Maintenance is a type of treatment which is administered over a long period of time, typically years, in an effort to sustain or enhance response which has already been achieved with prior therapy. The therapy can be the same or different than prior therapy. However, lower dosages are used and adjusted to achieve and sustain long term efficacy and tolerance.
A related type of treatment used within clinical trials is consolidation, which is administered in a higher dose or more intense fashion over a few days or weeks to achieve further reduction in myeloma tumor burden. Consolidation is not a “standard of care” approach to myeloma therapy.
Clinical trials have shown benefits with several types of maintenance including older forms such as with steroids (prednisone or dexamethasone) and α-interferon as well as more recent therapies such as Thalidomide, Revlimid®, and Velcade®. Currently, many questions remain, including ideal candidates, drug or combinations to use, ideal duration of therapy and risk factors for short term and/or longer term side effects, toxicities or complications.
Consolidation and maintenance are both ways to achieve a better response either within a few months or with ongoing therapy. The clear benefits still need to balanced against quality of life issues and costs -- and discussed on an individual basis.
©2015 International Myeloma Foundation