The Changing Landscape of Maintenance Therapy in Newly Diagnosed Multiple Myeloma: A Systematic Review With Network Meta-Analysis of the European Myeloma Network (EMN).

Authors

Heinz Ludwig, Evangelos Terpos, Francesca Gay, Niels W C J van de Donk, Sarah Bernhard, Monika Engelhardt, Gordon Cook, Fredrik Schjesvold, Hermann Einsele, Graham Jackson, Charlotte Pawlyn, María-Victoria Mateos, Sonja Zweegman, Martin Schreder, Meral Beksaç, Christoph Driessen, Enrique M Ocio, Rakesh Popat, Leo Rasche, Cyrille Touzeau, Pellegrino Musto, Annemiek Broijl, Meletios Dimopoulos, Roman Hajek, Mario Boccadoro, Pieter Sonneveld

Published in

American journal of hematology. Jun 18, 2026. Epub Jun 18, 2026.

Abstract

We performed a comprehensive review with meta- and network meta-analyzes of maintenance-therapy studies. Lenalidomide, proteasome inhibitors, and CD38 antibodies improved progression-free survival (PFS). However, overall survival (OS) benefit appeared only with lenalidomide in transplant-eligible (TE) patients, while CD38-directed therapy showed a trend toward improved OS not seen with proteasome inhibitors. The network meta-analysis ranked regimens against observation: daratumumab-lenalidomide (DR) yielded the greatest PFS benefit, followed by carfilzomib-lenalidomide-dexamethasone (KRd), KR in TE, and DRd in transplant-ineligible patients. Significant OS prolongation in TE patients occurred with KR, DR, and lenalidomide alone.

PMID:
42315477
Bibliographic data and abstract were imported from PubMed on 19 Jun 2026.

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