{"entity":{"id":"vrd","kind":"term","name":"VRd and Dara-VRd (myeloma induction regimens)","aka":["VRd","RVd","Dara-VRd","D-VRd","Isa-VRd","Dara-Rd","DRd","KRd","Dara-KRd","VMP","Dara-VMP","VCd","bortezomib-based","lenalidomide-based","CD38 antibody + PI + IMiD","PI + IMiD + dexamethasone"],"tldr":"The alphabet soup of myeloma treatment: V (bortezomib, Velcade), R (lenalidomide, Revlimid), d (dexamethasone), Dara (daratumumab), Isa (isatuximab), K (carfilzomib). Dara-VRd, a four-drug quadruplet, is now the standard first treatment for most patients.","summary":"VRd was the standard triplet for a decade (SWOG S0777). Adding a CD38 antibody made quadruplets standard: Dara-VRd before and after autologous transplant (PERSEUS) and in transplant-ineligible patients (CEPHEUS), Isa-VRd in IMROZ, with Dara-Rd (MAIA) for frailer patients. Bortezomib causes neuropathy and is often dropped after induction; lenalidomide continues as maintenance. MRD negativity rates above 60% with quadruplets are prompting trials of MRD-guided de-escalation and of CAR-T or bispecifics in place of transplant (CARTITUDE-5/6).","asOf":"2026-09-09","wikipedia":"https://en.wikipedia.org/wiki/Multiple_myeloma#Treatment","links":[{"label":"Wikipedia","url":"https://en.wikipedia.org/wiki/Multiple_myeloma#Treatment"}],"tags":[],"related":["proteasome-inhibitor","imid","autologous-transplant","umrd","doublet-triplet"],"cancers":["multiple-myeloma"],"sections":["chemotherapy","targeted-therapy"],"technologies":[],"targets":[],"drugs":["bortezomib","lenalidomide","daratumumab"],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":["cartitude-4"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"category":"Treatment jargon"},"route":"/terms/vrd/","neighbours":{"term":[{"id":"autologous-transplant","kind":"term","name":"Autologous stem cell transplant (ASCT)","route":"/terms/autologous-transplant/"},{"id":"doublet-triplet","kind":"term","name":"Doublet, triplet and quadruplet regimens","route":"/terms/doublet-triplet/"},{"id":"imid","kind":"term","name":"Immunomodulatory drugs (IMiDs) and CELMoDs","route":"/terms/imid/"},{"id":"proteasome-inhibitor","kind":"term","name":"Proteasome inhibitor (bortezomib, carfilzomib, ixazomib)","route":"/terms/proteasome-inhibitor/"},{"id":"umrd","kind":"term","name":"Undetectable MRD (uMRD / MRD-negative)","route":"/terms/umrd/"}],"cancer":[{"id":"multiple-myeloma","kind":"cancer","name":"Multiple myeloma","route":"/cancers/multiple-myeloma/"},{"id":"myeloma-transplant-eligible","kind":"cancer","name":"Newly diagnosed multiple myeloma, transplant-eligible","route":"/cancers/myeloma-transplant-eligible/"},{"id":"myeloma-transplant-ineligible","kind":"cancer","name":"Newly diagnosed multiple myeloma, transplant-ineligible","route":"/cancers/myeloma-transplant-ineligible/"}],"section":[{"id":"chemotherapy","kind":"section","name":"Chemotherapy","route":"/fronts/chemotherapy/"},{"id":"targeted-therapy","kind":"section","name":"Targeted Therapy","route":"/fronts/targeted-therapy/"}],"drug":[{"id":"bortezomib","kind":"drug","name":"Bortezomib","route":"/drugs/bortezomib/"},{"id":"daratumumab","kind":"drug","name":"Daratumumab","route":"/drugs/daratumumab/"},{"id":"lenalidomide","kind":"drug","name":"Lenalidomide","route":"/drugs/lenalidomide/"}],"trial":[{"id":"cartitude-4","kind":"trial","name":"CARTITUDE-4","route":"/trials/cartitude-4/"}]}}