Moving Toward Continuous Therapy in Multiple Myeloma.

The introduction of novel agents, characterized by favorable toxicity profiles and higher manageability compared to conventional drugs employed in the past, has considerably changed the treatment paradigm for multiple myeloma. Continuous therapy currently represents the standard approach for myeloma patients both at diagnosis and at relapse. In younger patients, long-term maintenance after autologous transplantation significantly improved progression-free survival and overall survival compared to observation. Also in transplant-ineligible patients, continuous treatment with combinations of newer agents and maintenance treatment following a more intense induction phase proved to be superior as compared to fixed-duration therapy. Maintenance and continuous therapy at diagnosis have shown to deepen responses and suppress minimal residual disease. At relapse, continuous therapy allowed better disease control over time. This review covers the main evidence supporting the use of continuous therapy in multiple myeloma as well as the open issues, such as the optimal agents to be used and the optimal candidates for receiving them.
Competing Interests: FG has received honoraria from Amgen, Bristol-Myers Squibb, Celgene, Janssen, Takeda, and served on the advisory boards for Amgen, Bristol-Myers Squibb, Celgene, Janssen, Roche, Takeda, and AbbVie. AL has received honoraria from Amgen, Bristol-Myers Squibb, Celgene and Janssen; has served on the advisory boards for Bristol-Myers Squibb, Celgene, Janssen, and Takeda. The remaining authors declare no competing financial interests.
(© 2019 International Academy for Clinical Hematology. Publishing services by Atlantis Press International B.V.)