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Jeffrey Wolf, MD, clinical professor, Department of Medicine, director, Myeloma Program, University of California, San Francisco Helen Diller Family Comprehensive Cancer Center, details the role maintenance therapy has in treating patients with myeloma.
Jeffrey Wolf, MD, clinical professor, Department of Medicine, director, Myeloma Program, University of California, San Francisco Helen Diller Family Comprehensive Cancer Center, details the role maintenance therapy has in treating patients with myeloma.
Wolf explains that the CALGB 100104 and the French IFM studies demonstrate the role maintenance therapy has in improving progression-free survival (PFS) in patients, including those with high-risk disease. In the CALGB 100104 study, lenalidomide (Revlimid) versus placebo after autologous stem cell transplantation was investigated in patients with newly diagnosed myeloma. In the French IFM study, the role of lenalidomide maintenance was also tested until relapse in patients under 65 treated with a vincristine/doxorubicin/dexamethasone regimen or induction therapy with bortezomib (Velcade)/dexamethasone, followed by high-dose melphalan.
Maintenance therapy has been proven to aid PFS and most likely overall survival, which is critical for patients with high-risk disease. Though a number of patients with myeloma relapse, Wolf maintains that until new drugs become available, initial therapy for myeloma should consist of triplet regimens, transplant, and maintenance therapy.