03163nam a2200277 4500 ESSALUD 20260804154305.0 ta t pe ||||| |||| 00| 0 spa d BMG eng Kumar, Shaji Autor 53732 Continuous or fixed-duration maintenance therapy in multiple myeloma páginas: 221-232 Background: Current treatment of newly diagnosed multiple myeloma involves lenalidomide maintenance therapy given until disease progression. The appropriate duration of maintenance therapy with lenalidomide has been unclear. Methods: In this phase 3 trial, we enrolled patients with standard-risk newly diagnosed multiple myeloma who were not undergoing up-front autologous stem-cell transplantation. After induction treatment with a proteasome inhibitor–lenalidomide combination, patients were randomly assigned to receive indefinite-duration (continuous) lenalidomide or fixed-duration lenalidomide (for 2 years). The primary end point was overall survival; the trial had 80% power to detect a 50% increase in median survival (from 5 years to 7.5 years), with a two-sided alpha level of 5%, 395 patients undergoing randomization, and 204 deaths occurring during 9 years of follow-up. Results: At the end of induction, 516 patients were randomly assigned to the indefinite-duration group (260 patients) or the fixed-duration group (256 patients). At a median follow-up of 86 months, overall survival did not differ significantly between the groups. With 80 deaths in each group, overall survival at 7 years was 68.6% in the indefinite-duration group and 69.0% in the fixed-duration group (difference, −0.4 percentage points; 95 confidence interval [CI], −9.0 to 8.3; P=0.93). Progression-free survival at 7 years was 36.1% in the indefinite-duration group and 29.7% in the fixed-duration group (difference, 6.4 percentage points; 95% CI, −2.6 to 15.4). The 5-year cumulative incidence of second primary cancers, excluding nonmelanoma skin cancer, was 11.2% with indefinite-duration lenalidomide and 8.3% with fixed-duration lenalidomide. More adverse events occurred with indefinite-duration lenalidomide; the incidence of nonhematologic events of grade 3 or higher was 48.2% with indefinite-duration therapy and 31.5% with fixed-duration therapy. Conclusions: In this phase 3 trial involving patients with standard-risk newly diagnosed multiple myeloma who were not undergoing up-front autologous stem-cell transplantation, indefinite-duration maintenance therapy after induction therapy did not result in significantly longer overall survival than fixed-duration maintenance therapy. LEUCEMIA 33873 LIMFOMA 53733 TRATAMIENTOS EN ONCOLOGÍA 53734 Jacobus, Susanna 53735 Cohen, Adam 53736 Weiss, Matthias 53737 Callander, Natalie 53738 Singh, Avina 53739 22717 22636 Massachusetts NEJM Group NEJM003 The New England Journal of Medicine ESSALUD 0028-4793 ARTICULOS 2026-07-31 SQB 22736 22736