Myeloma – Low-dose Maintenance Therapy

Combine Conventional (Lenalidomide) with Evidence-based Non-Conventional Low-dose Maintenance Therapy to Increase OS While Decreasing Toxic Damage

You’ve been diagnosed with multiple myeloma. Naturally you’re wondering about which therapies will work the best for you. Low-dose maintenance therapy has been shown to increase progression-free survival (PFS) but not overall survival (OS) consistently.

PFS means your first remission. But not an increase in OS aka overall survival. When it comes to myeloma survival, only low-dose maintenance therapy, on average, increases your first remission.

Low-dose maintenance therapy will increase your risk of side effects an probably lower your quality-of-life.

Being a long-term MM survivor who hasn’t had toxic therapies of any kind since 1997, I consider it my responsibility to think about conventional MM differently than how your oncologist thinks about therapy.

Take the issue in the study linked and excerpted below. I have to question if the issue is not if Revlimid (lenalidomide) is the reason for increased overall survival in multiple myeloma (MM), but if the issue is whether or not low-dose maintenance therapy is the reason for increases in overall survival in multiple myeloma.

What I mean by the above statement is that my research and personal myeloma experience is that hitting MM daily with apoptotic therapies is the reason why I have remained in complete remission from my MM since my complete remission in 4/99.

There are three known facts about low-dose Revlimid maintenance therapy:

Revlimid is antiangiogenic
low-dose maintenance therapy is “metronomic therapy”
Revlimid is toxic

Many different types of anti-angiogeneic therapies have been proven to kill MM. Whether it is in the form of chemotherapy like Revlimid, Thalidomide, Curcumin, or even cannabinoids. Antiangiogenesis kills MM.

Revlimid causes a host of side effects listed below.

Evidence-based anti-MM therapies such as curcumin, whole-body hyperthermia and exercise are also forms of metronomic therapy that can work synergistically with Revlimid and do not cause secondary cancers.

Consider evidence-based but non-toxic therapies that have been shown to enhance the efficacy of Revlimid while reducing it’s toxicity.

Please watch the video below to learn more about the evidence-based, integrative therapies to combat treatment side effects and enhance your chemotherapy.

Consider the idea of metronomic therapies increasing overall survival rather than Revlimid increasing overall survival. Consider integrating curcumin with Revlimid to enhance the efficacy while decreasing toxicity.

I am both a myeloma survivor and myeloma cancer coach. Please scroll down the page and post a question or comment and I will reply to you ASAP.

Thank you,

David Emerson

Myeloma Survivor
Myeloma Cancer Coach
Director PeopleBeatingCancer

Lenalidomide as Maintenance Therapy in Multiple Myeloma After Autologous Stem Cell Transplantation

“How It Works- Lenalidomide is a thalidomide (Thalomid) analog with immunomodulatory, antiangiogenic, and antineoplastic properties. It inhibits proliferation and induces apoptosis of certain hematopoietic tumor cells, including mantle cell lymphoma, multiple myeloma, and del(5q) myelodysplastic syndrome in vitro and delays tumor growth in hematopoietic tumor models including multiple myeloma…

The combination of lenalidomide and dexamethasone synergizes the inhibition of cell proliferation and the induction of apoptosis in multiple myeloma cells…

The most common adverse events of any grade across both maintenance studies (> 20% of lenalidomide patients) were neutropenia, thrombocytopenia, leukopenia, anemia, upper respiratory tract infection, bronchitis, nasopharyngitis, cough, gastroenteritis, diarrhea, rash, fatigue, asthenia, muscle spasm, and pyrexia. The most common grade 3 or 4 adverse events in the two studies (vs placebo) included neutropenia (59% vs 33% and 54% vs 8%), thrombocytopenia (38% vs 30% and 13% vs 3%), and leukopenia (20% vs 10% and 24% vs 2%).

Serious adverse events occurring in > 4.5% of lenalidomide patients were lung infection and neutropenia. The most common adverse events leading to discontinuation of lenalidomide were thrombocytopenia (2.7%) and neutropenia (2.4%).

