How do you utilize lenalidomide maintenance in non-transplant eligible myeloma?

Maintenance is a standard of care management for both transplant eligible and transplant ineligible, regardless of type of induction regimen. Studies have shown benefit for both groups. Time to progression (PFS) almost twice as long for both groups with maintenance compared to no maintenance.

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This is an important question with very recent potentially practice-changing data.

TLDR: For a patient with standard-risk myeloma who is not tolerating lenalidomide well and/or is keen to get off therapy, 2 years of lenalidomide maintenance is justified and should reflect a new standard of care.

The s...

First-line treatment for most myeloma patients in the US is 4-drug therapy with CD38Ab+RVd using lower cumulative exposure dosing in more frail patients, based in part on results from IMROZ, CEPHEUS, and BENEFIT trials. These all are expected to generate 80+% 2-year PFS and slightly better than 5-ye...