What is your preferred first line treatment regimen for patients with untreated transplant-ineligible MM?  

For transplant-ineligible patients, there are many excellent choices, including RVD lite and Dara Rd. My practice has shifted to Dara Rd for several reasons: The HR for Dara Rd v. Rd which is 0.56 appears to be better than the HR for RVd v. Rd in SWOG 0777, where it was 0.712 (though it should be n...

I was asked to give an update two years later, and evidently, some things haven't changed :) Still an ongoing debate between Dara-Rd and VRd-lite, although I'd argue (as others have below) that more and more physicians are going with Dara-Rd.This is based on the very impressive updated MAIA results ...

Based on data from phase three clinical trials, the combination of Lenalidomide with either daratumumab or bortezomib can be considered as initial therapies for patients with transplant-ineligible multiple myeloma. The choice between these two therapies may depend on preexisting comorbidities like p...

The initial process of choosing the right treatment for a patient with previously untreated myeloma without the intent to transplant, whether that's due to personal preference, age, co-morbidity, or other factors, starts with frailty assessment. This may be quick and informal in a younger patient wi...

For high-risk and ultra-high-risk patients, we prefer to put them on trial. If a patient was truly transplant ineligible, we have tended to use continuous anti-CD38-VRD or anti-CD38 plus CYBorD for high-risk patients who are not going to proceed to transplant. We have also started to monitor sustain...