Everything we have been asked

A weekly dose of an enzyme, NGA-8000, removes the amino acid arginine from your blood. Healthy cells make their own arginine and are unaffected. Many cancer cells cannot, so they starve: they stop growing, consume their own reserves, and over months die or become easy targets for your immune system and for any therapy combined with it. The course runs 24 weeks with reviews at weeks 8, 16 and 24.

No. Chemotherapy poisons dividing cells, healthy and cancerous alike. Arginine deprivation removes a nutrient that only cells with a specific defect depend on. It is a metabolic therapy. It can be combined with chemotherapy, often at lower doses, because starved cancer cells are more sensitive to it.

Not in the usual sense. It does not contain antibodies or modified immune cells. But its final actor is your immune system: the therapy holds the tumour still so that your own defences have time to clear it. Checkpoint inhibitors can be combined to strengthen that.

It is fasting at the level of one amino acid, applied directly to the blood, continuously, for months. A diet cannot do that: your body makes arginine and would replace what you do not eat. The enzyme removes it faster than any source can supply it. You eat normally during treatment.

Cancer cells survive short starvation by entering a dormant, low-energy state and recycling their own parts. That reserve lasts weeks. Only sustained deprivation exhausts it. Six months is the length at which laboratory and clinical experience suggest starved cells die rather than wait. Reviews at weeks 8 and 16 make sure you are not continuing something that is not working.

They make their own, from citrulline, through the urea cycle. The enzyme does not touch citrulline. Liver, kidney, muscle, nerves and immune cells keep working. Some functions that use arginine, such as blood vessel relaxation and wound healing, can be mildly affected and are monitored.

Arginine depletion triggers autophagy and fasting-like signalling in liver and fat cells, and our laboratory is studying it in metabolic disease. That is a separate indication with its own evidence, and it is not part of the cancer programme described on this site.

Those whose cells have lost the enzymes ASS1 or OTC. This loss is frequent in mesothelioma, liver cancer, melanoma, sarcoma, pancreatic and prostate cancer, and occurs in subsets of breast, lung, gastric, colorectal, bladder, ovarian and brain tumours and in some leukaemias. The full list is on the patients page. Whether your particular tumour qualifies is checked on your biopsy tissue.

By a standard immunohistochemistry stain on existing biopsy or surgical tissue. Your pathology department can usually release a slide or block. No new biopsy is needed in most cases. If no tissue exists, the decision rests on tumour type and the physicians' judgement, and you are told that the prediction is less certain.

Usually not as a first choice. Early-stage disease has established treatments with proven cure rates, and nothing on this site should delay them. The programme is for situations where standard therapy is exhausted, insufficient, declined after proper counselling, or where an oncologist wants to combine it with ongoing treatment.

We can review your case; that is what the eligibility review is for. We cannot promise help. Most of the observed patients had stage IV disease. Whether a 24-week course is realistic depends on your general condition, organ function and tumour type, and we will tell you honestly if it is not.

No fixed limit. Adults of any age are reviewed on condition, not years. We do not currently treat children; paediatric tumours have their own treatment pathways and arginine is essential for growth.

Pregnant or breastfeeding women; patients with urea-cycle disorders; severe liver, kidney or heart failure; uncontrolled infection or large open wounds; and patients whose condition makes a six-month course unrealistic. Details on the patients page.

By injection or short infusion, once a week, at the partner clinic. The administration takes minutes; you stay for observation afterwards, longer at the first doses. Plan about an hour per visit.

Arginine in the blood falls below the detection limit within hours of the first dose; that is measured and confirmed. Effects on the tumour take longer. Tumour markers often begin to move between weeks 2 and 8. Imaging changes, if they come, are usually seen at the week 8 or week 16 review. In one observed patient, markers reached the normal range by day 37.

Arginine will begin to return within days, and the tumour's starvation is interrupted. One missed dose does not undo the course, but it costs time. Tell the care team as early as possible so the schedule can be adjusted; the long half-life gives some margin.

Yes, and in many cases that is the intended design. Arginine deprivation is compatible with most standard treatments and is meant to make them more effective. Your oncologist decides on the combination and keeps prescribing the standard therapy.

