Maintenance and continuous therapy for multiple myeloma
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Maintenance and continuous therapy for multiple myeloma. / Richardson, Paul G; Laubach, Jacob; Gandolfi, Sara; Facon, Thierry; Weisel, Katja; O'Gorman, Peter.
In: EXPERT REV ANTICANC, Vol. 18, No. 8, 08.2018, p. 751-764.Research output: SCORING: Contribution to journal › SCORING: Review article › Research
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TY - JOUR
T1 - Maintenance and continuous therapy for multiple myeloma
AU - Richardson, Paul G
AU - Laubach, Jacob
AU - Gandolfi, Sara
AU - Facon, Thierry
AU - Weisel, Katja
AU - O'Gorman, Peter
PY - 2018/8
Y1 - 2018/8
N2 - INTRODUCTION: In multiple myeloma (MM), maintenance therapy is a longer, less intensive treatment course than initial therapy that is administered postinduction to delay disease progression. Maintenance and continuous therapy have been shown to suppress minimal residual disease and deepen and prolong responses, with the goal of improving progression-free survival and overall survival. Areas covered: In this review, we have summarized current clinical trial data on maintenance and continuous therapy in newly diagnosed MM and relapsed/refractory MM (RRMM), focusing on lenalidomide and bortezomib. We have also analyzed the potential uses of newer agents, including carfilzomib, daratumumab, elotuzumab, pomalidomide, and ixazomib. Expert commentary: Although lenalidomide- and bortezomib-containing regimens have demonstrated safety and efficacy, only lenalidomide is approved for maintenance; it is the preferred agent in the National Comprehensive Cancer Network and European Society for Medical Oncology guidelines. Furthermore, results from the FIRST trial support lenalidomide plus low-dose dexamethasone (Rd) as a standard of care for continuous therapy. In RRMM, newer agents have been successfully added to Rd and data from additional trials are awaited. The vital roles of maintenance and continuous therapy and their benefits are now more clearly understood, but important questions remain regarding optimal duration of therapy and regimens.
AB - INTRODUCTION: In multiple myeloma (MM), maintenance therapy is a longer, less intensive treatment course than initial therapy that is administered postinduction to delay disease progression. Maintenance and continuous therapy have been shown to suppress minimal residual disease and deepen and prolong responses, with the goal of improving progression-free survival and overall survival. Areas covered: In this review, we have summarized current clinical trial data on maintenance and continuous therapy in newly diagnosed MM and relapsed/refractory MM (RRMM), focusing on lenalidomide and bortezomib. We have also analyzed the potential uses of newer agents, including carfilzomib, daratumumab, elotuzumab, pomalidomide, and ixazomib. Expert commentary: Although lenalidomide- and bortezomib-containing regimens have demonstrated safety and efficacy, only lenalidomide is approved for maintenance; it is the preferred agent in the National Comprehensive Cancer Network and European Society for Medical Oncology guidelines. Furthermore, results from the FIRST trial support lenalidomide plus low-dose dexamethasone (Rd) as a standard of care for continuous therapy. In RRMM, newer agents have been successfully added to Rd and data from additional trials are awaited. The vital roles of maintenance and continuous therapy and their benefits are now more clearly understood, but important questions remain regarding optimal duration of therapy and regimens.
KW - Antineoplastic Agents
KW - Antineoplastic Combined Chemotherapy Protocols
KW - Disease Progression
KW - Disease-Free Survival
KW - Humans
KW - Multiple Myeloma
KW - Practice Guidelines as Topic
KW - Recurrence
KW - Survival Rate
KW - Time Factors
KW - Journal Article
KW - Research Support, Non-U.S. Gov't
KW - Review
U2 - 10.1080/14737140.2018.1490181
DO - 10.1080/14737140.2018.1490181
M3 - SCORING: Review article
C2 - 29932776
VL - 18
SP - 751
EP - 764
JO - EXPERT REV ANTICANC
JF - EXPERT REV ANTICANC
SN - 1473-7140
IS - 8
ER -