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.”

• 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

Tags: MRD, patient care, multiple myeloma, MRD testing, transplantation, Cellular therapy, Transplant, MRD negativity, transplantation and cellular therapy, measurable residual disease, dietary supplementation, Marrow Transplant