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Common Solvent Appears To Have Anti-Myeloma Activity

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Published: May 9, 2014 10:17 am; Updated: May 12, 2014 3:00 pm

A solvent used extensively for both industrial as well as pharma­ceutical pur­poses may have substantial anti-myeloma activity.

This is the conclusion of a recent study by an international team of re­searchers, which carried out a wide range of pre-clinical investigations of the solvent N-methyl-2-pyrrolidone (NMP).

The scientists looked at the effect of NMP on myeloma cells in laboratory cul­tures as well as in mice implanted with myeloma cells. Their testing indicates that safe doses of NMP may have anti-myeloma activity com­pa­ra­ble to – if not better than – Revlimid (lena­lidomide).

The research team that investigated NMP’s anti-myeloma activity was led by scientists from the Peter MacCallum Cancer Centre in Melbourne, Australia.  It also included researchers from the Mayo Clinic in Scottsdale, Arizona, and several additional cancer centers in Australia and New Zealand.

NMP’s activity against multiple myeloma appears to be the result of two separate but complementary pro­cesses.

First, in a manner similar to the “immunomodulatory” drugs Rev­limid and thalidomide (Thalomid), NMP makes the body’s own immune system more effective in fighting multiple myeloma.

Second, NMP also affects processes within myeloma cells that allow them to survive. In this regard, NMP functions similarly to a class of drugs known as bromodomain inhibitors. These drugs, which include the compound JQ1, have attracted attention in recent years as potential treatments for a range of different cancers, including multiple myeloma.

NMP, however, may be active against myeloma cells that have developed resistance to drugs such as Revlimid and thalidomide.  This is because mechanisms known to create resistance to existing im­muno­modu­la­tory myeloma therapies do not seem to play a role in NMP’s anti-myeloma activity.

NMP’s potential as a myeloma treatment was first noticed several years ago by Australian researchers. While testing other potential anti-myeloma therapies that had been dissolved in NMP, the scientists ob­served that the solvent, on its own, seemed to counteract myeloma cells.

NMP is currently used in a variety of different ways. It can be found in nail polish remover, paint stripper, patches to deliver drugs through the skin, orthopedic cements (including cements used for vertebroplasty), and as a solvent for injected drugs.

Although NMP is considered to be relatively safe at commonly used concentrations and exposure levels, it is listed by the state of California as having “reproductive toxicity.”

Because NMP is already widely produced, it has the potential to be not only a new myeloma therapy, but also an inexpensive new myeloma therapy.

The authors of the current study plan to start a phase 1 clinical trial of NMP in up to 30 Australian multiple myeloma patients later this year.  Funding for the trial has been secured from Australia’s National Health and Medical Research Council after peer-review of a funding proposal.

Even if NMP performs well in its initial clinical trial involving multiple myeloma patients, it would still need to undergo additional clinical trials to confirm both its safety and efficacy. These trials are required before an application could be filed with regulatory authorities – such as  the U.S. Food and Drug Administration (FDA) – for permission to sell the drug for use outside of clinical trials.

Overall, it typically takes more than five years for a cancer drug to go from its initial clinical trials to final reg­u­latory approval.  In the case of Kyprolis (carfilzomib), for example, FDA approval occurred almost seven years after the start of the drug’s first clinical trial.

For more information about the NMP study, please refer to Shortt, J., et al., “The drug vehicle and solvent N-methyl­pyr­rol­i­done is an immunomodulator and antimyeloma compound,” Cell Reports, 2014, dx.doi.org/10.1016/j.celrep.2014.04.008 (full text).

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46 Comments »

  • R said:

    Whooo-weee, Pardon me, if I’m a little skeptical.

    First, it was DMSO..or some such. Then it was curcumin.
    Now, NMS ??

    The hope in my Marrow, wishes it to be true.

    The pain in my bones, urges caution.

    The ganglia in my brain, sputter with Denial.

    How odd, that a chemical can arrest Multiple Myeloma, …when Chemicals or radiation are felt to cause it.

