Targeted therapy and maintenance in myeloma

Introduction: Maintenance therapy aims to extend progression-free survival (PFS) and overall survival (OS), but the convenience of administration, tolerability and toxicity are essentials. Source of data: A search was conducted to identify published literature and clinical studies about maintenance for multiple myeloma using PubMed and ClinicalTrials. gov. Areas of agreement: There are different drug classes able to ensure durable responses previously achieved after induction followed or not by transplant, translating into a significant benefit in PFS and OS. Areas of controversy: It is not well established the optimal maintenance approach, what the ideal duration of maintenance is, and whether all patients have to receive maintenance therapy. Growing points: To define the role of risk factors and minimal residual disease monitoring for tailored maintenance. Areas timely for developing research: The development of new therapies and monitoring strategies able to individualize the maintenance to prevent both under and overtreatment.