Following the news that not one but two new myeloma therapies are newly FDA approved, is it possible that the diabetes drug, meformin, could be a third? Before I post the fourth installment of Danny Parker’s series, I wanted to update everyone about how I’m holding up.

Following my first auto stem cell transplant this summer, I noticed things started to turn around for me at the 30 day mark. Thank goodness that sometimes history repeats itself. After over three weeks of relentless diarrhea, it finally broke like clockwork on Day 32. It’s only been two days, so I’m not ready to declare victory yet. But it’s hard to feel good when you’re battling dehydration and stomach cramps, so I’ll take it!

Starting chemotherapy after only three weeks of recovery isn’t any fun. I’ve started a bridge maintenance regimen of 3 mg pomalidomide, 21 days on with 7 days off, and 40 mg dex each week. No surprise I have more energy, and feel better, on dex days. Sunday I slept half the day away after the dex wore off. At least it gives me a kick for four days. I’m dragging a bit today but otherwise feel pretty good. The pom can make me foggy; but there doesn’t seem to be a pattern for when to expect it. I’ll take my dex tonight just before bed. I do that hoping to get to sleep before it kicks in. Taking an Ativan tab helps me sleep for four or five hours. Sometimes I can get back to sleep, sometimes I toss and turn, fitfully sleeping until morning.

Pattie has a bad, bad cold. She gets one every fall. It starts with a sore throat and morphs into a painful cough. Catching it could send me to the hospital, so I’m as careful as possible. But I don’t wear a mask around her and we sleep in the same bed. Honestly, it would hurt her feelings if I were too obsessed with keeping my distance. She’s had trouble with infections like this ever since she had a number of lymph nodes removed during her ovarian cancer surgery. I’m not sure there’s a connection, but I do know if I have gotten the same cold in the past, mine have been milder, even with a compromised immune system.

I’d prefer not to find out if the same holds true so soon after a pair of transplants. She’s been coughing for a week, so maybe I’ve lucked out.

As I get stronger, my focus turns back to myeloma related news that may help my friends in the myeloma community. I know Danny feels the same way. If existing drugs, like metformin, can help supplement heavy hitters like ixazomib and daratumumab, what a bonus!

Metformin as a Possible Treatment for Myeloma?

Could metformin, a common drug for treating Type 2 diabetes,be helpful for treating myeloma?

Dr OrlowskiI first heard about this possibility over a year ago from Dr. Robert Orlowski with MD Anderson, a myeloma specialist, who was a co-author of a paper on the topic published in The British Journal of Cancer. Generally, as with other cited evidence, the BJC paper indicated worse outcomes for diabetic myeloma patients, but also showed that treatment of such patients with metformin was associated with better results:

http://www.nature.com/bjc/journal/v111/n3/full/bjc2014307a.html

Beyond that there was other evidence that persons who had myeloma and were taking metformin regularly seemed to experience disease progression more slowly than others. Data shows that myeloma patients with diabetes, are associated with shorter survival, although research by Wu et al. (2014) seems to indicate that metformin ameliorated that risk:

http://www.ncbi.nlm.nih.gov/pubmed/24921909

There is also recent research showing that metformin may have potential therapeutic use in treating myeloma. Recent datafrom Zi et al. (2014) showed a direct effect of metformin against myeloma in vivo with Dexamethasone:

http://www.ncbi.nlm.nih.gov/pubmed/25305450

There is even a recent study suggesting Metformin increases the effectiveness of Bortezomib (Velcade) as recently described in research summarized by Jagganathan et al. (2015):

http://www.nature.com/leu/journal/vaop/ncurrent/full/leu2015157a.html

So, the takeaway is that several separate studies indicate that metformin my help potentiate the power of each of the existing myeloma therapies. But could be there more potent combinations?

You realize this goes deeper than metformin. There are thousands of drugs used for an endless number of ailments. If metformin may help, maybe there are others that might help, too.

“More potent combinations?” Tune in after the holiday for Danny’s next installment.

Feel good and keep smiling! Pat