Two Years of Myeloma Maintenance Drug Matches Lifelong Treatment, Trial Finds

The New England Journal of Medicine published the full results of the ENDURANCE trial, shared by the journal’s official account on X. According to the journal, seven-year overall survival rates were similar whether patients received two years of lenalidomide (a drug used to slow cancer progression after initial treatment) or continued taking it for the rest of their lives.

The findings carry a practical weight for patients. Indefinite therapy was associated with more adverse events and a higher rate of second cancers — meaning that stopping at two years did not cost patients survival time, but did appear to reduce those risks.

Multiple myeloma (a cancer of plasma cells in the bone marrow) is typically managed in stages: an initial treatment phase followed by maintenance therapy to keep the disease in check. Lenalidomide has become one of the most widely used maintenance options. The question of how long to continue it has been an open one — until now, the assumption in many cases has been that longer means better.

These results suggest that isn’t necessarily true. Two years may be enough.

The ENDURANCE trial is a phase 3 study, the gold standard for testing treatments in large groups of patients over time. Seven-year follow-up data gives clinicians a long view of outcomes that shorter studies can’t provide. The journal attributed the findings directly to the trial results rather than to any single research team in the post.

Patients currently on lenalidomide maintenance should not stop or change their treatment without speaking to their specialist. Any questions about how these findings might affect an individual treatment plan are best raised at the next clinic appointment or by contacting the clinical team directly.

For general health queries, NHS 111 is available by phone or online. Cancer-specific support is available through Macmillan Cancer Support on 0808 808 00 00.