Results from ENDURANCE, a randomized open-label phase III trial to determine duration of maintenance therapy in patients with newly diagnosed myeloma, has shown that "indefinite-duration maintenance with lenalidomide did not appear to have an overall survival benefit...compared to fixed-duration maintenance therapy for 2 years after induction therapy." Further, progression-free survival after 7 years was 36.1% for the indefinite-duration group compared to 29.7% in the fixed-duration group.
Click here to read more about the ENDURANCE study
Sources mentioned:
- Kumar S, Jacobus S, Cohen, A, et al. Continuous or Fixed-Duration Maintenance Therapy in Multiple Myeloma . N Engl J Med 2026;395(3):221-232.
- Mian H, Costa LJ. Time to Stop? Rethinking the Duration of Maintenance Treatment in Multiple Myeloma . N Engl J Med 2026;395(3):302-303.
An overall survival readout like this deserves attention, because maintenance in myeloma is usually discussed as if more treatment is automatically better — yet continuous lenalidomide means years of toxicity, infection risk and cost for the patient. If fixed-duration therapy delivers the same survival, the counselling conversation changes completely, especially for older patients. This is exactly the kind of practice-questioning result that gets dissected on the onc brothers podcast, since community oncologists are the ones who have to explain why stopping can be the right decision.
ReplyDeleteAn overall-survival readout like this is exactly the kind of practice-questioning result that makes this blog so valuable — when continuous lenalidomide means years of toxicity, infection risk, and cost for no survival gain, 'more treatment' stops being the obvious answer. For older patients especially, the counseling conversation flips completely toward quality of life. It is a reminder that negative results can be just as practice-changing as positive ones.
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