortium.
Updated February 8, 2017

Fermented wheat germ extract

Abstract and key points

  • Fermented wheat germ extract (FWGE) is produced from wheat germs of the genus Triticum vulgaris.
  • The active ingredient in FWGE is not yet known.
  • It has been claimed that orally used FWGE offers beneficial effects for cancer patients during chemo- and/or radiotherapy.
  • The evidence from clinical trials to support claims of efficacy is weak.
  • The oral intake of FWGE seems to cause no harm.

Fermented wheat germ extract (FWGE) is industrially produced and in clinical use. The production of FWGE involves fermenting wheat germs of the genus Triticum vulgaris by adding baker’s yeast (Saccharomyces cerevisiae). The medically active substances of FWGE are not yet known.

It has been proposed that 2,6-dimethoxy-p-benzoquinone and 2-methoxy benzoquinone found in wheat germ might act antiproliferative because of its high redox potential. FWGE is believed to increase efficacy of chemo- and radiotherapy, to reduce its side effects and to improve quality of life.

Although eight controlled clinical trials consistently reported positive results, the evidence for the claimed benefits is very weak, due to high risk of bias in trials published to this date. No placebo-controlled trials have been carried out.

There is no toxicity known by the intake of FWGE. Side effects are rare and mild.


Alexander Kalisch, Markus Horneber, CAM-Cancer Consortium. Fermented wheat germ extract [online document]. http://cam-cancer.org/The-Summaries/Dietary-approaches/Fermented-wheat-germ-extract. February 8, 2017.

Document history

Assessed as up to date in February 2017 by Barbara Wider.
Assessed as up to date in April 2016 by Barbara Wider.
Assessed as up to date in January 2015 by Barbara Wider.
Assessed as up to date in August 2013 by Barbara Wider.
Fully revised and updated in June 2012 by Alexander Kalisch and Markus Horneber.
Summary first published in February 2011, authored by Alexander Kalisch and Markus Horneber.


  1. Pfeifer B. Avemar. Onkologie integrativ. München: Elsevier, Urban and Fischer; 2006: 226-29.
  2. Hidvegi, M., Farkas R, Lapis K, and Raso E. Immunmodulatory and metastasis inhibiting fermented vegetal material, United States Patent, Patent No. 6355474B1. 2002.
  3. Barabas J, Nemeth Z. [Recommendation of the Hungarian Society for Face, Mandible and Oral Surgery in the indication of supportive therapy with Avemar]. Orv Hetil. 2006;147:1709-11.
  4. Demidov LV, Manziuk LV, Kharkevitch GY, Pirogova NA, Artamonova EV. Adjuvant fermented wheat germ extract (Avemar) nutraceutical improves survival of high-risk skin melanoma patients: a randomized, pilot, phase II clinical study with a 7-year follow-up. Cancer Biother Radiopharm. 2008;23:477-82.
  5. Jakab F, Shoenfeld Y, Balogh A, Nichelatti M, Hoffmann A, Kahan Z et al. A medical nutriment has supportive value in the treatment of colorectal cancer. Br J Cancer. 2003;89:465-69.
  6. Sukkar SG, Cella F, Rovera GM, Nichelatti M, Ragni G, Chiavenna G et al. 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). Mediterr J Nutr Metab. 2008;1:37–42.
  7. Posner, ES. The technology of wheat germ separation in flour mills. Assoc Operative Millers Bull Suppl 1,2. 1985. Ref Type: Abstract
  8. Heimbach JT, Sebestyen G, Semjen G, Kennepohl E. Safety studies regarding a standardized extract of fermented wheat germ. Int J Toxicol. 2007;26:253-59.
  9. Tömösközi-Farkas R, Daood HG. Modification of chromatographic method for the determination of benzoquinones in cereal products. Chromatographia. 2004;60:227-30.
  10. U.S.Department of Agriculture, Economic Research Service USDA ERS. U.S. per capita foodconsumption https://www.ers.usda.gov/data/foodconsumption/ accessed 8 February 2017.
  11. Johanning GL, Wang-Johanning F. Efficacy of a medical nutriment in the treatment of cancer. Altern Ther Health Med. 2007;13:56-63.
  12. Comin-Anduix B, Boros LG, Marin S, Boren J, Callol-Massot C, Centelles JJ et al. Fermented wheat germ extract inhibits glycolysis/pentose cycle enzymes and induces apoptosis through poly(ADP-ribose) polymerase activation in Jurkat T-cell leukemia tumor cells. J Biol Chem. 2002;277:46408-14.
  13. Boros LG, Nichelatti M, Shoenfeld Y. Fermented wheat germ extract (Avemar) in the treatment of cancer and autoimmune diseases. Ann N Y Acad Sci. 2005;1051:529-42.
  14. Telekes A, Kiss-Toth E, Nagy T, Qwarnstrom EE, Kusz E, Polgar T et al. Synergistic effect of Avemar on proinflammatory cytokine production and Ras-mediated cell activation. Ann N Y Acad Sci. 2005;1051:515-28.
  15. Lee sn, Park H, and Lee KE. Ctyotoxic activities of fermented wheat germ extract on human gastric carcinoma cells by induction of apoptosis. Journal of Clinical Oncology. ASCO Annual Meeting Proceedings 23(16S), 4254. 2005.
  16. Mueller T, Jordan K, Voigt W. Promising cytotoxic activity profile of fermented wheat germ extract (Avemar(R)) in human cancer cell lines. J Exp Clin Cancer Res. 2011;30:42.
  17. Balogh, A. Supportive Effects of Avemar in breast cancer http://www.fda.gov/ohrms/dockets/dockets/95s0316/95s-0316-rpt0260-08-vol189.pdf 1999. online document accessed 8 February 2017
  18. Garami M, Schuler D, Babosa M, Borgulya G, Hauser P, Muller J et al. Fermented wheat germ extract reduces chemotherapy-induced febrile neutropenia in pediatric cancer patients. J Pediatr Hematol Oncol. 2004;26:631-35.
  19. Hidvegi, M, Moldvay J, and Lapis K. Fermented wheat germ extract improves quality of life in lung cancer patients. (In Hungarian.) (Medicus Anonymus/Pulmono 11: 13-14). 2003.
  20. Szende B, Marcsek Z, Kocsis Z, Tompa A. Effect of simultaneous administration of Avemar and cytostatic drugs on viability of cell cultures, growth of experimental tumors, and survival tumor-bearing mice. Cancer Biother Radiopharm. 2004;19:343-49.