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 no...

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 a patient with newly diagnosed multiple myeloma who is considered ineligible for autologous stem cell transplantation, the choice of initial treatment depends on age and functional status. In addition, the presence of high-risk disease will also influence the choice of initial therapy as well as...

Presented at the ASH 2024, the multicenter, open-label, randomized, phase 3 CEPHEUS trial was the first phase 3 study of daratumumab with MRD as a primary endpoint in patients with newly diagnosed multiple myeloma who are transplant ineligible or when transplant is deferred. In this trial, the addit...

Fortunately, we have several regimens available to treat newly diagnosed MM that are based on high-quality phase 3 studies. In addition, the options among transplant-eligible and transplant-ineligible patients are becoming increasingly aligned, particularly regarding the incorporation of monoclonal ...

In my practice, I do use both quadruplet and triplet regimens in newly diagnosed MM, based on assessments of frailty and comorbidities. As an example, I recently treated two individuals, both 78. One had a history of Afib, type II diabetes, and a long history of cyclic vomiting syndrome. For this in...

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...

I try to take into consideration the patient's myeloma risk, their fitness level, and also issues such as distance from our clinic, options for treatments close to home, presence of a caregiver, financial burden of treatments (such as cost of meds, transportation), and comorbidities, e.g., existing ...