Maintenance Therapy - Multiple Myeloma

Maintenance Therapy – Multiple Myeloma

“Multiple myeloma is currently not a curable disease. There are a small number of patients whose disease will be well controlled for a long period following MM chemotherapy.”

The good news- Some studies have shown an overall survival benefit for low-dose maintenance therapy. The question to consider is how much toxicity should you undergo? And is there anything you can do to reduce the toxicity of maintenance therapy?

Keep in mind:

toxic long-term maintenance therapy increases the risk of treatment related secondary cancer.
According to the study linked below there are a small number of patients whose disease will be well controlled for a long period following primary therapy.
Even low-doses of MM chemotherapy (cytotoxic drugs) are toxic. You may experience collateral damage.

The solution, in my opinion, is to undergo maintenance therapy but:

1) make sure you take as low a dose as possible if the therapy is toxic.

2) add evidence-based, complementary and integrative therapies. Research shows that specific non-toxic therapies can enhance the efficacy of Revlimid while reducing its toxicity.

Consider adding evidence-based, anti-MM therapies such as

nutrition,
supplementation,
CBD oil,
lifestyle,
bone health
and mind-body therapies.

As you can read in the second study linked and excerpted below, curcumin enhances the efficacy of both Velcade and Revlimid.

Your goal as a MM patient, is to increase the efficacy of multiple myeloma chemotherapy. It doesn’t make a difference if that enhancement comes in the form of conventional or non-conventional MM chemotherapy.

Thank you,

David Emerson

MM Survivor
MM Coach
Director PeopleBeatingCancer

Should patients with multiple myeloma receive continuous therapy?

“Yes. All transplant-eligible and transplant-ineligible patients with multiple myeloma should be considered for maintenance/continuous therapy. The continuous and/or maintenance therapy must be well tolerated by the patient with convenient administration — preferably oral or very intermittent subcutaneous or IV.

Multiple myeloma is currently not a curable disease. There are a small number of patients whose disease will be well controlled for a long period following primary therapy. However, we are not able to prospectively identify these patients. In the absence of predictive biomarkers, all patients with multiple myeloma can potentially benefit from continuous therapy after primary induction treatment.

For transplant-eligible patients, this consists of induction therapy followed by hematopoietic stem cell collection, high-dose therapy with melphalan and infusion of hematopoietic stem cells. Following recovery, administration of maintenance lenalidomide (Revlimid, Celgene) until progression improved PFS in three large studies from the United States (CALGB 100104), France (IFM 05-2) and Italy (GIMEMA RV-MM-PI-209)…

Continuous maintenance therapy after autologous HSCT and after induction therapy for the transplant-ineligible patients can be considered a standard of care. New agents, such as monoclonal antibodies and agents with novel mechanisms of antimyeloma activity that are well tolerated, may be incorporated into long-term disease control strategies. Another important aspect of conducting clinical trials will be the development of early endpoints such as minimal residual disease negativity and immune profiling to determine the best choice of long-term therapy, with the ultimate goal of cure.”

Curcumin enhances the cytotoxic and chemo-sensitising effects of lenalidomide in human multiple myeloma cells

“Curcumin, the active component of the Curcuma longa plant, has been shown to potentiate the effect of the immunomodulatory drugs (IMiDs) thalidomide and Bortezomib against human myeloma cell lines and a nude mice model. Its effect on the other IMid, lenalidomide, has not been evaluated. This study aims to investigate the mechanism of action of curcumin and its potential ability to positively interact with lenalidomide.

Method: we designed an in-vitro study to investigate the cytotoxic and chemo-sensitising effects of curcumin alone and in combination with lenalidomide on the human myeloma H929 cell line.

Results: Incubation of H929 cells with curcumin (30mM) or lenalidomide (2.5 mM) for 3 days resulted in 26.35% (±1.06) and 30.81%(±2.98) apoptotic cells respectively. When 30 mM curcumin was combined with 2.5 mM lenalidomide, 50.4% (±3.37) apoptotic cells were detected by flow cytometry and the increase was significant compared to either curcumin alone or lenalidomide alone (anova p = 0.0026). Furthermore, gene analysis studies show that curcumin enhances the cytotoxic effect of lenalidomide via suppression of the cereblon and multi-drug resistant genes.

Conclusion: Curcumin exerts a cytotoxic effect additive to that of lenalidomide on H929 myeloma cells, and it also enhances the chemo-sensitizing effects of this agent.”

Recently Diagnosed or Relapsed? Stop Looking For a Miracle Cure, and Use Evidence-Based Therapies To Enhance Your Treatment and Prolong Your Remission

Maintenance Therapy – Multiple Myeloma

“Multiple myeloma is currently not a curable disease. There are a small number of patients whose disease will be well controlled for a long period following MM chemotherapy.”

Recommended Reading:

Should patients with multiple myeloma receive continuous therapy?

Curcumin enhances the cytotoxic and chemo-sensitising effects of lenalidomide in human multiple myeloma cells

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