    As Jimi Hendrix sang, “..excuse me while I kiss the sky”. ( Or was it “this guy”?)

    I’m gonna thunk on ‘dis ‘un fer awhile, Jethro. It dont’ sound like no Black Swan….

    Jed Clampett

  • Myeloma Beacon Staff said:

    Hi R,

    You have every right to be skeptical. We, too, always approach preclinical research — that is, research carried out in the laboratory, rather than with myeloma patients — with a lot of skepticism.

    As we noted in a forum posting earlier today, there have been far too many preclinical studies that have suggested drugs could be active against myeloma, yet the drugs later end up showing little or know activity when actually tested in myeloma patients.

    In this case, however, the preclinical research is really very, very extensive. If you haven’t already done so, click through to the paper the researchers published. You can also view the full PDF of the study, complete with supplementary tables, figures, and explanatory text, by following this link:

    http://www.cell.com/cell-reports/pdfExtended/S2211-1247(14)00295-2

    We think you’ll be impressed by the breadth and depth of the researchers’ investigations of NMP.

    Many preclinical studies simply test a drug’s activity in a few myeloma cell lines in laboratory cultures. The authors of the current study did this with NMP, but they also investigated the drug in mice implanted with myeloma cells.

    In addition, they did comparisons between the activity of NMP and other agents, and they extensively investigated exactly how the drug may work against multiple myeloma.

    It’s also worth mentioning that the researchers involved in the study are well known and have extensive experience with these sorts of investigations, and the journal where the study was published is well respected.

    None of this means that NMP is guaranteed to become an approved myeloma therapy sometime in the future. A tremendous amount of caution is still warranted. But the agent certainly shows promise based on the results of the study discussed above.

  • R said:

    Of course you are not going to print something, without preening the feathers of the product, first.

    Assuming all you say is true…and this becomes a viable treatment (FDA approved) etc. A basic question or two:

    Who’s going to sell something that costs several hundred dollars BY THE GALLON and market it to Providers/ Patients?

    The Patent exists, already.

    Assuming it works, or will work–Will BigPharma step in and stop it ?
    There is no profit in it–in fact, it will drive down the $14 K / month list price of Revlimid, N’est Pas ?
    Greatly, as a matter of fact.

    I know what I’d do, if I had an exclusive Patent that runs thru 2022…and I’m making bales of cash in 2014.

    Them’s lots of Gozinta’s, Jethro.

    The Milburn Drysdale’s of the World will simply tube it.

    Yee, Doggies!

    Uncle Jed

  • Blair said:

    I also sadly have become a “cynic” when it comes to all these studies. When my young husband was diagnosed, everything pointed to “hope” just around the corner. Over a year later, and I still feel just as scared as ever! Hoping all these ” new” drugs etc. will offer a true answer for this disease!

  • Stann said:

    Interesting stuff!

    Of course it’s ludicrous to get giddy and think you’re going to be cured by this discovery. But who knows, maybe it’ll be another tool in the box? Or lead to another line of tools?

    Thanks Beacon Staff for another great article.

    Now time to go sit by my daughter as she does her nails. (I do like the smell too).

  • Stann said:

    R — what is your point?

  • Alice said:

    When I was diagnosed, my consultant told me that it was a case of “keeping you going” until a cure is discovered. He truly believed this would happen in about 4 years. This conversation took place 3 years ago and despite hopeful headlines every now and again, I don’t feel we’re any closer to that elusive cure now than we were then.

  • Susan said:

    Alice, I am 18 years since diagnosis (that alone should give you hope). But, like you, I don’t think we are any closer to a cure.

    Whenever I hear a doctor or researcher speak at a myeloma seminar, the first words out of their mouths are invariably “Myeloma is a complex and baffling disease, and everybody’s disease is different”. A case of shooting us down before the good news gets hold of us!

    I have learned to take each new announcement (few and far between) with a pinch of salt and just trust my doctor. I have been with her since the beginning and can honestly say that trust in your doctor is the single most important factor in staying sane.

