The mission of the HealthTree Foundation is to improve patient outcomes by removing barriers to a cure. The HealthTree Foundation is a patient-driven, 501(c)3 non-profit organization that empowers patients with rare diseases at each step of their disease journey - from diagnosis, through education, care, and on to a cure using unique in-person and technical tools.
At HealthTree, we don’t just want to state our mission, we want to make it a reality. Today we are sharing how we have been able to empower patients to a cure thanks to donations like yours. Don’t miss our Giving Tuesday campaign on December 1st, 2020.
Audrey Burton-Bethke, the Myeloma Crowd Community Manager, interviewed Dr. Shah and has summarized the following information. The study explained below is one of six studies that the MCRI is conducting that you can donate to this Giving Tuesday.
Background of Dr. Urvi Shah
Dr. Urvi Shah is a physician and clinical investigator on the Myeloma Service, Division of Hematologic Malignancies at Memorial Sloan Kettering Cancer Center in New York City. She earned her medical degree from Grant Medical College in India and completed a residency in internal medicine at Tufts Medical Center in Boston. Following this, she completed fellowships in hematology/oncology at Montefiore Medical Center, and in cancer immunotherapy jointly sponsored by Memorial Sloan Kettering Cancer Center (MSK) and the Parker Institute for Cancer Immunotherapy in New York.
She is leading research efforts to examine the role of metabolic disorders (such as obesity, diabetes mellitus), nutrition, and the gut microbiome (microorganisms that live inside the human gut) in myeloma as well as identifying interventions to improve outcomes for these patients. For her prior research, she received the Celgene Future Leaders in Hematology Award. Currently, she works closely with other researchers investigating the metabolic links in this disease within large databases. She also collaborates with her basic scientist colleagues and their research is funded by the Parker Institute for Cancer Immunotherapy Career Development Award to study the epigenetic impact of metabolic disorders on CAR T cell therapies. She has gained experience in the development and conduct of clinical trials in plasma cell disorders. In addition, she is an investigator on numerous investigator-initiated clinical trials at MSK. She has written a pilot plant-based nutrition intervention study in overweight and obese patients with myeloma precursor disorders that will open in February 2021 at MSK. This trial is supported by the American Society of Hematology Clinical Research Training Institute Award.
Why we think this study is important
To date, most lifestyle interventions and clinical trials, especially those that are diet-related, have been conducted in patients with solid tumors (such as breast cancer and prostate cancer) and not in blood cancers, which is an area of unmet need. This provides an opportunity to design a study to assess whether specific healthy dietary changes improve outcomes. This data will be invaluable to physicians as they treat patients for these conditions.
As a myeloma physician, the most common question she receives from newly diagnosed patients is whether their diet or lifestyle caused the condition and whether they should alter their food habits. Currently, the only data available to guide physicians’ answers is epidemiologic. Meanwhile, there is an epidemic of lifestyle diseases such as obesity, diabetes mellitus, and poor nutrition in the U.S.—all of which are known modifiable risk factors for the development of plasma cell disorders. Plasma cell disorders include - multiple myeloma (MM), smoldering myeloma (SMM), monoclonal gammopathy of unknown significance (MGUS).
Being a cancer survivor herself, she is passionate about helping patients make wise nutritional and lifestyle choices as they face a cancer diagnosis to improve outcomes as well as prevent cancer. Despite needing to take some time off to undergo chemotherapy for Hodgkin lymphoma during her oncology fellowship training in 2016, she continued to focus on her research work and publish. She has shared her experience as an oncologist and cancer patient who also had COVID19 here (JAMA Oncology, 2020). This personal cancer experience led her to focus her research on risk factors that are within a patient’s control and develop an interest in studying metabolic and dietary factors involved in cancer. Since joining MSK, she has focused her efforts on plasma cell disorders.
What we hope to learn from this nutrition study in plasma cell disorders
The NUTRIVENTION-2 study, a Phase II randomized study will be the largest dietary intervention study in patients with plasma cell disorders and the largest study to date evaluating the stool microbiome in patients with plasma cell precursor disorders (MGUS/SMM). Patients will receive a whole food plant-based diet and/or dietary supplements or continue observation and will be followed for 12 months.
Prior studies have shown that the stool microbiome is progressively altered in MM and MGUS compared to healthy controls. MM patients have higher nitrogen-recycling bacteria (bad bacteria) and those patients that have higher abundances of bacteria that produce short-chain fatty acids such as butyrate (good bacteria) have better outcomes. Diet, as well as dietary supplements, play a role in shaping the gut microbiome and plant-based foods are associated with an increase in bacteria that metabolize carbohydrates thus increasing levels of short-chain fatty acids such as butyrate. Additionally, plant-based foods are high in fiber (and are nutrient-dense but not calorie-dense), which helps with early satiety compared to other approaches that are calorie restricted and thus unsustainable. Some dietary supplements have been studied individually in MM and shown to have improved outcomes. This study will evaluate the combined effects of plant-based nutrients (fruits, vegetables, whole grains, beans, legumes) and dietary supplements that have been shown to be associated with reduced risk of MM. This clinical trial will assess the impact of nutrition and/or dietary supplements on SMM/MGUS and specifically assess changes in the microbiome, inflammatory biomarkers, myeloma proteins/markers.
With this study, we hope to generate data that will inform guidelines to improve the outcomes of patients with MGUS/SMM. This study will help provide evidence-based guidance to cancer patients in relation to their diet and weight to prevent cancer and improve survival. This novel study will be the first such trial in hematologic malignancies and plasma cell disorders and will lead the way to help patients manage lifestyle-based preventable risk factors. Indeed, it will test an intervention that is expected to address nutrition-based risk factors already known to increase the likelihood of progression from precursor plasma cell disorders such as MGUS/SMM to multiple myeloma.
Why you should consider donating
Greater than 3% of the population over the age of 50 have precursor plasma cell disorders (MGUS or SMM) and some of these individuals will go on to develop multiple myeloma. By supporting this cause, you will directly have a large-scale impact for individuals living with plasma cell disorders in helping them manage lifestyle-, microbiome- and diet-related risk factors, backed by scientific evidence. Every dollar counts towards reaching this goal. Thank you for considering! To donate head here!