Study: MS drug may diminish side effects in myeloma treatment

By Allen Cone  |  April 27, 2018 at 11:09 AM
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April 27 (UPI) -- A drug commonly used to treat multiple sclerosis could reduce the effects of a chemotherapy of myeloma patients, according to a study of mice.

Researchers from from the Saint Louis University School of Medicine hope the oral drug fingolimod could help myeloma patients successfully complete treatment and offer pain relief for the bortezomib chemotherapy drug. The findings were published Friday in the Journal of Experimental Medicine.

The side-effect condition is called chemotherapy-induced peripheral neuropathy, or CIPN. More than 40 percent of patients with multiple myeloma and mantle cell lymphoma experience CIPN when taking bortezomib, the researchers wrote.

"This growing problem is a major unmet clinical need because the increased efficacy of cancer therapy has resulted in nearly 14 million cancer survivors in the United States, many suffering from the long-term side effects of CIPN," Daniela Salvemini, professor of pharmacology and physiology at the Saint Louis University School of Medicine, said in a press release.

Myeloma is a cancer of the plasma cells in which they grow too much, forming a mass or tumor in the bone marrow and many bones of the body. The Centers for Disease Control and Prevention reported 23,555 people were diagnosed with myeloma and 12,112 died from it in 2014.

The researchers found that bortezomib accelerates molecules called sphingolipids that have previously been linked to neuropathic pain.

Rats treated with bortezomib began to accumulate two sphingolipid metabolites -- sphingosine 1-phosphate and dihydrosphingosine 1-phosphate -- in their spinal cords when they experienced neuropathic pain. By blocking the production of these molecules, the animals didn't develop CIPN.

The researchers found that they can activate a cell surface receptor protein called S1PR1.

Fingolimod, an orally administered drug approved to treat multiple sclerosis, did not inhibit bortezomib's ability to kill myeloma cells and actually it reduced tumor growth and enhanced the effects of bortezomib. Gilenya, the drug's brandname made by Novartis, was approved by the Food and Drug Administration in 2010.

"Because fingolimod shows promising anticancer potential and is already FDA approved, we think that our findings in rats can be rapidly translated to the clinic to prevent and treat bortezomib-induced neuropathic pain," Salvemini said.

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