Major treatment regimens in MM
Regimen . | Usual dosing schedule . |
---|---|
Frontline | |
VMP | Bortezomib: 1.3 mg/m2 IV, days 1, 8, 15, 22; melphalan: 9 mg/m2 oral, days 1-4; prednisone: 60 mg/m2 oral, days 1-4; repeated every 35 d |
Rd | Lenalidomide: 25 mg oral days 1-21 every 28 d; dexamethasone: 40 mg oral days 1, 8, 15, 22 every 28 d; repeated every 4 wk |
MPT | Melphalan: 0.25 mg/kg oral, days 1-4 (use 0.20 mg/kg per day oral, days 1-4 in patients >75 y of age); prednisone: 2 mg/kg oral, days 1-4; thalidomide 100-200 mg oral, days 1-28 (use 100-mg dose in patients >75 y of age); repeated every 6 wk |
VCD | Cyclophosphamide: 300 mg/m2 orally on days 1, 8, 15 and 22; bortezomib 1.3 mg/m2 intravenously on days 1, 8, 15, 22; dexamethasone 40 mg orally on days 1, 8, 15, 22; repeated every 4 wk |
VTD | Bortezomib: 1.3 mg/m2 IV, days 1, 8, 15, 22; thalidomide: 100-200 mg oral, days 1-21; dexamethasone: 20 mg on day of and day after bortezomib (or 40 mg on days 1, 8, 15, 22); repeated every 4 wk × 4 cycles as pretransplant induction therapy |
VRd | Bortezomib: 1.3 mg/m2 IV days 1, 8, 15; lenalidomide: 25 mg oral, days 1-14; dexamethasone: 20 mg on day of and day after bortezomib (or 40 mg on days 1, 8, 15, 22); repeated every 3 wk |
Relapsed/refractory disease | |
KRd | Carfilzomib 20 mg/m2 (cycle 1) and 27 mg/m2 (subsequent cycles) intravenously on days 1, 2, 8, 9, 15, 16; lenalidomide 25 mg oral days 1 to 21; dexamethasone 20 mg on day of and day after bortezomib (or 40 mg days 1, 8, 15, 22); repeated every 4 wk |
VD-Pano | Bortezomib: 1.3 mg/m2 IV, days 1, 8, 15, 22; dexamethasone: 20 mg on day of and day after bortezomib; panobinostat: 20 mg oral, days 1, 3, 5, wk 1 and 2; repeated every 3 wk (cycles 1-8) |
Kd | Carfilzomib: 56 mg/m2 IV, days 1, 2, 8, 9, 15, 16 (20 mg/m2 d 1, 2, cycle 1 only); dexamethasone: 20 mg, days 1, 2, 8, 9, 15, 16, 22, 23; 28-d cycles |
Rd-Elo | Lenalidomide: 25 mg oral, days 1-21; dexamethasone: 40 mg/wk; elotuzumab: 10 mg/kg IV per week cycle 1 and 2, every other week cycles 3+; repeated every 28 d |
IRd | Lenalidomide: 25 mg oral, days 1-21; dexamethasone: oral 40 mg, days 1, 8, 15, 22; ixazomib: 4 mg oral, days 1, 8, 15; repeated every 28 d |
DVd | Bortezomib: 1.3 mg/m2 subcutaneous, days 1, 4, 8, 11 (cycles 1-8); dexamethasone: 20 mg oral, days 1, 2, 4, 5, 8, 9, 11, 12 (cycles 1-8); daratumumab: 16 mg/kg IV every week (cycles 1-3), every 3 wk (cycles 4-8), every 4 wk (cycles 9+); cycles 1-8: repeated every 21 d; cycles 9+: repeated every 28 d |
DRd | Lenalidomide: 25 mg oral, days 1-21; dexamethasone: 40 mg oral, every week; daratumumab 16 mg/kg IV every week (cycles 1-2), every other week (cycles 3-6), q4w cycles 7+; cycles: 28 d |
Regimen . | Usual dosing schedule . |
---|---|
Frontline | |
