The Study Abstract:
Santosa D, Suharti C, Riwant I, et al. Curcumin as adjuvant therapy to improve remission in myeloma patients: a pilot randomized clinical trial. Casp J Int Med. 2022;13:375–84.
Background: The treatment for ineligible transplant multiple myeloma is melphalan prednisone. Curcumin has an anti-inflammatory and antiangiogenesis in cancer-directed to nuclear factor-kappa B (NF-kB) pathway. Interleukin 6 (IL-6), vascular endothelial growth factor (VEGF), tumor necrosis factor-alpha (TNF-α), C-reactive protein (CRP), and lactate dehydrogenase (LDH) were also involved in the pathogenesis of myeloma. No clinical study has evaluated the efficacy of curcumin in myeloma patients. To evaluate the efficacy of curcumin as adjuvant into melphalan prednisone in myeloma patients
Methods: 33 myeloma patients at Dr. Kariadi General Hospital, Semarang, Indonesia during 2016-2017 were randomly assigned single-blindedly into MPC (n=17) and control group (n=16). The MPC group was treated with melphalan 4 mg/m2, prednisone 40 mg/m2 for 7 days, and curcumin 8 gram daily for 28 days. The MP control group was treated with melphalan, prednisone, and placebo. The primary endpoint was the overall remission. Pre and post-treatment was examined for NF-κB, VEGF, TNF-α, IL-6, LDH, and CRP levels All data analyses were per protocol.
Results: There was a significant difference in overall remission between the MPC and MP control groups [75% vs 33.3%, x2=6.89, P=0.009]. A significant decrease of NF-κB, VEGF, TNF-α levels shown in the MPC group compared with the MP control group. There was a significant decrease in IL-6 levels in a subgroup analysis of the MPC group. TNF-α levels had a significant correlation with remission [OR=1.35; (95%CI=1.03-1.76); P=0.03].
Conclusion: Curcumin has an efficacy in improving overall remission and decreasing NF-κB, VEGF, TNF-α, and IL-6 levels in myeloma patients.
WHAT THIS MEANS TO YOU:
Myeloma is a cancer of blood plasma that produces abnormal, nonfunctional antibodies. Common treatments include chemotherapy, radiation, and drug regimens, including the combined protocol of melphalan (a chemotherapy drug) and prednisone. Unfortunately, the remission rates from these treatments are not always very strong, and their side effects—nausea, diarrhea, alopecia (hair loss), and dermatitis—can feel overwhelming.
However, curcumin, a compound from turmeric, can help. Curcumin is widely known for its anti-inflammatory and cell-protecting properties. This study was no exception.
While all patients in this study received the standard drug melphalan and prednisone treatment, one group also received eight grams of curcumin enhanced with turmeric essential oil (BCM-95) for improved absorption and bioavailability.
In just 28 days, 75 percent of those in the curcumin group were in remission, versus only 33 percent of the drug-only group, which had received a look-alike placebo in addition to the melphalan and prednisone.
In the curcumin group, researchers noted significant reductions in a variety of disease markers, including vascular endothelial growth factor (VEGF), which can create blood vessels that help feed tumors; transcription factor NF-κB, which helps cancer cells replicate; and TNF-a, an inflammatory compound that creates damage that may initiate cancer.
This study illustrates the importance of reducing unchecked inflammation, and the advances of combining conventional treatments with botanical medicines that have proven value in clinical work. In the case of myeloma specifically, remission can make all the difference, helping people live three times longer (or more) than those who do not achieve remission.