Treatment regimens based on disease sensitivity to lenalidomide
| Disease status . | Preferred treatment options . | Alternative treatment options . | Special considerations . |
|---|---|---|---|
| Len sensitive | Dard, KRd, Elo-Rd, DVd | Ixa-Rd, VRd, KCd | Always encourage participation in clinical trial. If newer drugs not available—Rd, Vd, VTd, VCd, or VMP. |
| Len refractory/intolerance | DKd, PVd, DPd, Isa-Kd | DVd, Kd, KPd, SVd, KCd | Always encourage participation in clinical trial. If newer drugs not available—VCd, Vd, or VMP. |
| Plasma cell leukemia | VD-PACE | If patient has CHF, use DCEP |
| Disease status . | Preferred treatment options . | Alternative treatment options . | Special considerations . |
|---|---|---|---|
| Len sensitive | Dard, KRd, Elo-Rd, DVd | Ixa-Rd, VRd, KCd | Always encourage participation in clinical trial. If newer drugs not available—Rd, Vd, VTd, VCd, or VMP. |
| Len refractory/intolerance | DKd, PVd, DPd, Isa-Kd | DVd, Kd, KPd, SVd, KCd | Always encourage participation in clinical trial. If newer drugs not available—VCd, Vd, or VMP. |
| Plasma cell leukemia | VD-PACE | If patient has CHF, use DCEP |
Bort, bortezomib; CHF, congestive heart failure; DCEP, dexamethasone-cyclophosphamide-etoposide-cisplatin; DKd, daratumumab-carfilzomib-dexamethasone; DPd, daratumumab-pomalidomide-dexamethasone; DRd, daratumumab-lenalidomide-dexamethasone; DVd, daratumumab-bortezomib-dexamethasone; Elo-Rd, elotuzumab-lenalidomide-dexamethasone; Isa-Kd, isatuximab-carfilzomib-dexamethasone; Ixa-RD, ixazomib-lenalidomide-dexamethasone; KPd, carfilzomib-pomalidomide-dexamethasone; KRd, carfilzomib-lenalidomide-dexamethasone; Len, lenalidomide; PVd, pomalidomide-bortezomib-dexamethasone; SVd, Selinexor-bortezomib-dexamethasone; VCd, bortezomib-cyclophosphamide-dexamethasone; VD-PACE, bortezomib-dexamethasone-cisplatin-doxorubicin-cyclophosphamide-etoposide; VMP, bortezomib-melphalan-dexamethasone; VRd, bortezomib-lenalidomide-dexamethasone; VTd, bortezomib-thalidomide-dexamethasone.