This protocol targets patients with AL amyloidosis whose disease has relapsed or become refractory and who have demonstrated resistance to bortezomib-based therapy — a clinical scenario that calls for a distinct regimen strategy.
Patients in this setting have AL amyloidosis that has progressed on or after prior treatment and is specifically resistant to bortezomib. This resistance pattern directly informs which treatment classes and combinations are appropriate.
For this population, the evidence supports regimens built around either a daratumumab-based or an immunomodulatory agent-based backbone — with specific combinations, sequencing, and clinical selection criteria detailed in the full protocol.
DOI: 10.1200/OP.22.00396
If V-resistant
Dara-based (preferred) or IMiD-based regimen: Rd or Pd with or without Dara; Dara-d
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