D-VRd regimen
| Component | Dosage | Schedule |
| Daratumumab (D) | 1800 mg SC or 16 mg/kg IV | Days 1, 8, 15 of cycles 1-4; Day 1 of cycles 5-6; then every 4 weeks |
| Lenalidomide (R) | 25 mg PO | Days 1-14 of each 21-day cycle |
| Bortezomib (V) | 1.3 mg/m2 SC | Days 1, 8, 15 of each 21-day cycle |
| Dexamethasone (d) | 40 mg PO | Days 1, 8, 15 of each 21-day cycle |
Toxicity profile:
| Adverse Event | D-VRd (%) | VRd (%) |
| Neutropenia (Grade 3/4) | 62.1 | 51.0 |
| Thrombocytopenia (Grade 3/4) | 29.1 | 17.3 |
| Diarrhea (Grade 3/4) | 10.5 | 7.8 |
| Pneumonia (Grade 3/4) | 10.5 | 6.1 |
| Febrile neutropenia | 9.4 | 10.1 |
The D-VRd regimen demonstrated improved depth of response and PFS compared to VRd alone, with a manageable safety profile
The D-VRd regimen demonstrated improved depth of response and PFS compared to VRd alone, with a manageable safety profile[1][11]. The most common grade 3/4 adverse events were hematologic, particularly neutropenia and thrombocytopenia. While some toxicities were increased with D-VRd, the overall safety profile was consistent with the known profiles of daratumumab and VRd individually[11].
Citations:
[1] https://www.targetedonc.com/view/dara-rvd-extends-survival-in-older-multiple-myeloma-patients
[2] https://www.nejm.org/doi/full/10.1056/NEJMoa2312054
[3] https://www.pharmacytimes.com/view/d-vrd-treatment-regimen-demonstrates-better-progression-free-survival-among-transplantation-eligible-patients-with-multiple-myeloma
[4] https://www.onclive.com/view/daratumumab-plus-rvd-as-induction-therapy-improves-responses-survival-in-newly-diagnosed-myeloma
[5] https://www.hematology.org/newsroom/press-releases/2023/lba1
[6] https://ash.confex.com/ash/2023/webprogram/Paper187339.html
[7] https://www.frontiersin.org/journals/oncology/articles/10.3389/fonc.2020.624661/full
[8] https://www.jnj.com/media-center/press-releases/darzalex-daratumumab-based-regimens-significantly-improve-clinical-outcomes-in-both-transplant-eligible-and-ineligible-patients-who-are-newly-diagnosed-with-multiple-myeloma
[9] https://pmc.ncbi.nlm.nih.gov/articles/PMC7903234/
[10] https://www.janssenlabels.com/package-insert/product-monograph/prescribing-information/DARZALEX+Faspro-pi.pdf
[11] https://www.jnj.com/media-center/press-releases/darzalex-faspro-daratumumab-and-hyaluronidase-fihj-based-quadruplet-therapy-regimen-shows-significant-improvement-in-outcomes-for-patients-with-transplant-eligible-newly-diagnosed-multiple-myeloma
[12] https://www.darzalexhcp.com/indications-and-dosing/
[13] https://ashpublications.org/blood/article/136/8/936/454474/Daratumumab-lenalidomide-bortezomib-and