OnCo
termsTerm

Maintenance therapy

aka maintenance, maintenance treatment, switch maintenance, continuation maintenance, PARP maintenance, lenalidomide maintenance, until progression, treat to progression, indefinite therapy

A gentler, ongoing treatment given after the main course to keep the cancer from returning, sometimes for years or until it progresses. Its value is judged against the burden of never stopping.

PARP inhibitor maintenance after platinum response transformed ovarian cancer (SOLO-1, PRIMA, PAOLA-1). Lenalidomide maintenance after autologous transplant is standard in myeloma; rituximab maintenance extends remission in follicular lymphoma; pemetrexed or immunotherapy continues after platinum doublets in lung cancer; avelumab maintenance after chemotherapy in urothelial cancer (JAVELIN Bladder 100) improved survival. Costs are cumulative toxicity, financial burden and the risk that a drug used to progression cannot be re-used, hence trials of fixed-duration or MRD-guided stopping, and of maintenance intensification with newer agents (tucatinib in HER2CLIMB-05).

Category
Treatment jargon

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