Dr. Berdeja on Maintenance Therapy in Multiple Myeloma

Jesus Berdeja, MD, director of Multiple Myeloma Research at Sarah Cannon Research Institute, discusses maintenance therapy in multiple myeloma.

Following stem cell transplant, maintenance therapy with lenalidomide (Revlimid) is the standard of care, says Berdeja. Although data from the PURPOSE trial have suggested that bortezomib (Velcade) can also be used in select patients, Bordeja cautions that the arm that received bortezomib maintenance also received bortezomib at the time of induction. Physicians are unsure of whether the benefit was due to the patient’s exposure to the proteasome inhibitor (PI) during induction, or their exposure to the PI during maintenance.

At the 2018 ASH Annual Meeting, a study was presented on maintenance with ixazomib (Ninlaro), adds Berdeja. For this trial, investigators set out to answer the question of whether or not a PI as maintenance therapy can improve progression-free survival and overall survival. Although the study follow-up is relatively short, there seems to be an improvement in PFS with maintenance ixazomib, says Bordeja, but whether or not it is superior to lenalidomide maintenance remains to be seen.