VMP | Bortezomib: 1.3 mg/m2 IV, days 1, 8, 15, 22; melphalan: 9 mg/m2 oral, days 1-4; prednisone: 60 mg/m2 oral, days 1-4; repeated every 35 d |
Rd | Lenalidomide: 25 mg oral days 1-21 every 28 d; dexamethasone: 40 mg oral days 1, 8, 15, 22 every 28 d; repeated every 4 wk |
MPT | Melphalan: 0.25 mg/kg oral, days 1-4 (use 0.20 mg/kg per day oral, days 1-4 in patients >75 y of age); prednisone: 2 mg/kg oral, days 1-4; thalidomide 100-200 mg oral, days 1-28 (use 100-mg dose in patients >75 y of age); repeated every 6 wk |
VCD | Cyclophosphamide: 300 mg/m2 orally on days 1, 8, 15 and 22; bortezomib 1.3 mg/m2 intravenously on days 1, 8, 15, 22; dexamethasone 40 mg orally on days 1, 8, 15, 22; repeated every 4 wk |
VTD | Bortezomib: 1.3 mg/m2 IV, days 1, 8, 15, 22; thalidomide: 100-200 mg oral, days 1-21; dexamethasone: 20 mg on day of and day after bortezomib (or 40 mg on days 1, 8, 15, 22); repeated every 4 wk × 4 cycles as pretransplant induction therapy |
VRd | Bortezomib: 1.3 mg/m2 IV days 1, 8, 15; lenalidomide: 25 mg oral, days 1-14; dexamethasone: 20 mg on day of and day after bortezomib (or 40 mg on days 1, 8, 15, 22); repeated every 3 wk |
Relapsed/refractory disease | |
KRd | Carfilzomib 20 mg/m2 (cycle 1) and 27 mg/m2 (subsequent cycles) intravenously on days 1, 2, 8, 9, 15, 16; lenalidomide 25 mg oral days 1 to 21; dexamethasone 20 mg on day of and day after bortezomib (or 40 mg days 1, 8, 15, 22); repeated every 4 wk |
VD-Pano | Bortezomib: 1.3 mg/m2 IV, days 1, 8, 15, 22; dexamethasone: 20 mg on day of and day after bortezomib; panobinostat: 20 mg oral, days 1, 3, 5, wk 1 and 2; repeated every 3 wk (cycles 1-8) |
Kd | Carfilzomib: 56 mg/m2 IV, days 1, 2, 8, 9, 15, 16 (20 mg/m2 d 1, 2, cycle 1 only); dexamethasone: 20 mg, days 1, 2, 8, 9, 15, 16, 22, 23; 28-d cycles |
Rd-Elo | Lenalidomide: 25 mg oral, days 1-21; dexamethasone: 40 mg/wk; elotuzumab: 10 mg/kg IV per week cycle 1 and 2, every other week cycles 3+; repeated every 28 d |
IRd | Lenalidomide: 25 mg oral, days 1-21; dexamethasone: oral 40 mg, days 1, 8, 15, 22; ixazomib: 4 mg oral, days 1, 8, 15; repeated every 28 d |
DVd | Bortezomib: 1.3 mg/m2 subcutaneous, days 1, 4, 8, 11 (cycles 1-8); dexamethasone: 20 mg oral, days 1, 2, 4, 5, 8, 9, 11, 12 (cycles 1-8); daratumumab: 16 mg/kg IV every week (cycles 1-3), every 3 wk (cycles 4-8), every 4 wk (cycles 9+); cycles 1-8: repeated every 21 d; cycles 9+: repeated every 28 d |
DRd | Lenalidomide: 25 mg oral, days 1-21; dexamethasone: 40 mg oral, every week; daratumumab 16 mg/kg IV every week (cycles 1-2), every other week (cycles 3-6), q4w cycles 7+; cycles: 28 d |
q4w, every 4 weeks; Rd-Elo, lenalidomide/dexamethasone/elotuzuman; VD-pano, bortezomib/dexamethasone/panobinostat; VTD, bortezomib/thalidomide/dexamethasone.