The Changing Landscape of Maintenance Therapy in Newly Diagnosed Multiple Myeloma: A Systematic Review With Network Meta-Analysis of the European Myeloma Network (EMN) - Report - MDSpire
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Evolving Approaches to Maintenance Therapy in Newly Diagnosed Multiple Myeloma: A Systematic Review and Network Meta-Analysis from the European Myeloma Network (EMN)

  • By

  • Heinz Ludwig

  • Evangelos Terpos

  • Francesca Gay

  • Niels W. C. J. van de Donk

  • Sarah Bernhard

  • Monika Engelhardt

  • Gordon Cook

  • Fredrik Schjesvold

  • Hermann Einsele

  • Graham Jackson

  • Charlotte Pawlyn

  • María-Victoria Mateos

  • Sonja Zweegman

  • Martin Schreder

  • Meral Beksaç

  • Christoph Driessen

  • Enrique M. Ocio

  • Rakesh Popat

  • Leo Rasche

  • Cyrille Touzeau

  • Pellegrino Musto

  • Annemiek Broijl

  • Meletios Dimopoulos

  • Roman Hajek

  • Mario Boccadoro

  • Pieter Sonneveld

  • June 18, 2026

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Clinical Report: Evolving Approaches to Maintenance Therapy in Newly Diagnosed Multiple Myeloma

Overview

This systematic review and network meta-analysis evaluates maintenance therapy strategies for newly diagnosed multiple myeloma (NDMM). It highlights the established role of lenalidomide maintenance post-autologous stem-cell transplantation.

Background

Maintenance therapy is crucial in the management of NDMM, aiming to prolong remission and improve overall survival while minimizing toxicity. The introduction of novel therapies has prompted a reevaluation of maintenance strategies.

Data Highlights

No specific numerical data or trial results were provided in the source material.

Key Findings

  • Lenalidomide maintenance post-ASCT is the current standard of care, improving progression-free survival (PFS) and overall survival (OS).
  • Continuous treatment for transplant-ineligible patients has shown significant benefits in PFS and OS.
  • Novel immune and cellular therapies are being investigated as potential maintenance options.
  • Recent guidelines emphasize maintenance therapy as a core element of frontline care for NDMM.
  • Long-term follow-up studies indicate improved outcomes with daratumumab maintenance compared to observation.

Clinical Implications

Clinicians should consider the established benefits of lenalidomide maintenance in NDMM while staying informed about emerging therapies that may offer additional advantages. Ongoing evaluation of treatment guidelines will be essential for optimizing patient management.

Conclusion

The evolving landscape of maintenance therapy in NDMM underscores the importance of integrating both established and novel treatment strategies to enhance patient outcomes.

Related Resources & Content

  1. Blood Cancer Journal, 2016 -- The role of maintenance therapy in multiple myeloma
  2. The ASCO Post, 2012 -- Maintenance with Lenalidomide or Bortezomib Prolongs Remission in Elderly Patients with Multiple Myeloma
  3. The ASCO Post, 2014 -- High-Dose Melphalan, Early Stem Cell Transplant, and Lenalidomide Maintenance in Myeloma: One Size Still Does Not Fit All
  4. Treatment of Multiple Myeloma: ASCO Living Guideline, Version 2026.1.1 | Journal of Clinical Oncology
  5. EHA–EMN Evidence-Based Guidelines for diagnosis, treatment and follow-up of patients with multiple myeloma | Nature Reviews Clinical Oncology
  6. Multiple Myeloma, Version 5.2026, NCCN Clinical Practice Guidelines In Oncology - PubMed
  7. The ASCO Post — High-Dose Melphalan, Early Stem Cell Transplant, and Lenalidomide Maintenance in Myeloma: One Size Still Does Not Fit All
  8. Daratumumab with lenalidomide as maintenance after transplant in newly diagnosed multiple myeloma: the AURIGA study - PMC
  9. Daratumumab, Bortezomib, Thalidomide, and Dexamethasone Followed By Daratumumab Maintenance in Transplant-eligible Newly Diagnosed Multiple Myeloma (CASSIOPEIA): >6 Year Update of an Open-label, Randomised, Phase 3 Trial - PMC
  10. Continuous or Fixed-Duration Maintenance Therapy in Multiple Myeloma | New England Journal of Medicine
  11. Treatment of Multiple Myeloma: ASCO Living Guideline, Version 2026.1.1 | Journal of Clinical Oncology
  12. EHA–EMN Evidence-Based Guidelines for diagnosis, treatment and follow-up of patients with multiple myeloma | Nature Reviews Clinical Oncology
  13. Multiple Myeloma, Version 5.2026, NCCN Clinical Practice Guidelines In Oncology - PubMed
  14. Final OS analyses from the TOURMALINE- MM3 and -MM4 RCTs of ixazomib maintenance in newly diagnosed multiple myeloma - PMC
  15. The Changing Landscape of Maintenance Therapy in Newly Diagnosed Multiple Myeloma: A Systematic Review With Network Meta-Analysis of the European Myeloma Network (EMN) - PubMed
  16. Lenalidomide, ixazomib, or daratumumab maintenance therapy in multiple myeloma - PubMed

Original Source(s)

The Changing Landscape of Maintenance Therapy in Newly Diagnosed Multiple Myeloma: A Systematic Review With Network Meta-Analysis of the European Myeloma Network (EMN)

  • by Heinz Ludwig, Evangelos Terpos, Francesca Gay, Niels W. C. J. van de Donk, Sarah Bernhard, Monika Engelhardt, Gordon Cook, Fredrik Schjesvold, Hermann Einsele, Graham Jackson, Charlotte Pawlyn, María-Victoria Mateos, Sonja Zweegman, Martin Schreder, Meral Beksaç, Christoph Driessen, Enrique M. Ocio, Rakesh Popat, Leo Rasche, Cyrille Touzeau, Pellegrino Musto, Annemiek Broijl, Meletios Dimopoulos, Roman Hajek, Mario Boccadoro, Pieter Sonneveld

  • June 18, 2026

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