Alpha lipoic acid is one of the best–if not the best–anti-neuropathy supplements available. Velcade (bortezomib) causes peripheral neuropathy (PN) in most patients that use it.
So understandably, many cancer centers that treat multiple myeloma are recommending patients take alpha lipoic acid (ALA) to help minimize Velcade induced PN.
But apparently, alpha lipoic acid shouldn’t be taken with Velcade. According to researchers at the Institute for Myeloma & Bone Cancer Research, West Hollywood, CA and Millennium Pharmaceuticals, Inc., Cambridge, MA (the manufacturers of Velcade), not only does alpha lipoic acid disrupt the ability of Velcade to do it’s job, ALA also helps promote myeloma cell growth.
Here is their conclusion from a study published at ASH in December, 2009:
Results: The exposure of cells to ALA alone had a stimulatory effect on the growth of both MM cell lines in vitro…
Conclusions: Our data suggest that ALA has the potential to antagonize the anti‑MM effects of bortezomib based on our in vitro results using MM cell lines. Thus, it is possible that ALA could negatively impact the therapeutic benefit of bortezomib for MM patients…
SAY IT AIN’T SO! You mean to tell me that our doctors are still recommending a supplement that interferes with Velcade and may even make our myeloma worse?
I take a lot of alpha lipoic acid–and I’m currently undergoing weekly Velcade sub-q therapy. Which raises the question: Does this mean Velcade users shouldn’t be taking it at all, or just the day of and/or the days before and after treatment?
Who knows? This is a sub-clinical study–so we would only be guessing.
Anyway, this got me thinking. Velcade does seem to be unusually sensitive to certain foods and supplements. So what other things should we or shouldn’t we be consuming while we are using Velcade?
I will put together a list of things to avoid while undergoing Velcade therapy tomorrow.
In the meantime, CLICK HERE to access the abstract that I reference above if you would like to read more.
Since my maintenance treatment regimen only calls for Velcade once a week, I think I’m going to not use ALA the day before, day of and day following my Velcade infusion, because I think it does help minimize my PN a bit. But what about the possibility that it might help stimulate myeloma growth? Oops! Forgot about that part!
Darn it! I just bought a new bottle of the stuff yesterday. Anyone want a free month’s supply?
Feel good and keep smiling! Pat
August 25th, 2012 at 3:04 pm
Hi Pat,
My husband takes fairly high doses of Gabapentin 3X daily for his Velcade induced neuropathy.His last Velcade was May 2011, followed by stem cell transplant and the neuropathy pain has very gradually improved.
Our focus has been on other things but I do worry that some of the meds taken for side effects could have a stimulating effect on the myeloma cells.I’ll be interested to read your “things to avoid” list.
Thanks!
August 25th, 2012 at 5:01 pm
I take a lot of Gabapentin too, Sue. As far as I know, that’s OK to take with Velcade. How is your husband doing?
August 25th, 2012 at 5:21 pm
Wow–that bites…you find something that helps the annoying side effects of chemo and then you can’t take it b/c it negates the chemo and encourages the cancer to grow. I’m sure you’ve got green tea on your list of things to avoid when taking Velcade. That was a study done by the Univ. of Southern California.
In any event, thanks again for all your research!
August 25th, 2012 at 7:20 pm
Pat,
Certainly good to know. Luckily I haven’t taken it. Generally, I’m not taking any supplements which have not been show to help combat myeloma– either singly or in concert with conventional therapy.
In some way it shouldn’t be surprising that stuff that reduce chemotherapy side effects are also more likely to compromise the therapy.
That is certainly the case with glucosamine, glutamin, hyaluronic acid and now with alpha lipoic acid.
I’ll add it to the accumulating list.
Danny
August 26th, 2012 at 12:05 am
I agree, Susan and Danny. The alarming thing to me is that some of our docs are recommending we use it. I was taking L-glutamin when I read your column about how that wasn’t a good idea. Details tomorrow, so stay tuned!
August 26th, 2012 at 7:29 am
Thanks for asking,Pat.My husband is doing well..his transplant got him into remission.Really,his main issue has been the very severe neuropathy which was a huge quality of life issue..Drs told him it would gradually improve but would take a long time and that has been the case.
He has opted not to do maintenance.One question..most studies now seem to be showing an overall survival benefit with Revlimid maintainance but I never see the length of that benefit..months,years?
Thanks again.
August 26th, 2012 at 1:05 pm
Not much OS benefit so far, Sue. There is a significant PFS (progression free survival) benefit of up to 20 months. But in the end, only a month or two OS difference in most studies. I would have chosen to skip maintenance if my SCT had put me in remission…
October 1st, 2012 at 4:20 pm
re: multivitamin.
The specialist recommends it (oncologist, myeloma specialist) at Mayo.
The Complimentary and Alternative Med. Dr. at a similar institution (University of Iowa) suggests EVERY OTHER DAY instead of every day. She actually had a study that indicated cancer patients do better not taking the multivitamin daily, but alternate days.
For what it is worth.