Elie G. Dib, Hematologist Oncologist at Trinity Health, shared a post on LinkedIn:
“Proud to be part of the ENDURANCE trial team, published this week in the New England Journal of Medicine. This ECOG-ACRIN Cancer Research Group study asked a question that’s hard to answer but essential to get right: how long does maintenance therapy actually need to last?
The answer, after a median follow-up of 86 months: 2 years of fixed-duration lenalidomide maintenance produced overall survival essentially identical to indefinite, continuous therapy (68.6% vs. 69.0% at 7 years) in patients with standard-risk, newly diagnosed multiple myeloma. And patients on the fixed 2-year course had less toxicity and a lower risk of second primary cancers along the way.
As the accompanying NEJM editorial put it, the burden of proof should rest on the intervention, not its absence — and for decades we’ve defaulted to indefinite therapy simply because no one tested whether it was truly necessary. This trial finally did.
This kind of question requires a large, academically driven, multi-site cooperative trial with the patience and infrastructure to randomize patients to less treatment. Grateful to have worked alongside so many outstanding cancer centers across the country on this. Trinity Health’s NCORP site was honored to contribute — a great example of community oncology and academic medicine working side by side.
Most importantly, this gives patients and their physicians real data to have a different conversation: the option to step off therapy after 2 years with confidence, sparing unnecessary treatment burden while preserving strong outcomes. Looking ahead, MRD-guided trials hold real promise for helping us further personalize how long maintenance should last for each patient.”
Title: Continuous or Fixed-Duration Maintenance Therapy in Multiple Myeloma
Authors: Shaji Kumar, Susanna Jacobus, Adam Cohen, Matthias Weiss, Natalie Callander, Avina Singh, Terri Parker, Michael Green, Raymond Thertulien, Benjamin Parsons, Pankaj Kumar, Prashant Kapoor, Aaron Rosenberg, Elie Dib, Daniel Almquist, Jeffrey Zonder, Edward Faber, Zihan Wei, Kenneth Anderson, Sagar Lonial, Paul Richardson, Robert Orlowski, Lynne Wagner, S. Vincent Rajkumar
Read the Full Article on The New England Journal of Medicine
Other posts featuring Elie G. Dib on OncoDaily.