How Long Does Myeloma Maintenance Therapy Last?

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Topics include: Treatments

So you’ve finished treatment, and your doctor wants to put you on a maintenance therapy. What is it, and how long will you be on this therapy? Dr. John Burke from Rocky Mountain Cancer Centers discusses the role of maintenance therapy as well as including the research and the controversy. 

Sponsored by the Patient Empowerment Network through educational grants from Onyx Pharmaceuticals and Takeda Oncology.

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Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you. 

Mike:

Under multiple myeloma, can a multiple myeloma patient actually after they do the maintenance chemo, can they—if they go on to remission, do they have to take that maintenance chemo forever?  Or can they get off of it, time will tell, and then be checked?   

Dr. Burke:

Great question, and it's an area I think of—of controversy even among the word's experts at myelomas to what exactly is the role of—of maintenance?  What should maintenance consist of?  And how long should it go on?  There are some—some conflicting data from the research studies.  Probably, what maintenance therapy does—and by the way, just to define that for everyone in the room, generally, refers to a low dose of drug therapy often after a stem cell transplant designed to maintain a remission, and so that's what it means.

And the studies suggest that such maintenance therapy keeps the myeloma in remission for longer than if you simply stopped all therapy altogether.  What you really want to do is not just that.  You want it to make you live longer, because it's one thing to keep taking a drug for a long time and have it keep your myeloma under control. But while you're taking the drug, remember, it's causing some side effects, and it might be adversely impacting your quality of life.

And if you would be just as well off doing no therapy for a couple of years and then just taking the drug when your cancer gets worse, you would probably choose that way over maintenance therapy where you got a long exposure to a drug that's causing you side effects.  And so what you really want a maintenance therapy to do is make you live longer.  And there [are] some studies that show that maintenance therapy may do that, but there [are] other studies that haven't quite confirmed that.

And so I think it's an area of controversy and—and ongoing research.  And so exactly how long to do it, if you're going to do it?  I think it’s undefined depending on the drug.  One of the side effects of maintenance lenalidomide (Revlimid®) is other cancers.  We—we know now that after a bone marrow transplant, people who are taking a low dose of lenalidomide for a long time have an increased risk of getting other cancers unrelated to their myeloma compared with if they didn't take any treatment at all. 

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you. 

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Page last updated on December 23, 2015