Multiple Myeloma Coverage from Every Angle

Maintenance Therapy for Myeloma: Can Minocycline Reduce the Symptom Burden?

By: Kayci Reyer
Posted: Wednesday, June 23, 2021

According to research presented in Supportive Care in Cancer, the semisynthetic antibiotic minocycline does not appear to effectively reduce the symptom burden or inflammatory markers in patients with multiple myeloma during maintenance therapy. Despite being well tolerated with a low toxicity profile, minocycline did not produce statistically significant positive outcomes in this patient population.

“Additional exploration of minocycline for reduction of disease-/treatment-related symptoms in a cohort of [multiple myeloma] patients is not warranted,” concluded Charles S. Cleeland, PhD, of MD Anderson Cancer Center, Houston, and colleagues.

The phase II study included 69 patients with multiple myeloma who were undergoing maintenance therapy. Patients were randomly assigned to receive either 100 mg of minocycline twice daily (n = 33) or a placebo (n = 36). Symptoms were evaluated weekly using the MD Anderson Symptom Inventory for Multiple Myeloma (MDASI-MM). Symptom burden was determined using effect size, AUC, t-tests, and a longitudinal analysis identified inflammatory markers related to symptom severity change over time.

The most severe symptoms were fatigue, pain, disturbed sleep, numbness/tingling, and drowsiness. No significant difference between the AUC for these symptoms was reported in the minocycline arm versus the placebo arm. In both arms, an association was identified between pain reduction and decreased soluble tumor necrosis factor-α receptors 1 and 2 serum levels while receiving treatment (P < .05, all). Treatment-related adverse events of grade 3 or higher were not noted.

Disclosure: For full disclosures of the study authors, visit

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