Yes. Arginine-deprived cells repair radiation damage less well. Combination with radiotherapy is planned in glioblastoma and can be considered in other tumours where radiation is part of the plan.

Yes. Consent can be withdrawn at any time without giving reasons. You pay for blocks already started, not for the rest. We will ask you to tell your oncologist, and we will send them a summary.

A full review and a written summary. Depending on the course: end of treatment with monitoring by your oncologist, a pause, or, where the tumour is responding and the physicians agree, an extension agreed case by case. There is no automatic continuation.

Yes. Some tumours switch ASS1 back on and regain their own arginine supply. This is why tumour markers and imaging are tracked: a tumour that stops responding is a reason to stop treatment, not to continue it. Combinations are timed to act before resistance can develop.

From trials of related enzymes: reactions at the injection site, fatigue especially in the first weeks, nausea, rash, transiently raised liver enzymes, mild blood count changes, and rarely allergic reactions. In the five patients observed with NGA-8000, no adverse events were reported, but five patients cannot establish a safety profile. Everything is monitored at every visit.

Any protein given by injection can cause an allergic reaction, which is why the first doses are observed. Arginine is involved in blood pressure regulation and wound healing; large changes have not been seen with related enzymes, but both are watched. Patients who cannot make their own arginine (urea-cycle disorders) would be harmed and are excluded. We know of no death attributed to arginine deprivation enzymes in the published trials.

Your immune system can recognise an injected protein as foreign and neutralise it. With the bacterial enzyme ADI-PEG 20 this happens in most patients after about eight weeks and the treatment stops working. NGA-8000 is a mammalian protein with an albumin shield, designed to avoid this. Whether it succeeds in you is visible in the arginine level: if it rises despite dosing, antibodies are the likely cause and treatment is reconsidered.

Some patients are, especially in the first two to four weeks while the body adapts. It usually settles. Light daily exercise and adequate food help more than rest alone. Persistent severe fatigue is reported to the care team and investigated.

Not from the enzyme. Hair loss is a chemotherapy effect; if chemotherapy is combined, its usual effects apply, often reduced because lower doses are used.

You have a contact number answered by someone who knows your case. For anything acute, you go to the nearest emergency department as you would with any illness, and you carry a card stating that you are receiving an arginine-depleting enzyme, so that doctors can act accordingly.

The full 24-week course costs EUR 250,000, billed in three blocks of eight weeks, one third before each block. The price covers the enzyme, weekly administration and visits, and the scheduled laboratory and imaging monitoring; it does not cover combined therapies prescribed by your oncologist, travel or accommodation. Every patient receives a binding written quote before consent. If treatment stops at week 8 or 16, the remaining blocks are never charged. Details on the patients page.

Not for the enzyme or the programme: no insurer we know of covers unlicensed individual treatment. Standard therapies combined with it remain standard care and may be covered as usual. Monitoring done by your own oncologist is billed by them. Some insurers reimburse parts of laboratory or imaging costs on receipt; we provide receipts for everything.

At partner clinics in Georgia, the United Arab Emirates and Hong Kong, each with oncology staff, laboratory and imaging. Which clinic is proposed depends on your tumour type, your language and where you live; it is agreed with you after the eligibility review, together with the practicalities of travel and stay. For the first block most patients stay nearby; from the second block, parts of the schedule can sometimes be arranged closer to home.

Most of our enquiries come from abroad. The programme is built for it: weekly visits, help with planning the stay, results sent to your home oncologist. Travel and accommodation are not included in the price; you book and pay directly.

Typically four to six weeks: five working days for the first reply, two to three weeks for records, staining and the eligibility review, one to two weeks for disclosure, consent and planning. Faster is possible when records are complete and tissue is available quickly.

English and German with the coordinating team. Treating physicians speak English; interpreters are arranged where needed. All documents are in English; German translations of the information sheet and consent form are available.

No. The enzyme removes arginine faster than food can replace it, so you eat normally. Eating well matters: protein, vegetables, enough calories. Weight loss is not a goal and works against you.

