onkommon.com
Systemic therapy
Maintenance therapy
Lower-intensity treatment continued after the main course, to hold a response.
What it is
Maintenance is treatment continued after the intensive phase has done its work, usually a single, better-tolerated agent, given to keep disease controlled rather than to shrink it further.
The trade-off is explicit and personal: continuing costs money, time and side effects indefinitely; stopping risks losing control sooner. That is a conversation, not a default.
When it is used
- After a response to first-line treatment, in defined disease settings
- Where a well-tolerated agent exists that can be continued
- Where the patient, informed of the trade-off, wants to continue
How the decision is made
- What maintenance is expected to add, stated honestly rather than assumed.
- How long, indefinitely, or to a defined stop point, and what triggers a review.
- The cumulative cost, because this is a recurring expense with no natural end.
- The cumulative toxicity, particularly neuropathy and fatigue, which build quietly.
Oral at home, or periodic infusion at a partner unit.
Who does what
What we handle, and what happens elsewhere
KPCIRC handles
- The maintenance decision and its stated goal at the board
- A scheduled review point, not an open-ended prescription
- Cumulative toxicity monitoring
- Cost review as the months accumulate
- A documented plan for stopping
Performed and billed elsewhere
- The medicine
- Infusions where given
- Surveillance imaging
- Maintenance side effects accumulate slowly enough to be normalised. Report changes in sensation, balance or stamina, those are the ones patients tolerate for too long.
Questions to ask your own doctor
Take these with you. They work whether or not you are treated here.
- What is maintenance expected to achieve for me?
- For how long, and what would make us stop?
- What does it cost per month, indefinitely?
- What are the side effects that build up over time?
Support that goes with it
Where this is used
Cancers this commonly forms part of
Not sure this is the right option for you?
That is exactly what a second opinion is for. Bring what you have, we will tell you what is missing and what the alternatives actually are, in writing.