Velcade and Green Tea: A Myeloma No-No

Many of us myeloma patients have Velcade (bortezomib) as part of our treatment program, be it during induction, consolidation, or maintenance. There are plenty of companies/websites advertising the beneficial effects of green tea including “cancer prevention.” Just enter “green tea and cancer” in Google and you will find a near endless list of outfits ready to sell you green tea in a variety of forms.

However, a recent paper in the journal Advances in Clinical and Experimental Medicine reports on progress made in understanding the way green tea interacts with Velcade. There is no reason to go into the full detail of the science of the underlying mechanism of action between green tea and myeloma cell lines and the interaction with Velcade. There is, however, a reason to get right to the bottom line with the published conclusions:

“When bortezomib is involved in the multiple myeloma chemotherapy, the consumption of green tea should be avoided in order to maintain the biological efficacy of bortezomib.” [emphasis added]

The paper referenced above builds on prior research published in the journal Blood in 2009 that concluded:

“Taken together, our results indicate that green tea polyphenols may have the potential to negate the therapeutic efficacy of BZM and suggest that consumption of green tea products may be contraindicated during cancer therapy with BZM.” [emphasis added]

If you’d like to learn more about green tea you may wish to check out this website from Memorial Sloan Kettering Cancer Center in NYC that is very comprehensive and answers a wide variety of questions you may have. Under the section “Herb-Drug Interaction” you will find Velcade (bortezomib) with the warning:

“Bortezomib: EGCG and other polyphenols can inhibit the therapeutic effect of bortezomib and other boronic acid-based proteasome inhibitors.” [emphasis added]]

This last highlight is important because that would mean that combining green tea and treatment with Ninlaro (ixazomib) would also be a myeloma “no-no.” 

I cannot, however, find specific studies linking a negative interaction between Ninlaro and green tea. The second paper, referenced above, makes the comment, however, “This pronounced antagonistic function of EGCG was evident only with boronic acid-based proteasome inhibitors (BZM, MG-262, PS-IX), but not with several non-boronic acid proteasome inhibitors (MG-132, PS-I, nelfinavir). “

If you are a multiple myeloma patient on Ninlaro therapy and you consume green tea/green tea extract, then you may wish to consult with your physician and/or specialty pharmacist.