ECOG-ACRIN ENDURANCE, a phase 3 trial coordinated through Mayo Clinic, reported that extending lenalidomide maintenance beyond two years did not improve overall survival in patients with standard-risk multiple myeloma. The randomized evidence tests a long-standing practice in which continuous therapy often continued until progression. The trial results, published in the New England Journal of Medicine, directly target the question of when maintenance benefit plateaus, aiming to reduce treatment exposure without sacrificing outcomes. The findings carry practical implications for clinicians balancing efficacy, toxicity, quality of life, and long-term treatment burden. The ENDURANCE readout complements ongoing efforts to refine maintenance strategies by risk category and patient characteristics rather than defaulting to indefinite dosing. For manufacturers, the trial may also influence future demand assumptions for lenalidomide across maintenance-duration segments, especially in standard-risk settings.