    Good luck with your journey through this maze.

  • Myeloma Beacon Staff said:

    Lots of great points, everyone. Thanks for the feedback.

    We should probably clarify straight away that nothing about the research that has been done so far with NMP suggests it is anything near to being a cure for myeloma.

    It has the potential to become another anti-myeloma treatment — another tool in the tool chest, so to speak. Exactly how effective it will be is not yet clear because it hasn’t been tested in myeloma patients, just in cell cultures and laboratory mice. But none of those tests indicate that, at reasonable doses, it is going to wipe out all myeloma cells in a patient’s body.

    Still, another tool in the tool chest is a good thing to have. Each additional tool likely improves the expected survival of myeloma patients.

    That said, remember that it takes quite a while for a drug to go from its first clinical trial to being approved by the FDA and therefore widely available. It took Kyprolis (carfilzomib) seven years from the start of its first clinical trial until it was approved by the FDA, making it widely available to myeloma patients.

    Finally, as R suggests, a challenge with NMP will be that you can already go out and buy it from multiple different companies. What will be the incentive for a company to invest in developing the drug when it may not be able to get a return on that investment?

    There are, we suspect, ways that companies could overcome that hurdle. But it’s still a hurdle.

    Of course, it’s also possible that researchers — such as some of those involved in the current study — may go forward with clinical trials anyway, simply because the drug is readily, and inexpensively available, and is showing promise.

  • R said:

    Don’t misinterpret my comments.

    I appreciate every bit of up to date information, as much as the next Myelomer. Hope drips from the pores of everyone of us.

    However, having struggled with the first 2 years of this disease, and seeing that profit motive is seemingly the #1 motivator of Oncological Big Pharma, I am a little suspect that anyone would actually fund Phase I-III studies and pursue FDA approval, for purely altruistic reasons.

    ( See, Joint letters criticizing cost and availability of formularies,as signed by leading Oncologists in 2012 and 2013.)

    I wish it were not so, however; “it is, what it is.”

    Perhaps the FDA could be persuaded on “Humanitarian grounds” to allow it’s use –if this stuff is truly as effective as Revlimid.

    Thanks for posting this.

    Happy Mothers Day to all Mothers out there.

    PS–The prospect of a chemical curing a chemically caused Dyscrasia, is still deeply ironic, to me. Chelation style therapies, I can see, because of the physical properties of affinity.
    A Chemical solvent “fumigation” though, is conceptually difficult to embrace.

  • R said:

    N‑methylpyrrolidone 4 Quarts Methylpyrrolidon…
    $64.99
    eBay

    * * * * *

    According to the ASH Presentation in 2011, NMP is a sub-unit of thalidomide, and has similar methods of action /chemical structure.

    Gee, we can now buy our Chemo..on eBay ??
    Wonder what the delivery charges are….!!?

    yeah,… but Revlimid is 100 times stronger than NMP !
    Okay–100 times 64.99 = $6,499 (Gallon)

    Odd stuff.

  • Sylvia said:

    I was at the meeting here in Australia when the young PhD student who first noticed the effect of NMP on myeloma cells first spoke about his work to the general public. It was quite an electric moment — he was so enthusiastic about his research and what he had seen.

    Thank goodness we do have dedicated scientist and other medical researchers looking for new treatments and lets not pour cynical cold water on their efforts. We all need them so badly, it’s not for want of trying that a cure has not been found yet. What we do need to do is pressure our governments to spend more, not less, on medical research — especially the sort of pure research that finds answers out of left field.

  • Thomas said:

    Thank you for this interesting discussion. Just the fact, that NMP, in a laboratory setting, is more effective than Revlimid is worth a story. Think about the effects (just a mindgame) if Revlimid maintenance will be replaced through the very much cheaper agent with a favorite profile. This discovery could have deep impact on the stock of Celgene or Amgen.

