[Ricardo]

Actos (pioglitazone) for multiple myeloma?

by Ricardo on Tue Aug 21, 2012 3:06 pm

Has anyone has their myeloma specialist mention to them the possibility of taking the diabetes drug Actos (pioglitazone) to assist their anti-myeloma therapy?

I ask because, apparently, there is some research showing that Actos has an anti-myeloma effect.

Here's a study that I found that looks at the anti-myelom activity of Actos and valproic acid (an anti-seizure medication):

http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2141.2009.07902.x/full

and here's the abstract:

"The main challenge in using chemotherapy to treat multiple myeloma (multiple myeloma) is drug resistance. In order to evaluate the anti-neoplastic properties of a new drug combination in multiple myeloma, two clinically available drugs, valproic acid (VPA) a histone deacetylase (HDAC) inhibitor and pioglitazone, a peroxisome proliferator-activated receptor gamma (PPARγ) agonist, were tested in vitro on multiple myeloma cell lines and multiple myeloma patient cells. The sensitivity towards VPA alone was observed on several multiple myeloma cell lines tested and also on primary myeloma cells and peripheral blood mononuclear cells from healthy donors. Importantly, the addition of a PPARγ agonist to the VPA treatment increased the cytotoxic effect of VPA in a synergistic/additive manner on the different multiple myeloma cell lines and multiple myeloma patient cells. This effect was observed at the physiological range of VPA used to treat epileptic patients. The mechanisms underlying this increase induced a cell cycle arrest and caspase-dependent apoptosis. The potentiation of the effect of VPA by pioglitazone was mediated by higher acetylation levels of histones H3 and H4 compared to levels induced by HDAC inhibitors alone. This association reveals a new promising chemotherapeutic combination to be tested in multiple myeloma."

This research apparently has attracted enough attention that Actos is being studied in a German phase 1/2 clinical trial in combination with Revlimid and the chemotherapy drug treosulfan as third-line treatment for multiple myeloma.

Here's the clinical trial information:

http://clinicaltrials.gov/ct2/show/NCT01010243

Note: Actos has been linked to an increased risk of bladder cancer. So it's not without its risks.