Diabetes may speed multiple myeloma growth

 New research from Memorial Sloan Kettering Cancer Center (MSK) examines how diabetes may speed the growth of multiple myeloma; analyzes the increasing number of patients who are benefiting from precision oncology; and highlights the unexpected role of the integrated stress response in response to genomic instability in mitochondrial DNA.

Diabetes is known to increase risk for developing multiple myeloma, as well as being associated with worse survival in those diagnosed. But researchers did not know whether diabetes was directly causing or accelerating this blood cancer. Now a team led by multiple myeloma specialist Urvi Shah, MD, has found clues in mice of how diabetes might speed the growth of multiple myeloma. They also found a surprising difference in how diabetes affects survival of Black patients versus white patients.

When investigating what might drive multiple myeloma growth, Dr. Shah and colleagues observed that human tumors grew more rapidly in diabetic mice than in non-diabetic controls. The diabetic mice had an insulin-related signal that was overactivated — suggesting that higher insulin levels may accelerate cancer growth.

“I work with many multiple myeloma patients who also have diabetes,” Dr. Shah says. “This study suggests we may improve patient outcomes further by treating diabetes at the same time we treat multiple myeloma.”

The researchers also looked at racial disparities in survival rates among those living with both conditions. (Both diseases are also approximately twice as common in Black patients than in white patients.) They studied health records of more than 5,300 patients with multiple myeloma, of whom 15% had diabetes. To their surprise, diabetes was associated with worse survival outcomes among white patients but not Black patients.

“It’s possible that in Black people, having diabetes increases multiple myeloma risk in the same way it does in white patients, but for some reason it doesn’t affect survival in the same way,” she says. “But we need to do more research to see if there is truly a difference in biology or if the discrepancy is caused by other clinical factors such as the younger age of Black patients.” Read more in Blood Advances.

https://www.mskcc.org/news/msk-research-highlights-october-19-2023