The question, “should multiple myeloma patients undergo low-dose metronomic or maintenance therapy?” depends on your goals. As usual, the devil is in the details.
The good news:
- According to the study linked below, there is an overall survival (OS) benefit with maintenance therapy. The question to consider is how much toxicity should you undergo?
Keep in mind:
- toxic long-term maintenance therapy increases the risk of treatment related secondary cancer.
- According to the study linked below there are a small number of patients whose disease will be well controlled for a long period following primary therapy.
- Even low-doses of cytotoxic drugs are toxic. You may experience collateral damage.
The answer, in my opinion, is to undergo maintenance therapy but 1) make sure you have a really a low dose if the therapy is toxic. And secondly, add evidence-based, complimentary and integrative therapies. Research shows that specific non-toxic therapies can enhance the efficacy of Revlimid while reducing its toxicity.
Consider adding evidence-based, anti-MM therapies such as nutrition, supplementation, CBD oil, lifestyle, bone health and mind-body therapies.
“Yes…There are a small number of patients whose disease will be well controlled for a long period following primary therapy. However, we are not able to prospectively identify these patients. In the absence of predictive biomarkers, all patients with multiple myeloma can potentially benefit from continuous therapy after primary induction treatment.
The 26% reduction in risk for death represented an estimated 2.5-year increase in median survival.