Treatment of Relapsed/Refractory Multiple Myeloma Refractory to Lenalidomide and Bortezomib

Clinical Scenario

This protocol applies to patients with relapsed and/or refractory multiple myeloma whose disease has become refractory to both lenalidomide and bortezomib, but who have not developed refractoriness to anti-CD38 antibodies — a specific double-refractory setting with distinct treatment options.

Defining Features of This Population

All of the following apply:

Relapsed and/or refractory disease Refractory to lenalidomide Refractory to bortezomib Not refractory to anti-CD38 antibodies

Treatment Approach

Current evidence-based guidelines recommend several treatment options for this double-refractory setting, including a cellular therapy approach for eligible patients as well as combination antibody-based regimens. The full structured protocol — covering all recommended options and their selection criteria — is accessible below.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1038/s41571-025-01041-x

Patients with disease both refractory to lenalidomide and bortezomib, and who have not received or have disease sensitive to anti-CD38 antibodies should receive cilta-cel, BelaPd, DaraKd or IsaKd [I, A], or DaraPd [II, B].

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