Of three randomized trials testing lenalidomide maintenance in myeloma, a survival benefit is apparent in one. An increased risk of second cancers is seen in all three trials. Maintenance must be considered after a review of risks and benefits, but it is premature to recommend lenalidomide maintenance for all patients.
Key Points
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Insufficient data to recommend routine lenalidomide maintenance to all patients given lack of survival benefit in two of three trials and the risk of second malignancies
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Lenalidomide maintenance can be considered after weighing risks and benefits in patients who fail to achieve a complete response or very good partial response following initial therapy. If maintenance is used, limit maximum duration to 2 years
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Rajkumar, S. Lenalidomide maintenance—perils of a premature denouement. Nat Rev Clin Oncol 9, 372–374 (2012). https://doi.org/10.1038/nrclinonc.2012.100
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DOI: https://doi.org/10.1038/nrclinonc.2012.100
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