Curcumin and Doxorubicin Combo in Relapsed/Refractory Multiple Myeloma

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Conclusion: PAd is an active salvage therapy with manageable toxicity in patients with relapsed/refractory multiple myeloma.

The good news is that there is a long and growing list of conventional, FDA approved therapies for the treatment of multiple myeloma. The bad news is that your body can take only so much toxicity before “the cure is worse than the disease” as the saying goes.

The solution? Integrative therapy. As the study linked and excerpted below explains, curcumin enhances doxorubicin while minimizing toxicity. When DOX is combined with bortezomib (Velcade- also synergistic with curcumin) and low-dose dexamethasone, relapsed/refractory MMers have a good chance at another remission.

Illustration of multiple myeloma plasma cells

When I was diagnosed with multiple myeloma in 2/94 as induction therapy I was given VAD  (vincristine, adriamycin, and doxorubicin). Unfortunately, I developed MDR and the DOX didn’t work too well. In addition, I suffered a late-stage side effect called chemotherapy-induced cardiotoxicity. I developed heart damage in 2010 that resulted in chronic A-Fib- (atrial-fibrillation)  meaning that I have an irregular heartbeat 24/7.

Curcumin is a natural supplement (that I have taken since 2006)  that has been shown to increase the effectiveness of DOX by reducing “multidrug resistance (MDR).” Curcumin supplementation enhances the efficacy of chemo by reducing cancer’s ability to become resistant. In addition, curcumin protects your heart from damage from DOX.

I am both a MM survivor and MM cancer coach. Please watch the MM CC webinar featured on the right of the page.

When were you diagnosed with multiple myeloma? What previous therapies have you undergone? Scroll down the page, post a comment or question and I will reply to you ASAP.

Thank you,

David Emerson

  • MM Survivor
  • MM Cancer Coach
  • Director PeopleBeatingCancer

Articles of Interest:

Understanding Blood Clots/VTE and Multiple Myeloma

Multiple Myeloma Bone Health Therapies- both Conventional and Non-Conventional

David Emerson: Multiple Myeloma Survivor Since 3/94

Doxorubicin

Doxorubicin, sold under the trade names Adriamycin among others, is a chemotherapy medication used to treat cancer. This includes breast cancer, bladder cancer, Kaposi’s sarcoma, lymphoma, and acute lymphocytic leukemia. It is often used together with other chemotherapy agents. Doxorubicin is given by injection into a vein.[3]..”

Bortezomib, doxorubicin and dexamethasone in advanced multiple myeloma.

“Bortezomib has shown significant activity in myeloma. In this multicenter trial, we assessed for the first time the combination of bortezomib, doxorubicin and low-dose dexamethasone (PAd) in the treatment of relapsed/refractory myeloma

Fifty-eight percent of patients had undergone prior autologous transplantation, 70% prior anthracycline and 27% prior bortezomib-based regimens.

  • Forty-three patients (67%) achieved at least a partial response
  • including 16 (25%) with at least a very good partial response.

One-year event-free survival was 34% after PAd and

  • 31% after the previous line of therapy
  •  One-year overall survival from the start of PAd was 66%.

Grade 3-4 toxic effects included:

  • thrombocytopenia (48%),
  • neutropenia (36%),
  • infections (15%),
  • anemia (13%),
  • gastrointestinal disturbances (11%) and
  • peripheral neuropathy (10%).
  • Two patients had grade 3-4 cardiac heart failure…

A composite polymer nanoparticle overcomes multidrug resistance and ameliorates doxorubicin-associated cardiomyopathy

“Acquired chemotherapy resistance is a major contributor to treatment failure in oncology. For example, the efficacy of the common anticancer agent doxorubicin (DOX) is limited by the emergence of multidrug resistance (MDR) phenotype in cancer cells…

While dose escalation of DOX can circumvent such resistance to a degree, this is precluded by the appearance of cardiotoxicity, a particularly debilitating condition in children.

In vitro studies have established the ability of the natural phytochemical curcumin to overcome MDR; however, its widespread clinical application is restricted by poor solubility and low bioavailability.

Building upon our recently developed polymer nanoparticle of curcumin (NanoCurc or NC) that significantly enhances the systemic bioavailability of curcumin, we synthesized a doxorubicin-curcumin composite nanoparticle formulation called NanoDoxCurc (NDC) for overcoming DOX resistance.

Compared to DOX alone, NDC inhibited the MDR phenotype and caused striking growth inhibition both in vitro and in vivo in several models of DOX-resistant cancers (multiple myeloma, acute leukemia, prostate and ovarian cancers, respectively).

Notably, NDC-treated mice also demonstrated complete absence of cardiac toxicity, as assessed by echocardiography, or any bone marrow suppression, even at cumulative dosages where free DOX and pegylated liposomal DOX (Doxil®) resulted in demonstrable attenuation of cardiac function and hematological toxicities.

This improvement in safety profile was achieved through a reduction of DOX-induced intracellular oxidative stress, as indicated by total glutathione levels and glutathione peroxidase activity in cardiac tissue.”

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