Симвастатин для снижения резистентности к ПХТ при ММ

[Dr.Vad]

Вот такой начальный опыт назначения симвастатина к bortezomib или bendamustine у пациентов с рефрактерной множественной миеломой:

In the case of no change (paraprotein increase less than 25% and paraprotein decline less than 50%) after two cycles of bortezomib (one cycle: 1.3 mg/m2 day 1, 4, 8, 11) or bendamustine (one cycle: 100 mg/m2 day 1 + 2) the patients received two further cycles with concomitant simvastatin treatment (80 mg daily starting 2 d before chemotherapy and stopping 2 d after chemotherapy)...

In three out of six patients (no. 1, no. 2, and no. 4) the paraprotein serum levels increased during the first two cycles of chemotherapy but clearly dropped after the addition of simvastatin. In patients no. 3 and no. 5, the serum paraprotein was quite stable after the first two cylces, but declined upon simvastatin co-medication. Only in the last patient on protocol the paraprotein was not affected by simvastatin. In addition to the paraprotein levels, we have determined the cholesterol serum levels as marker of HMG-CoA-reductase inhibition. In all of the first five patients serum cholesterol levels were significantly reduced upon simvastatin treatment (mean −34%; range: −23% to −48%), but only in patient no. 6 the serum cholesterol level increased by 5% between time points B and C. We conclude from these observations that the HMG-CoA-reductase was not sufficiently inhibited in patient no. 6, possibly due to insufficient gastrointestinal absorption or, more likely, to non-compliance.
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Eur J Haematol. 2007 Jul 26;
First clinical experience with simvastatin to overcome drug resistance in refractory multiple myeloma.
Schmidmaier R и соавт.