  • Joyce E. said:

    R – Just thought that I would let you know that all of the chemo you take that makes you feel better is chemicals. In fact, your entire body is full of chemicals. Sometimes they cause problems, and sometimes they solve them.

  • Tr2sa said:

    If NMP has even weak effect in clinical trials, it is currently in biotech grade ~2000 times cheaper than Lenalidomide. Looking at the molecular structure and previous research, it has quite higher than average chance to have immunomodulative effects. I would say it would create quite unique situation with further clinical trials, if the Australians report at least some success.

  • Pauline said:

    It takes many years of research and thousands of experiments to try to find new treatments and therapies, but only takes one experiment to disprove a theory. Positive results don’t prove or provide an instant cure but provide understanding and hope that we are heading toward better outcomes.

    I am one of the people who have spent my life trying to find some of those positive results and let me tell you they are few and far between. So instead of flagging our positive work with doubt, you could support us in our quest to find solutions to some of our most complicated diseases.

    We (medical researchers) are the most unrewarded and unsupported profession. We are educated to the highest levels, yet have the lowest of salaries and have to fight in a competitive environment for funding to support ourselves and our research. Why? Because we care.

  • Thomas said:

    Pauline, I just want to explain my point of view: As a German patient with three small children, I’ve a special view on discoveries. Although it might be not polite, I want to discuss about any discovery – and I have to admit, sometimes with a critical point of view. Why? In the discussions, questions and exchange with fellow patients I try to find out if something really new is on the horizon.

    Every myeloma patient has very bad days. Before bone marrow biopsy. After relapse diagnosis. During the night when the pain don’t let you sleep. In these hours, discussions and forums like the Beacon help me to walk through the darkness.

    But discussion about some new agents never mean, that I underestimate the hard work of the scientists in the laboratory. We know and respect, that scientists work for us and help us. Why do you think that we’re “flagging” your work? We love it. For me, you and your colleagues are almost heroes. You prolong our lives. We know that!

    I’ve only one question: As a consultant I work sometimes with big pharma companies and above this my younger sister is a senior researcher at a US company in Thousand Oaks. And there, they pay very, very good money for that hard work and the working conditions are, as we Germans say, prima!

  • Terri J said:

    All this discussion is good. Two years ago, our 32 year old daughter was diagnosed with myeloma. I hope for a cure every day. Every time they talk about something new, it gives me hope and we all need that. Yes, they are not cures, but they keep people with myeloma going.

    I have been diabetic since I was 14. I am not CURED, but I am keeping going, for 45 years in fact. I hope this at least can be the way of myeloma.

  • Ron Harvot said:

    If and when NMP comes out as an approved treatment for MM and if it is shown to be effective, the market for it will take off. That should put extreme pressure on the price of Revlimid and Pomalyst. That is a very good thing. The cost of these drugs currently is extreme, to put it lightly. So I hope NMP succeeds. The other point is that you can almost bet that the active ingredient that makes NMP successful against MM will be refined and strengthened just as Revlimid and Pomalyst have improved upon thalidomide.

  • Nancy Shamanna said:

    This may be a question that is obvious, but is NMP already a generic drug? Or, is it classified as a drug at all, since it is used as a solvent? I would imagine that a pharmaceutical use of it for a cancer would have to be a special formulation. That would be more expensive than just the every day use of it. I agree though , that a less expensive yet very effective drug would be very welcome on the market place for myeloma drugs! Part of the costs of a drug are in the clinical trials that must be run before it is approved, though.

  • Mike said:

    If true that the NMP provides some anti-myeloma effect, but it itself proves of no use directly, there may be a mechanism here to be understood. Possibly re-formulated/ patented (and therefore big pharma makes their money), it could be as was said, another tool in the kit.
    Be reasonably optimistic but keep your skepticism powder dry!

