Survival Outcomes with Maintenance Therapy Versus Observation for Multiple Myeloma

Maintenance therapy increases survival in patients with multiple myeloma (MM) compared with observation, according to a study published in the European Journal of Haematology.

Researchers conducted a systematic review and meta‐analysis of randomized, controlled trials (RCTs) available in Medline, Embase, and the Cochrane database through February 28, 2020, that compared maintenance therapy versus observation newly diagnosed transplant-ineligible patients with MM.

Two authors independently screened studies for eligibility, extracted data, and assessed risk of bias. Researchers performed meta‐analyses using a random‐effects model and assessed certainty using GRADE methodology.

A total of five RCTs comprising 1,139 patients were included in the final analysis. Patients receiving maintenance therapy had improved progression‐free survival (PFS) compared with observation (hazard ratio [HR], 0.48; 95% confidence interval [CI], 0.38-0.62; high certainty). However, there was no difference in overall survival (HR, 0.96; 95% CI 0.76‐1.2; moderate certainty) between the two management options. Adverse events (AEs) were more common in the maintenance group compared with observation (very low to moderate certainty).

“Maintenance therapy increases PFS in transplant ineligible [patients with] MM following a fixed period of induction therapy; however, this must be weighed against the increased risk of AEs,” the researchers concluded.