Quadruplet Regimens for NDMM
Frontline therapy
Frontline therapy is the first treatment given to patients with newly diagnosed multiple myeloma (NDMM). Frontline therapy has a long-term effect on patients with myeloma as their first remission is usually their longest. This is why the choice of frontline therapy is so important for patients. Myeloma doctors strive for higher response rates with lower rates of side effects. Response to treatment refers to a clinically meaningful improvement in the signs and symptoms of myeloma.
Biology of myeloma
The biology of myeloma is complex. Extensive research has established that myeloma is controlled better with multiple drugs from different drug classes than with a single drug. Different mechanisms of action (MoA), the process through which a drug induces its effect in the body, have different ways of attacking myeloma. Each drug can enhance the activity of the other drugs in a combination therapy.
Triplet regimens
For many years, the standard of care for patients with NDMM was the “triplet” (3-drug) combination of the proteasome inhibitor Velcade® (bortezomib) + the immunomodulatory agent Revlimid® (lenalidomide) + the steroid dexamethasone [VRd]. The other commonly used triplet, primarily for transplant-ineligible patients, has been the monoclonal antibody Darzalex® (daratumumab) + Revlimid + dexamethasone [DRd]. (continues on reverse side)