  • Stann said:

    I cringe when I hear the generic criticism of “Big Pharma”. I’ve had MM for 5 years. It seemed when I started this journey that life expectancy was 4 years. Last I heard, newer patient life expectancy is 7-10 years. Obviously those numbers are open to interpretation, but the bottom line is that modern western medicine has increased OUR life expectancy significantly over the last few years. Regulated capitalism is great, it works. I love sausage but don’t like to watch it being made. Capitalism is like that … I’m sure smaller companies are pushed out of the way, FDA officials might get a free vacation here and there. But, in the end, we have fierce competition to produce products that save our lives.

    And if it turns out that Drano is the cure, there will be hospitals than open up for MM patients who hire doctors who are willing to dispense Drano pellets to MM patients. And those hospitals will put pressure on those in power to approve its use.

    And yes, Joyce, I agree. If you don’t have access to water, you’ll die within 72 hours. If you have access to too much water, you drown.

  • Multibilly said:

    Such cynicism about the progress of research in MM and such disdain for the pharmaceutical companies (that fund this R&D).

    When it comes to MM, I for one am thankful we live in these current times as opposed to just a few years ago. I’m also thankful that we have such a rich and varied set of new drugs in the pipeline that are often times being bankrolled by these same pharmaceutical companies (if you haven’t taken the time to scan through the ASH 2013 proceedings, I suggest you do). There are certainly a lot of things that are broken with our overall health system and just how much these new drugs cost … but the research and products that these pharma companies put out is nothing short of amazing and the scientists doing this research are indeed heroes … IMHO.

    I wish the Peter Mac team (which is largely funded by national grants) good success and I look forward to seeing their first results on human patients. Perhaps the research will disappear into obscurity or perhaps this will be yet another example of where a cheap chemical is transformed into a widely used chemo agent that we can have available to us in our tool chest.

  • Mike said:

    I wonder if there are other investigators on NMP, other than the group in Australia? If its effects could be replicated in other trials, we can be more certain of the results.

  • Eric Hofacket said:

    I would not get hung up on NMP being described as a solvent. Water is a solvent. As the article stated, NMP is already used in medicine as a solvent for other drug agents. So its toxicity to humans is probably already fairly understood.

    Clinical trials to determine the effectiveness as an agent to treat myeloma are going to be expensive and I am unsure if the pharmaceutical industry would fund these trials unless using NMP as a myeloma treatment can be patented. I do not know the answer to that, I do not believe that NMP itself can be patented at this point. And I believe there are a lot of countries that would not recognize a NMP patient for myeloma treatment.

    But “big pharma” is not the only funder of clinical trials though. If NMP shows promise as a myeloma treatment, I am sure that public sector government agencies and universities around the world would fund trials for NMP. Somebody is already funding a phase 1 trial in Australia.

    It is great news that it appears to still be effective against myeloma that is refractory to Revlimid. I am not expecting a cure, but wouldn’t it be fantastic if we could finally get a myeloma treatment that does not become refractory ever.

  • Kay said:

    You can’t always believe everything you read on the Internet. My cousin gave my mother flaxseed to take for advanced anal cancer, and made her worse than before. He said it would help her because he read it on the Internet. All of you Internet junkies would do better to go to church than try to play doctor because you read it on the Internet. Follow the doctors orders, not someone who can’t even understand or read all of the technical wording, but think the Internet made them smarter than a physician with extended years of schooling.

  • Eric Hofacket said:

    Kay,

    No one who commented on this thread tried to play doctor, gave any kind of order, or suggested that anyone should start self-medicating and take NMP on their own without a doctor’s supervision. We read about these developments in myeloma treatment so we can be prepared to have discussions with our physicians about them.

    I have not seen anyone here who thinks the Internet made them more an expert on myeloma than the Beacon’s medical advisers. But there are a lot of Beacon readers and myeloma patients who are pretty knowledgeable about myeloma, myeloma treatments, and the testing and labs done to track the progress of the disease. This is a good thing, as myeloma patients can have more meaningful discussions with their doctors.

    Often patients need to make decisions with their doctors about what to do and not just follow orders blindly without knowing what is going on. If a second opinion is sought, often the patient will be the one who needs to sort out what path to follow, and I would want to make that decision from a position of knowledge, not ignorance.

