Optimal maintenance and consolidation therapy for multiple myeloma in actual clinical practice.
Multiple myeloma is an incurable malignant plasma cell-originating cancer. Although its treatment outcomes have improved with the use of glucocorticoids, alkylating drugs, and novel agents, including proteasome inhibitors (bortezomib and carfilzomib) and immunomodulatory drugs (thalidomide, lenalidomide, and pomalidomide), relapse remains a serious problem. Strategies to improve outcomes following autologous stem cell transplantation and frontline treatments in non-transplant patients include consolidation to intensify therapy and improve the depth of response and maintenance therapy to achieve long-term disease control. Many clinical trials have reported increased progression-free and overall survival rates after consolidation and maintenance therapy. The role of consolidation/maintenance therapy has been assessed in patients eligible and ineligible for transplantation and is a valuable option in clinical trial settings. However, the decision to use consolidation and/or maintenance therapy needs to be guided by the individual patient situation in actual clinical practice. This review analyzes the currently available evidence from several reported clinical trials to determine the optimal consolidation and maintenance therapy in clinical practice.
Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea.
Ho Sup
HS
Lee
Division of Hematology, Department of Internal Medicine, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.
Chang-Ki
CK
Min
D000069286:Bortezomib / Q000627:therapeutic use; D060830:Consolidation Chemotherapy / Q000379:methods; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use; D000077269:Lenalidomide; D060046:Maintenance Chemotherapy / Q000379:methods; D009101:Multiple Myeloma / Q000188:drug therapy* / Q000628:therapy; D061988:Proteasome Inhibitors / Q000627:therapeutic use; D033581:Stem Cell Transplantation; D013792:Thalidomide / Q000031:analogs & derivatives / Q000627:therapeutic use; D014182:Transplantation, Autologous
D007155:Immunologic Factors; D061988:Proteasome Inhibitors; D013792:Thalidomide; D000069286:Bortezomib; D000077269:Lenalidomide
Consolidation; Immunologic factors; Maintenance; Multiple myeloma; Proteasome inhibitors