L-arginine, L-citrulline, L-ornithine, and any pre-workout or "nitric oxide booster" product; they feed the tumour exactly what the enzyme removes. Tell us about every other supplement and medicine. Most are fine.

Yes, within your limits, and we encourage it. Daily walking is the single most useful habit during the course. Hard training is possible once you know how you tolerate the therapy.

Many patients do, particularly from the second block. The first weeks may be tiring, and weekly visits need to fit your schedule. Remote work is compatible with the programme.

Little or none. Your liver processes the products of the enzyme and is monitored; alcohol adds load and clouds the picture.

Keep taking them and bring a full list. Interactions with the enzyme are not expected because it acts only on arginine in the blood, but the physicians check every medicine, especially those affecting the liver, kidneys or blood pressure.

The principle is: a related enzyme extended survival in a Phase III trial in mesothelioma. NGA-8000 itself has preclinical data, treatment experience in more than 100 patients, structured observations in five, and no controlled trial. That is why it is available only as individual treatment, and why we say plainly that it may not work for you.

We do not quote one. More than 100 patients have been treated, but a response rate requires uniform follow-up under a protocol, and that exists only for the five documented cases. Four of those five showed falling tumour markers; that is encouraging and it is not a rate. Be wary of anyone who quotes a percentage for an unlicensed therapy.

Approval requires controlled trials with hundreds of patients, which take years and tens of millions in funding. Related enzymes are at that stage; NGA-8000 is earlier. Individual treatment exists precisely for the gap between promising science and regulatory approval, for patients who cannot wait.

If one is open for your tumour type, you should consider it, and we will say so. Trials of ADI-PEG 20 and pegzilarginase run in several countries; your oncologist or a trial registry can find them. A trial gives you a tested protocol and no cost; individual treatment gives you access without entry criteria and randomisation.

Only with your written permission, anonymised, and you can refuse without any effect on your treatment. Records are kept so that what is learned from each patient is not lost, but they stay confidential.

Yes. We ask for it, and we will not begin treatment without their knowledge. They need to know what is in your blood to treat you safely, and the therapy works best when combined with what they prescribe.

We will talk to them if you and they agree. Their concern may be well founded, and if it stands after that conversation we will tell you so. We do not treat against a treating oncologist's considered advice without a second opinion from another oncologist.

Every one, after every block or more often if they ask, and a full written summary at the end. We write clinical summaries for physicians as well as plain-language summaries for you.

Use the enquiry form and state that you are a physician. You receive a clinical summary, the enzyme data and a direct line to the treating physicians. The clinicians' section has the comparative data and references.

WYSS PERFORMANCE LLC-FZ in Dubai, directed by Martin Wyss, PhD. Treatment is given by licensed physicians at partner clinics, named to you in writing before consent. The enzyme is developed and produced in the company's own biotech laboratory; laboratory documentation is available to clinicians on request. Details on the about page.

More than 100 patients have received NGA-8000 through the programme and its partner physicians. Structured before-and-after laboratory documentation of the kind shown on the evidence page exists for five of them; those five are the only cases we present, because they are the only ones we can show with numbers. Experience from the others informs dosing, monitoring and patient care, but we do not turn it into statistics.

Physicians assigned to your case, not a fixed team. The assignment follows your tumour type, your language and the clinic where treatment takes place, so the specialist for a leukaemia patient is not the one for a pancreatic cancer patient. All of them are licensed, trained in oncology or internal medicine, and experienced with the enzyme. You receive their names, qualifications and licence numbers in writing before you consent, and you can decline and ask for another assignment.

A physician's decision to use an unlicensed therapy for one named patient, where recognised options are exhausted or insufficient, the scientific rationale is sound, and the patient consents after full disclosure. It is recognised in most medical systems under names such as individual treatment attempt, named-patient use or compassionate use. It is not a trial and not a licensed product.

Nanosome is our laboratory's extracellular-vesicle platform for delivering growth factors to support tissue regeneration. It can be discussed as an adjunct for recovery. It is not part of the cancer therapy described here, and nothing on this site should be read as a claim about it.