Taking Control of Diet May Improve Outcomes for Multiple Myeloma

Patients with multiple myeloma may be able to sustain their MRD negativity and improve their long-term survival by eating a plant-based diet.

A healthier diet that consists of plant-based foods and seafood was associated with sustained minimal residual disease (MRD) negativity in patients with multiple myeloma, according to study results.

Sustained MRD (assessment of malignant cells or DNA remaining in a patient's body after treatment) negativity is important for patients with multiple myeloma because it is associated with improved long-term survival. The purpose of this study was to better understand whether modifiable risk factors, such as diet, were associated with this outcome, Dr. Urvi A. Shah, lead author on the study and assistant attending physician in myeloma service at Memorial Sloan Kettering Cancer Center in New York, said in an interview with CURE. Researchers did this through evaluating stool samples and dietary surveys from patients with multiple myeloma who were receiving Revlimid (lenalidomide) as maintenance therapy, which is a standard of care for this disease.

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Results, which were published in Clinical Cancer Research, demonstrated that healthier dietary protein, such as that derived from seafood and plants, correlated with higher stool butyrate levels, which in turn was associated with higher sustained MRD negativity rates. Butyrate is a short-chain fatty acid with anti-cancer and anti-inflammatory effects, and it is made by beneficial bacteria in the gut microbiome. Additionally, consumption of dietary flavonoids (plant nutrients with antioxidants) correlated with stool butyrate concentration, which was associated with sustained MRD negativity.

“Even though it’s a small study, it’s the first study to show an association that people who are eating healthy diets have higher amounts of healthier bacteria in the stool and higher sustained MRD negativity rates,” Shah said. “It could empower patients, because up until now, we just say, ‘Take this drug. There’s nothing else you can do.’ But now we can say, ‘Take this drug, but you also have this opportunity to further improve your outcomes through a healthier diet.’”

She also noted that in addition to it being a small study, it is a retrospective study, which means there was no intervention group and patients were only observed in what they were already eating. However, the results are still powerful, and the associations were significant. “Patients hearing about this could feel empowered and feel in control to potentially take measures beyond just the chemotherapy to improve their outcomes and lifestyle,” Shah said.

Moreover, even if a healthier diet did not affect a patient’s myeloma outcome, it is likely to positively affect other comorbidities, such as cardiovascular disease, diabetes and obesity that are associated with worse outcomes overall. “We have shown a direct mechanism in myeloma, but it will also help their overall health,” Shah said. “I don’t see any major downside to gradual healthier dietary switches.”

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