Role of consolidation/maintenance therapy in multiple myeloma

Multiple myeloma is a highly treatable but still incurable malignancy. Many advances have been made in the treatment of this disease, particularly thanks to the introduction of the immunomodulatory drugs, thalidomide and lenalidomide, and the proteasome inhibitor, bortezomib. Different trials have supported the inclusion of consolidation/maintenance therapy as part of a sequential approach after induction therapy and transplantation (for eligible patients). This therapeutic strategy aims to maintain or even improve response obtained after induction, and ultimately to prolong survival. The role of consolidation/maintenance therapy has been assessed in patients eligible and ineligible for transplantation, and proved to be a valuable option. The improved outcome reported with consolidation/maintenance therapy should, however, be balanced against the toxicity profile of such an approach. Prolonged exposure to a drug might in fact increase toxicity, and prompt management of adverse events is necessary.