Plant-Based Diet, Butyrate Production “Associated With Sustained MRD Negativity in Multiple Myeloma

Sustained MRD negativity in multiple myeloma (MM) has been associated with a plant-based dietary pattern and production of the short-chain fatty acid butyrate in stool. The study –the first to show such an association – appeared in Clinical Cancer Research on Sept. 28.

The study involved 74 patients enrolled in a phase 2 study of the effects of 5 years of lenalidomide maintenance. Sustained MRD negativity was defined as MRD negativity at 2 consecutive time points 1 year apart between enrollment, 12 months, and 24 months. MRD status was assessed at enrollment; 42 patients were MRD positive and 32 MRD negative. Dietary factors were examined using a food frequency questionnaire, stool metabolites using gas chromatography-mass spectrometry, and the stool microbiome using 16S sequencing.

“In MM on lenalidomide maintenance, stool butyrate concentration at 3 months was associated with higher rates of sustained MRD negativity. Increased seafood and plant proteins, dietary flavonoids, and diversity of dietary flavonoids correlated with stool butyrate concentrations. Thus, a healthy diet, with adequate plant and seafood protein, and containing flavonoids, associates with stool diversity, butyrate production and sustained MRD-negativity,” write Urvi A. Shah, MD, of Memorial Sloan Kettering Cancer Center, and colleagues.

The findings “support the hypothesis that a healthy diet, with adequate high-quality plant and seafood protein, and dietary flavonoids may have a positive impact on stool diversity, butyrate production and MM outcomes,” the authors write, adding that they “have initiated a whole-foods plant based dietary interventional trial in MM precursor disease.”

Reference

Shah UA, Maclachlan KH, Derkach A, et al. Sustained Minimal Residual Disease Negativity in Multiple Myeloma is Associated with Stool Butyrate and Healthier Plant-Based Diets [published online ahead of print, 2022 Sep 28]. Clin Cancer Res. 2022;CCR-22-0723. doi:10.1158/1078-0432.CCR-22-0723