    There is lots of good information on the Internet, but you certainly should not believe everything you read. Looking at the Gerson therapy and Gonzales therapy for cancer treatments, I would go as far to say as you should not necessarily believe everything you read even from a doctor. I understand it can be difficult to sort out what the truth really is or interpret correctly the information that is presented.

    I believe that lots of doctors recommend flaxseed oil as a dietary supplement to help with overall health. I seriously doubt that flaxseed oil is used as a treatment for advanced anal or any other cancer. I do not understand how flaxseed oil would make cancer worse though. You sound pretty angry about this. Did your mother stop seeking medical treatment from a doctor believing you cousin’s advice to take flaxseed oil for advanced anal cancer?

  • cronkster said:

    I would jump on that clinical trial in a heartbeat if it were allowed here in the US. I just passed my 6th year of dealing with a very aggressive form of MM as of this March. I am grateful to the folks that developed carfilzomib [Kyprolis]. It kept my MM in check for 4 years while I was on the clinical trial. Unfortunately the carfilzomib ran out of gas. I have completed 2 stem cell transplants and one mini transplant. I have been on 3 clinical trials since the carfilzomib trial and they were completely unsuccessful in combating my MM. My numbers are now climbing into the danger zone once again and I fear my tool box is empty.

    I have noticed in the past when a pharma product had shown a nominal sign of MM fighting ability in a petri dish several clinical trials in different countries would become available. Funny how the NMP trial is only in Australia (Aussies call it like it is). Seeing how our US onocological researchers are connected at the bone marrow with the pharma companies, there wasn’t much of a rush to start trials here. I’ll be seeing my guys tomorrow and will ask them about this. I am currently going to the John Theurer Cancer Center in Hackensack, NJ. These folks are top shelf.

  • Myeloma Beacon Staff said:

    Just a quick FYI … We’ve updated the article above a bit to reflect or address some of the issues that were raised in the comments on the article thus far.

    We’ve added information, for example, about who the researchers who conducted the study and also about the fact that planned clinical trial has been funded. Also, just to ensure that there are no misunderstandings, we’ve clarified the sort of timeline that is typical for a drug like NMP when it is undergoing development.

    Nancy – To the best of our knowledge, NMP has never been tested or approved as a treatment for any disease. It’s current use in pharmaceuticals is to dissolve other drugs that are delivered either as injections or in skin (transdermal) patches.

  • Stann said:

    Eric — good post. Question: Melphalan was discovered in the 40′s and I’m sure it’s patent has run out. But somebody is funding more studies with that product. Maybe the companies that market anti-nausea meds? Ha. (that was a dark humor ha)

    And come to think of it, thalidomide has been around since the 50′s or 60′s. Is Celgene the only company producing it? I wonder if all companies had access to play with thalidomide to produce sister products like Celgene has.

    Stann

  • Mike F. said:

    One other thing to keep in mind. NMP is already used as a drug delivery vehicle at concentrations that (if the current research is correct) should be effective against myeloma. Therefore, its toxicity in humans is already pretty well understood. This is different from a compound that’s never been put into large numbers of peoples’ bodies. This will make the development process much cheaper and therefore something that’s more likely to get funded by groups not associated with pharma companies. NMP is already well ahead of other compounds that are being investigated.

    The big questions now are whether anyone can duplicate the Australians’ results and how well the phase one trials go.

  • Bob M said:

    Stann, regarding Thalidomide, from what I understand, Celgene was granted sole source provider status for Thalidomide in the US by the FDA. Even though it is sold for pennies internationally, Celgene has the ability to sell it, and mild variations of it, for insane coin, as they have the monopoly.

    I am all for free market capitalism, but this is not an example of free market capitalism; it is eliminating competition via governmental forces.

