Future Directions in Maintenance Therapy in Multiple Myeloma.
Sarah A HolsteinVera J SumanJens HillengassPhilip L McCarthyPublished in: Journal of clinical medicine (2021)
Autologous stem cell transplantation (ASCT) has been a backbone of therapy for newly diagnosed patients with multiple myeloma eligible for high-dose therapy for decades. Survival outcomes have continued to improve over time, in part because of the incorporation of highly effective induction regimens prior to ASCT as well as post-ASCT maintenance therapy. Randomized phase III clinical trials have helped establish lenalidomide maintenance as a standard of care. However, as nearly all patients will eventually experience disease relapse, there continues to be significant interest in developing novel maintenance strategies to improve upon lenalidomide maintenance. In this review, we summarize the available evidence for the use of immunomodulatory drugs, proteasome inhibitors, and monoclonal antibodies as post-ASCT maintenance therapies as well as discuss future directions and unanswered questions in the field.
Keyphrases
- newly diagnosed
- stem cell transplantation
- multiple myeloma
- high dose
- phase iii
- clinical trial
- open label
- double blind
- phase ii
- low dose
- end stage renal disease
- palliative care
- stem cells
- chronic kidney disease
- ejection fraction
- randomized controlled trial
- prognostic factors
- quality improvement
- patient reported outcomes
- chronic pain
- chronic lymphocytic leukemia
- mesenchymal stem cells
- free survival
- replacement therapy