Dr. Landgren on Maintenance Therapy in Myeloma

Ola Landgren, MD, PhD, Head, Multiple Myeloma Section, National Cancer Institute, discusses the pros and cons of maintenance therapy for patients with myeloma.

Maintenance therapy in myeloma, Landgren says, is not new, as studies have analyzed steroids, interferon, thalidomide, lenalidomide, and proteasome inhibitors. Several studies have demonstrated progression-free survival advantage with maintenance therapy.

One study, with lenalidomide, showed overall survival advantage but also severe side effects. Patients treated with lenalidomide had an increased risk of developing a secondary hematologic malignancy than with placebo, though the risk was not great. Though lenalidomide can provide overall survival advantage, a secondary hematologic malignancy would be devastating to a patient.