In patients receiving lenalidomide maintenance therapy following high-dose intravenous melphalan and autologous stem cell transplant, hematologic second primary malignancies occurred in 7.5% of patients compared to 3.3% of patients receiving placebo…”

Metronomic chemotherapy

“Toxic effects and chemoresistance are major hurdles in chemotherapy and to avoid these problems caused by traditional chemotherapeutic regimens, a new modality of drug administration called “metronomic chemotherapy” has emerged. Such regimen involves the frequent administration of conventional chemotherapeutic agents at very low doses to target activated endothelial cells in tumors, the advantages of which include minimal adverse effects and a rare chance of developing acquired drug resistance. Previously it was thought that they act by targeting angiogenesis, but recently additional mechanisms have been discovered which has established metronomic chemotherapy as a type of multi-targeted therapy…”

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

“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…”

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Paulson Ambookan says 4 years ago

I am a MM patient. Taking Darcalex every two months. I used to do it every month and I thought it was too much. Can you recommend how I can be MM free in the long term. I am 59 I did the Revelimid Cel aid and dextramethazone treatment and the did the ASCell treatment but the MM came back

David Emerson says 4 years ago

Hi Paulson- I replied to you directly via email.

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Chris says 7 years ago

Hi David-
I was diagnosed with stage1 MM in Sept 2016. Since then, I have gone thru autogolous SCT (Jan 2017), melphalan treatment prior to SCT, two cycles of RVD post SCT, and am currently on Revlimid maintance. I didn’t find Your site until recently and I have been intrigued. My most recent M spike results went from unquantifiable to sub 0.5. While that is still very low, I would like to do my part in some form of integrative therapies. Not knowing where to go or who to trust with this, I landed here and am writing you now.
The CBD oil, curcumin and Omega-3 therapies seem to make the most sense. However, any suggestions you may have would be greatly appreciated.

David Emerson says 7 years ago

Hi Chris-

I will send a guide about integrative MM therapies to you via your email address. This info will give you an understanding of “doing your part” in enhancing the anti-MM action of revlimid.

You are correct. Your m-spike is still quite low which is excellent but the goal is to keep it there (low) for years if no decades. CBD oil is also mentioned as an integrative therapy but the efficacy of CBD oil depends on the state in which you live.

Read over the integrative therapies guide and let me know if you have any questions.

Hang in there,

JoAnn M. Stiles Cramer says 7 years ago

Found out I had MM in May, my doctor said I would have had 2 weeks to live if it was nit detected! My kidneys were clogged, and fell at the hospital and broke my arm( which was a blessing in disguise) spent 9 days and got cancer treatments and fluids immediately! Today my doctor said I’m doing so well my blood work doesn’t even look like I have cancer! They are so amazed at how the chemo, Revlimid and regular MM treatment is working on me! I’m really blessed!! My question is can the cannibis oil help with the cure??Will it interfere with my treatment?

Hi JoAnn-

I am sorry to read of your MM diagnosis though happy to read that you are now in remission. You are correct on two counts. Yes, conventional MM chemotherapy drugs such as revlimid will eventually stop working (MM eventually becomes resistant…). And yes, CBD oil has been shown to enhance the efficacy of revlimid (aka bortezomib). I cannot tell you that CBD cures MMers but it will synergize with chemo.

I encourage you to add evidence-based but non-toxic therapies such as CBD oil, anti-MM nutrition, supplementation, bone health and other therapies to your regimen.

Let me know if you have any questions.

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

Myeloma – Low-dose Maintenance Therapy

Combine Conventional (Lenalidomide) with Evidence-based Non-Conventional Low-dose Maintenance Therapy to Increase OS While Decreasing Toxic Damage

Recommended Reading:

Lenalidomide as Maintenance Therapy in Multiple Myeloma After Autologous Stem Cell Transplantation

Metronomic chemotherapy

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

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