The goal of maintenance therapy is to prevent a relapse once a patient is in remission. Maintenance therapy has been successfully used in several hematologic malignancies, such as multiple myeloma and lymphoma. In acute myeloid leukemia (AML), the role of maintenance therapy has historically been less clear. But we now have data from the QUAZAR study demonstrating a survival benefit derived from oral azacitidine maintenance among AML patients who were ineligible for transplant.1 The median overall survival in the QUAZAR study in the patients who received oral azacitidine was 24.7 months, compared to 14.8 months in the placebo patients. So maintenance appears to be beneficial in this population. The other setting where maintenance therapy has had success is in FLT3-positive AML patients who are in remission and who are ineligible or unwilling to undergo transplant.

Reference:

1. Wei AH, Döhner H, Pocock C, et al. Oral azacitidine maintenance therapy for acute myeloid leukemia in first remission. N Engl J Med. 2020;383(26):2526-2573.