A large national cooperative group clinical trial led by Mayo Clinic researchers found that continuing maintenance therapy with lenalidomide beyond two years after initial treatment for standard-risk multiple myeloma did not improve overall survival compared with stopping treatment after two years. The survey results are New England Medical Journalmay help physicians and patients make more informed decisions about the duration of maintenance therapy.
It is often thought that the longer the treatment period, the better, but this is not always the case. As treatments become more effective, it is becoming increasingly important to determine not only which treatments are effective, but also how long patients need them. ” The researchers say this discovery could make treatment less burdensome for many patients and reduce the costs associated with years of ongoing treatment.
Dr. Shaji Kumar, Mayo Clinic hematologist and study principal investigator
“Knowing that maintenance therapy can be safely terminated after a defined period of time could reduce the need for long-term treatment for patients,” said S. Vincent Rajkumar, M.D., a Mayo Clinic hematologist and chair of the ECOG-ACRIN Cancer Research Group’s Myeloma Committee, who led the study. “These findings support informed, shared decision-making between doctors and patients.”
New treatments for multiple myeloma over the past two decades have improved survival rates, and some patients are now experiencing long-term disease control. This study applies specifically to standard-risk multiple myeloma patients who did not undergo prior stem cell transplantation.. Additional studies are underway to determine the optimal duration of maintenance therapy for patients with high-risk disease and to examine whether measurable residual disease testing can be used to adjust treatment duration.
“This study is a reminder that clinical trials should not just focus on adding new treatments,” Dr. Kumar says. “It should also help us understand when it is safe to stop treatment.”
The study was designed and conducted by the ECOG-ACRIN Cancer Research Group through the National Clinical Trials Network, with support from the National Cancer Institute of the National Institutes of Health. Amgen provided additional support.
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Reference magazines:
Kumar, S. Others. (2026) Continuous or fixed-term maintenance therapy in multiple myeloma. New England Medical Journal. DOI: 10.1056/NEJMoa2600157. https://www.nejm.org/doi/full/10.1056/NEJMoa2600157
