Multi-drug resistance (MDR) is the reason why all myeloma patients stop responding to conventional chemotherapy. To put it differently, eventually your MM will no longer respond to any form of chemotherapy.
It’s only logical then, to try to figure out ways to reduce or eliminate MDR so that MMers continue to respond to chemotherapy treatments and continue to reach remission again and again. To put this differently, if MM survivors continually responded to chemotherapy, then they could treat their incurable blood cancer as if it were a chronic disease.
The phrase “evidence-based therapy” is a foundational concept of conventional oncology. Unfortunately, oncologists routinely tell their patients that evidence-based therapies shown to reduce multi-drug resistance, such as curcumin, resveratrol and others, may interfere with their conventional chemo regimens such as velcade aka bortezomib.
Suppose you have undergone the standard-of-care, FDA approved therapy plan for all newly diagnosed myeloma patients. And you have reached remission and relapsed once, twice, three, maybe even four times. And, because of multi-drug resistance, you are running out of therapy options to control your MM. Notice I didn’t say that you wanted to “cure” your myeloma, but you wanted to “control” your myeloma.
The cure versus control debate in myeloma is another central concept to my understanding of multiple myeloma. I encourage you to read Dr. Vincent Rajkumar’s essay. After struggling with the short, long-term and late stage side effects that can accompany potentially curative myeloma therapies, you might be open to just controlling it?
Or to put this another way, after years of living with toxicities you may be open to controlling your myeloma with less toxicity?
Consider controlling your myeloma with low-dose velcade or revlimid. Even if you have already undergone these therapies, your myeloma might still respond to them. Low doses of either/or may give you both a higher quality of life while enjoying a longer quantity of life.
To Learn More about short, long-term and late stage side effects- click now
If you have any questions about managing your myeloma or “re-challenging” your incurable blood cancer to chemotherapy, scroll down the page, post a question or comment and I will reply to you ASAP.
Thank you,
David Emerson
- MM Survivor
- MM Cancer Coach
- Director PeopleBeatingCancer
I believe that thinking outside the conventional MM therapy box is the key to long overall survival in multiple myeloma- conventional therapies all run into multi-drug resistance.
“Proteasome inhibitors are one of the most important classes of agents to have emerged for the treatment of multiple myeloma in the past two decades, and now form one of the backbones of treatment. Three agents in this class have been approved by the United States Food and Drug Administration-the first-in-class compound bortezomib, the second-generation agent carfilzomib, and the first oral proteasome inhibitor, ixazomib. The success of this class of agents is due to the exquisite sensitivity of myeloma cells to the inhibition of the 26S proteasome, which plays a critical role in the pathogenesis and proliferation of the disease. Proteasome inhibition results in multiple downstream effects…
These multiple biologic consequences of proteasome inhibition result in synergistic or additive activity with other chemotherapeutic and targeted agents for myeloma, and proteasome inhibitor-based combination regimens have become established as a cornerstone of therapy throughout the myeloma treatment algorithm, incorporating agents from the other key classes of antimyeloma agents, including the immunomodulatory drugs, monoclonal antibodies, and histone deacetylase inhibitors…”
“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…
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.”
“Exposure to EPA and DHA induced apoptosis and increased sensitivity to bortezomib in MM cells. Importantly, they did not affect viability of normal human peripheral mononuclear cells…
Our study suggests that EPA and DHA induce selective cytotoxic effects in MM and increase sensitivity to bortezomib and calls for further exploration into a potential application of these n-3 polyunsaturated fatty acids in the therapy of MM…”
