Maintenance in myeloma – pro
The treatment meets the plan’s criteria for medical necessity because it required for the treatment or management of a medical condition and commonly recognized as appropriate. In multiple myeloma (MM), maintenance therapy is a longer, less intensive treatment course than initial therapy that is administered postinduction to delay disease progression. Maintenance and continuous therapy have been shown to suppress minimal residual disease and deepen and prolong responses, with the goal of improving progression-free survival and overall survival. Several trials demonstrated the impact of novel agent-based maintenance in newly diagnosed multiple myeloma (NDMM), but there is no current evidence demonstrating the superiority of one regimen over the other, owing to the lack of direct/indirect comparisons.
Richardson PG et al, Maintenance and continuous therapy for multiple myeloma.Expert Rev Anticancer Ther. 2018 Aug;18(8):751-764. Epub 2018 Jul 3.
Susanne Schmitz, Vanessa Buchanan, Joy Leahy, Sujith Dhanasiri, Charlotte Pawlyn and John Ashcroft, Systematic Review and Network Meta-Analysis of Maintenance Treatment for Patients with Newly Diagnosed Multiple Myeloma Post-Autologous Stem Cell Transplant. Blood 2017 130:1832;
Gay F, Jackson G, Rosiñol L, et al. Maintenance Treatment and Survival in Patients With Myeloma: A Systematic Review and Network Meta-analysis. JAMA Oncol. 2018;4(10):13891397.