What is your preferred approach to therapy in transplant ineligible multiple myeloma initially treated with CyBorD owing to acute renal failure, after achieving a VGPR (+IFE alone) with continued mild-moderate renal impairment?

Would you change to an alternative triplet therapy, or switch to maintenance therapy? Are there variations in depth of response short of CR that would influence your decision above? If further triplet therapy were chosen, but lenalidomide were contraindicated due to renal impairment, what regimens would you consider switching to? Would ixazomib offer any additional benefit over bortezomib-containing triplets or maintenance in this setting?