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21-10-2016 | Treatment | Article

The role of maintenance therapy in multiple myeloma

Authors: B Lipe, R Vukas, J Mikhael

Abstract

Multiple myeloma is the second most common type of blood cancer and remains incurable despite advances in therapy. Current therapy for multiple myeloma includes a phased-approach, often consisting of initial induction therapy, consolidation and maintenance therapy. With an ever-growing landscape of treatment options, the approach to optimal therapy has become increasingly complex. Specifically, controversy surrounds the optimal use and duration of maintenance therapy. We conducted a comprehensive literature search to analyze the most current literature and to provide recommendations for maintenance therapy in multiple myeloma.

Blood Cancer J 2016; 6: e485. doi: 10.1038/bcj.2016.89

Multiple myeloma (MM) is an incurable hematologic malignancy of plasma cells with a median overall survival (OS) of 6.1 years for patients diagnosed since 2006.The disease is characterized by periods of active disease requiring systemic therapy followed by periods of relative quiescence dependent on both biology and ongoing treatment. Phases of treatment for MM have been characterized as induction therapy (a limited period of therapy for initial disease reduction), consolidation therapy (more limited therapy aimed at deepened therapeutic response) and maintenance therapy (continuous therapy aimed at long term disease control). This review will focus on maintenance therapy and assume patients have received optimal and appropriate initial and consolidation therapy, which currently consists of two or three drug combinations depending on the clinical context2, 3, 4, 5

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