  • Barry said:

    There appears to be some confusion around the issue of patentability. The key point is that if a new use is found for a known chemical entity then it is possible to protect that discovery by filing a use patent. The Peter MacCallum Cancer Centre filed patents in 2013 which presumably cover the use of NMP in myeloma. There is ample precedent for repurposing known drugs. Thalidomide comes immediately to mind. Patents covering its use in myeloma were filed more than 40 years after its initial discovery.

  • R said:

    Due to extreme toxicity–especially in the reproductive sphere, NMP/Revlimid/Thalidomide/Thalidomide handling, dispensing, and use are very tightly regulated by the FDA.

    The propensity to cause fetal damage/death, as well as severe developmental malformations, has foisted an additional patent consideration, on to this family of drugs. Incidental contact and damage is very real, for this compound….and the FDA.

    “Safety of delivery”, is thus a mandatory component of the Patent App and the obligatory “Wrapping paper” reflecting same, is required.

    As pointed out by the same researcher/presenter at ASH 2011–NMP is a Sub-unit of Thalidomide.

    It will need to be patented, before its use is allowed–atleast here in the US. Cost then becomes the first casualty.

    That was the point Uncle Jed made.

  • William said:

    I personally am happy that the work by the doctors and big pharmaceutical companies and their doctors and scientists keep finding new “chemicals” in the fight against myeloma. In the seven years since diagnosis, I have had a series of remissions and relapses that is very familiar to many of us. Just recently my doctor told me to get my affairs in order as my passing seemed inevitable. I was the placed on a ACY 1215 study which has brought my kappa number down. Just recently I was able to see my daughter graduate college. I never thought that would happen. So I salute them. Keep up the fight. The only thing that saddens me is that everyone I know does not have the same insurance and access to care that I have.

  • Dick said:

    I was intrigued by Susan’s post (May 9) in which she said she was first diagnosed 18 years ago. I myself was clinically diagnosed ten years ago, but have experienced no symptoms. I consider myself extremely lucky, and am very grateful. Are there any studies going on among people who are asymptomatic? Perhaps there are some common threads in the lifestyles of such people that could prove helpful to others.

    I have no idea why symptoms have not developed, nor does my oncologist; at the end of each three-month monitoring session, all he says is, “Just keep on doing what you’ve been doing.” Wish I knew if something I’m unwittingly doing (or not doing) is contributing to the absence of symptoms. Perhaps Myeloma Beacon Staff has some ideas.

  • Tony B said:

    R – You seem to have misunderstood this exciting primary research article here. NMP was thought to be related to thalidomide (hence the 2011 ASH abstract). However, the newer research indicates NMP & IMiDs are less related and work quite differently, so your dramatic claims of ‘extreme toxicity’ due to relatedness to IMiDs in humans is unfounded as of yet!

  • R said:

    Hey Tony, don’t tell me, tell the FDA. We are all subject to their process(es).

    I’d certainly like to take for my MM maintenance something that: is NOT Toxic; is Cheap; is safe; is readily available; is effective; and with few side effects. Preferably in Pill form.

    I suspect other MM’s feel likewise.

    Excuse me, I have to call in and take another “Revlimid Survey” to get next months meds. (FDA Required)(due to reproductive toxicity, etc)

    MM’s are stuck in the middle…between Big Pharma and the FDA.

    Regards,

    PS–Ever see pictures of “Thalidomide babies”?

    PSS- The most repeated phrase in every PDR (Big Pharma) is: “…the precise method of action in humans is poorly understood, at this time”.

    PSSS–Unfounded ?

  • Tony B said:

    Again R,

    Yes, unfounded — this article doesn’t have anything at all to do with ‘thalidomide babies’ because it explicitly states NMP is different from an IMiD. And more importantly, what makes this such a great story is that it’s not big pharma trying to extort us, it’s researchers funded by government grants in a public hospital disclosing all of their information. You need not worry about that here.

  • R said:

    When they pull a Jonas Salk (give away their patent(s)to the public domain) and demonstrate that NMP (a sub-unit of thalidomide) has a completely different method of action (Demonstrated), then I will be impressed….and in deep appreciation.

