COMy 2025 | Reviewing the evolving role of maintenance therapy in multiple myeloma

Well, my discussion in this meeting will be about the value of maintenance as we see it as a developing and evolving therapeutic paradigm. And I’m sharing the session with Dr Xavier Leuleu, and Xavier is going to focus more on the very specific role of maintenance after transplant. But obviously maintenance is integral to all treatment that we now do in myeloma as we think about continuous treatment. So in that context, I review the rationale for maintenance and the rationale for maintenance until progression and or intolerance. And most importantly, how vital a maintenance strategy is, in my opinion, for older patients and younger patients. And obviously now we’re seeing a number of patients choosing to keep transplant in reserve and defer the option of high-dose melphalan with stem cell support, collect cells and continue on their quadruplet therapy and then taper to a maintenance strategy. So we review that data and some of the really remarkable results we’ve had, for example, from the IMROZ study and also most recently from the CEPHEUS trial with progression-free survival estimates that are really unprecedented. So that’s kind of where I go with the talk to sort of explain to people why it’s important to use maintenance, why it’s important for it, in my opinion, to be continuous and what data support that position. And I think a key other second point is the evolving treatment options that we have as maintenance, starting with the lenalidomide backbone, the addition of proteasome inhibitors, and then the really exciting data that shows the addition of a monoclonal antibody makes an enormous difference, not just in induction, but as part of maintenance. So we’ll review daratumumab and its role, as well as, of course, the role of isatuximab in that space.

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