That is where I am at now Nick, 2 years got my 1st monthly labs improved slightly. If 3 months of labs show stability will go to testing every 3 months.🙏

It’s a crapshoot. I was offered just maintenance with lenalidomide because they caught my smoldering MM early. I elected to have a transplant and am now on maintenance 10 mgs of Lenolidomide every day for the rest of my life as long as I can hack it or if things change. While I was under treatment before the transplant my research found
That having the transplant would possibly give me a better quality of life later on with the disease. The decision was all mine. Only time will tell if the transplant was worth the suffering and the long recovery. Everyone is in a different situation. Best of luck with whatever you all decide!

@A MyMyelomaTeam Member I didn't totally stop taking the lenalidomide, but I cut back. June/July 21 day cycle ended 07/16. I took it every other day (11/21), blood test scheduled for 07/27.
New 21 starts on 07/24, I'll continue the alternate days method and see what happens on the 27th.
Probably not enough time elapsed for any significant changes, so I will stay with this experiment until the next blood draw on 08/24. Obviously I hope nothing concerning shows up, one way or the other I'll let him know what I tried. I'm sure he'll get PO'd, but if the tests remained normal, maybe he'll consider giving me a break.
The key for all of us post-sct two+ years, especially those who got an sct/melphalan now on lenalidomide maintenance, is to get an accurate MRD test. That will determine if we get a break.

Mentioned Users

A MyMyelo...

Unfortunately, (in terms of new cancer risks) is the fact I had an sct with melphalan 06/24, then maintenance 10mg/Eliquis5 starting 10/24, two years this upcoming September. Supposedly, that is the worst combination (sct, melphalan, lenalidomide) to have gotten, specifically should prolonged use of lenalidomide continues.

Once again, I went to IMF's Myelo to ask:

Do the chances of a relapse increase dramatically if a patient gets a three month break from taking lenalidomide especially since said patient was stable?

This was the answer:

The research shows that discontinuing lenalidomide maintenance therapy doesn't necessarily lead to dramatic increases in relapse risk, particularly for patients who meet specific criteria for stopping treatment.

Key Findings on Lenalidomide Discontinuation:
MRD-Negative Patients Can Safely Stop
Studies demonstrate that patients with multiple myeloma who achieve multimodal minimal residual disease (MRD) negativity can discontinue maintenance therapy with sustained disease control. In the MRD2STOP study, discontinuation of maintenance therapy among patients with MRD-negativity resulted in high rates of sustained MRD-negativity and lack of disease progression at 1 and 2 years of follow-up.

Individual Assessment is Critical
The safety of taking a break from lenalidomide depends heavily on individual factors, including:
• Current disease status and MRD results
• Duration of previous treatment response
• Overall health and risk factors
• Specific clinical circumstances

Important Considerations
While some patients can safely discontinue lenalidomide, this decision should never be made without careful medical evaluation. The research indicates that MRD testing using advanced assays may help identify patients who can safely stop therapy, but this requires specialized testing and expert interpretation.

I firmly believe that after two years on Revlimid/lenalidomide, every patient should get accurate MRD testing. If the results are favorable, then to continue taking Revlimid/lenalidomide is potentially asking for more trouble to arise.

Article suggests just the opposite of what AI suggests.