What is your preferred approach to a patient with myeloma who has refractory disease to Dara-VRd in the frontline setting?

Unless the patient is not actually receiving some or all of the Dara-RVd (lenalidomide compliance can be challenging), this functionally defines high risk disease. Most patients don't usually have disease stability for autologous transplant, or even if they are stable for a hot second, transplant pr...

Agreed with @Dr. First Last's and @Dr. First Last's excellent comments. I'd favor KPd as my general option here. And I agree wholeheartedly re: oral Cytoxan not being so useful and hyperCVAD/DCEP being very intense.

UPDATE, SEPTEMBER 2024: The remainder of this response below presumes that second-lin...