David S. Siegel, MD, PhD, of the John Theurer Cancer Center at Hackensack University Medical Center in New Jersey, commented to The ASCO Post that essentially all patients with multiple myeloma could be candidates for maintenance therapy. “But I don’t know that we have established that maintenance therapy is unequivocably the right way to go,” he said.
“These trials are not necessarily designed to answer that question in an absolute sense,” he noted. “It’s hard to do a trial that has a real survival endpoint,” which is what needs to be determined in order to understand the true benefit of continuing therapy, he said. Dr. Siegel does not use maintenance therapy in patients posttransplant, but he does continue patients on drug therapy indefinitely outside the context of transplant, he explained. ■
Disclosure: Dr. Siegel has been an advisor for Celgene and Millennium.
The benefit of maintenance therapy in newly diagnosed multiple myeloma patients ineligible for stem cell transplant, such as the elderly, is still debated, though value appears to be emerging, according to studies presented at the 2011 American Society of Hematology (ASH) Annual Meeting....