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COMy 2026 | Single-agent versus combination therapy for maintenance therapy in myeloma
Pieter Sonneveld, MD, PhD, Erasmus MC, Rotterdam, The Netherlands, discusses how single-agent maintenance therapy in multiple myeloma (MM) compares with more intensive regimens. Prof. Sonneveld notes that, although lenalidomide has been standard of care for years, combination therapies have shown favorable outcomes in the Phase III IsKia (NCT04483739) and PERSEUS (NCT03710603) trials, and lenalidomide plus daratumumab has the potential to become the new standard. This interview took place at the 12th World Congress on Controversies in Multiple Myeloma (COMy) in Paris, France.
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Transcript
So I think now living in 2026, we have been using single agent maintenance, mainly with lenalidomide, for years and years and years. And all phases of treatment in multiple myeloma have gone from one to two to three or even four agents together, the quadruplets. So why would we continue to do this for maintenance as well? There are alternatives now, for example, combining lenalidomide with daratumumab or other agents, carfilzomib...
So I think now living in 2026, we have been using single agent maintenance, mainly with lenalidomide, for years and years and years. And all phases of treatment in multiple myeloma have gone from one to two to three or even four agents together, the quadruplets. So why would we continue to do this for maintenance as well? There are alternatives now, for example, combining lenalidomide with daratumumab or other agents, carfilzomib. And I think these have been explored now in a couple of clinical trials, including the IsKia trial and the PERSEUS trial. And we have seen that lenalidomide plus daratumumab produces a much higher rate of MRD negativity and also sustained MRD negativity. And this seems to be associated with a better PFS as well. It’s maybe a bit early to give a final judgment about that, but the data as they are now, they look promising. And I think the combination of daratumumab plus lenalidomide will be at least one of the standards for future maintenance regimens in multiple myeloma.
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