Curcumin, Doxorubicin Combo in Relapsed/Refractory Multiple Myeloma

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 (MM). 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.

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 cardiomyopathy. 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 botha MM survivor and MM cancer coach.

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

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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Daniel Bossut says 3 years ago

Thank you for being a MM coach and posting this quite instructive website.
I was diagnosed with MM since 05/2018 after over a month of excruciating vertebral and costal pain. I immediately started a ketogenic and anti-angiogenic diets even before starting any chemo, and stuck to it strictly for 3 months (apparently cancer cells can switch metabolic pathway and ketogenic no longer effective)
Since June 1, 2018, I have received about 7 different chemo treatments all without any lasting improvement, but also without any drastic side effects (except episodic heart fibrillation with dexamethazone, bad tolerance to daratumumab, and general deterioration of my hematopoietic system).
ASCT in 03/2019 with slow recovering but somewhat OK response but not remission, and chemo restarted 1 month later. Never close to remission (M-spike between 1.5 and 4.3).
Currently pretty low RBC, HGB and platelets that any chemo make worse (up to transfusion of RBC and platelets).
In Fall 2019, I came across the book by Jane McLelland: ” How to starve cancer without starving yourself” which provided me with pretty good insight for a series of supplements that lead her to current cervical cancer remission receiving a non survival prognosis of of only a weeks in 1999 in the UK.
My current high doses of daily supplements include:
Oral Vit-C (up to 25g), Vit b12, folate, iron, multivitamins, omega-3, omega-6, magnesium, red beet powder, papaya leaves power (sometimes fresh papaya leaves), Turmeric/curcumin, Berberine, Quercetine, and independent of MM: Saw Palmetto and Resveratrol.

That a lot and, even though I checked, some may even be antagonist to any improvement.
Your opinion?

David Emerson says 3 years ago

Hi Daniel,

I have replied to this post direction via your email address. Let me know if you have any questions.

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Curcumin, Doxorubicin Combo in Relapsed/Refractory Multiple Myeloma

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

Recommended Reading:

Doxorubicin

Bortezomib, doxorubicin and dexamethasone in advanced multiple myeloma.

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

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