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Related Concept Videos

Rational Dosage Regimen: Maintenance Dose and Loading Dose01:24

Rational Dosage Regimen: Maintenance Dose and Loading Dose

A rational dosage regimen considers a drug's pharmacokinetics, including its absorption, distribution, metabolism, and elimination from the body. By understanding these factors, the appropriate dosage can be determined, and the dosing schedule can be designed to achieve and maintain the desired therapeutic effect while minimizing adverse effects.
In most cases, drugs are administered repetitively or infused continuously to maintain a steady-state concentration in the body. At a steady state,...
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Dosage Regimen: Fixed Dose

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Drug Accumulation During Multiple Dosing: Intermittent IV Infusions

Intermittent intravenous (IV) infusion is a method of drug administration where medications are delivered over short infusion periods followed by intervals of no drug delivery. This approach helps to prevent sustained high drug concentrations in the bloodstream, reducing the risk of adverse effects associated with prolonged exposure. Unlike continuous infusion, steady-state concentrations may not be achieved during a single dosing cycle but can be reached through repeated...
Determination of Multiple Dosing Parameters: Loading and Maintenance Doses01:25

Determination of Multiple Dosing Parameters: Loading and Maintenance Doses

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Related Experiment Videos

Continuous or Fixed-Duration Maintenance Therapy in Multiple Myeloma.

Shaji Kumar1, Susanna Jacobus2, Adam Cohen3

  • 1Mayo Clinic, Rochester, MN.

The New England Journal of Medicine
|July 15, 2026
PubMed
Summary

Indefinite-duration lenalidomide maintenance therapy did not significantly improve overall survival compared to fixed-duration therapy in newly diagnosed multiple myeloma patients. Adverse events were more frequent with continuous lenalidomide treatment.

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Area of Science:

  • Hematology
  • Oncology
  • Clinical Trials

Background:

  • Current standard treatment for newly diagnosed multiple myeloma includes lenalidomide maintenance therapy until disease progression.
  • The optimal duration for lenalidomide maintenance therapy has remained an area of uncertainty.

Purpose of the Study:

  • To compare the efficacy and safety of indefinite-duration versus fixed-duration lenalidomide maintenance therapy in patients with standard-risk newly diagnosed multiple myeloma.
  • To evaluate the impact of maintenance therapy duration on overall survival and progression-free survival.

Main Methods:

  • A phase 3 trial enrolled patients with standard-risk newly diagnosed multiple myeloma post-induction therapy.
  • Patients were randomized to receive either continuous (indefinite-duration) or fixed-duration (2 years) lenalidomide maintenance.
  • Overall survival was the primary endpoint, with a planned follow-up of 9 years.

Main Results:

  • Overall survival did not significantly differ between the indefinite-duration and fixed-duration lenalidomide groups at a median follow-up of 86 months.
  • Progression-free survival at 7 years was higher in the indefinite-duration group (36.1%) compared to the fixed-duration group (29.7%).
  • Higher rates of grade 3 or higher nonhematologic adverse events were observed with indefinite-duration lenalidomide (48.2%) versus fixed-duration (31.5%).

Conclusions:

  • Indefinite-duration lenalidomide maintenance therapy did not lead to significantly longer overall survival compared to fixed-duration therapy in this patient population.
  • The findings suggest that a fixed duration of lenalidomide maintenance may be a viable option, balancing efficacy with reduced toxicity.
  • Further research may be warranted to refine maintenance strategies in multiple myeloma.