    I’m quoting the 2011 paper/presentation and the new paper(s).

    Until then…who (or what) is unfounded ?

  • Igor said:

    How much can cost research that reproduces the NMP effectiveness in cell lines?

  • Myeloma Beacon Staff said:

    Thanks, everyone, for all the comments.

    Dick – From what you wrote in your comment, specifically that you were diagnosed, but never have had any symptoms, it sounds like you have smoldering myeloma. We are not aware of any studies that link certain patient characteristics (including lifestyle characteristics) to long-term lack of progression in smoldering myeloma. (There may be such studies, but, as we said, we’re not aware of any.)

    It is worth pointing out that in one of the best known studies of smoldering myeloma, published almost seven years ago in the New England Journal of Medicine, researchers found that slightly more a fifth of smoldering myeloma patients do not progress to active (symptomatic) multiple myeloma within 20 years of their initial diagnosis (see Figure 2 in the article).

    Thus, it is not as uncommon as some people think for smoldering myeloma patients *not* to progress to active multiple myeloma.

  • Pete N said:

    To Myeloma Beacon staff:

    Is NMP currently used as a solvent for existing multiple myeloma (MM) drugs?

    If so, will the FDA ask drug companies to “back test” their drugs WITHOUT NMP?

    In other words: is it possible that NMP is an “active” agent in the MM (or other) drugs in which it is used as a solvent?

    Pete N

  • Myeloma Beacon Staff said:

    Pete N – Good question.

    We’ve done some initial checking and, based on what we’ve found, it does not appear that NMP is used as a solvent for either Velcade, Kyprolis, infused melphalan (Alkeran) or infused cyclophosphamide (Cytoxan).

    So it doesn’t appear that any “back testing” of these anti-myeloma drugs will be necessary.

  • kathy cartwright said:

    I have read the article as well as all the comments. First, Kay, nothing wrong with praying to God for the cure or treatments that keep us on earth longer; BUT GOD gives us tools. The tools he has blessed us with are smart researchers, doctors, nurses, pharmaceutical companies, The IMF, MMRF, LLS, etc. that care enough to find that cure or that treatment for us. They may make some $$ while doing it – BUT they too have to pay rent (so to speak). Eric you make a lot of good points – I think you sum it all up!

    I am a MM survivor for 13 yrs & have been chemo free for 5yrs. Got on drug trials 13 yrs ago – thalidomide + dex, then 12 yrs ago – a vaccine against my MM. I think something is working? I know I am blessed to be here. I just watched my son graduate from college this past weekend. He was 10 years old when I was diagnosed. My daughter was just 12 – I got to watch her graduate a couple of years ago. She is now in Oz in grad school!

    Education in what is ailing you is another tool GOD gives you! USE IT!

  • take said:

    Related article was published:

    Tomoko Tatsuno et al, “Multiple solvent, N-methyl-2-pyrrolidone, acts as a novel adjuvant for enhancing cutaneous immune responses”, Bioscience, Biotechnology, and Biochemistry, Published online: 29 May 2014.
    http://www.tandfonline.com/doi/full/10.1080/09168451.2014.912114

    Abstract: N-methyl-2-pyrrolidone (NMP) is known for its multi-solvent properties. However, its biological, especially immunological significance still remains to be elucidated. In this study, we show for the first time that NMP stimulates the skin immune system by activating epidermal Langerhans cells (LCs). In contrast with the placebo tape, when the NMP-containing adhesive tape was applied on murine skin, LCs were stimulated immediately. Activated LCs not only exhibited enhanced expression of major histocompatibility complex class II and morphological changes, including the loss of dendrites, but also migrated effectively to draining lymph nodes. In addition, application of the tyrosine-related protein-2 peptide, which is the cytotoxic T lymphocyte (CTL) epitope against B16 melanoma, in combination with the NMP tape, resulted in explosive expansion of specific CTLs in mouse spleens. Taken together, these results demonstrate a novel role of NMP as an adjuvant in percutaneous peptide immunization.