Treatment of Relapsed or Refractory Multiple Myeloma After One Prior Line of Therapy
This protocol is for patients with relapsed and/or refractory multiple myeloma who have received one prior line of therapy and retain bortezomib-sensitive disease, with no exposure to lenalidomide or an anti-CD38 antibody. The treatment landscape at this stage is guided specifically by those prior-therapy characteristics.
This scenario applies when:
- Relapsed and/or refractory multiple myeloma
- Exactly one prior line of therapy received
- Bortezomib-sensitive disease
- No prior treatment with lenalidomide
- No prior treatment with an anti-CD38 antibody
Treatment Approach
For patients meeting this profile, preferred regimens involve anti-CD38 antibody-based triplet combinations, with several evidence-based options available depending on individual patient factors. A range of additional approved regimens — triplets and doublets — is also available for specific circumstances. The complete regimen selection, sequencing guidance, and supporting evidence are in the full protocol.
References
DOI: 10.1038/s41571-025-01041-x
- Patients who have received a bortezomib-based regimen upfront without lenalidomide or an anti-CD38 antibody and have bortezomib-sensitive disease should preferably receive DaraRd, DaraKd, IsaKd or BelaVd [I, A].
- Other approved regimens include KRd, IxaRd, EloRd, SelVd and Kd [I, A].
- In patients who have received lenalidomide, BelaPd is also an efficacious option [I, A].
- DaraVd or PVd can also be used if BelaVd or BelaPd, respectively, is unavailable [panel consensus; I, A].
View source ↗