Continuous treatment in multiple myeloma: The future?

Major therapeutic advances in the treatment of multiple myeloma (MM) have dramatically improved response rate, remission duration and overall survival. These advances include the introduction of high-dose therapy plus autologous stem cell transplantation in younger patients and, in more recent years, the use of “novel” agents such as Thalidomide, Bortezomib, and Lenalidomide.However, despite this progress, most patient will ultimately relapse and die from resistant disease.The role of maintenance therapy in MM has been investigated for more than 30 years, but evidence of clear benefit has only recently emerged. The widely use of novel agents renewed the concept of maintenance or “continuous” treatment, after high dose therapy, as well as after conventional therapy in elderly patients. Recently, a number of randomized studies showed a benefit from maintenance therapy with these agents, including increased response rate, PFS and even OS.