Management of 1st Relapse Multiple Myeloma

Authored by Rajshekhar Chakraborty, published on 2026-06-16 15:42:52.0

  1. Multiple Myeloma 1st Relapse
    • Anti-CD38 mAb-naive (Lenalidomide-exposed/refractory)
      • Preferred / Alternatives (Anti-CD38 mAb-naive)
        Preferred: 1st choice: Tec-Dara* [MajesTEC-3] 2nd choice: Cilta-cel [CARTITUDE-4] 3rd choice: Tal-Dara* (Pom) [MonumenTAL-3] *While BsAbs have been approved as continuous therapy until progression, it is reasonable to discontinue after 12-18 months in responding patients. Alternatives/Less Preferred: Bela-Vd [DREAMM-7] Bela-Pd [DREAMM-8] Dara-Kd [CANDOR] Isa-Kd [IKEMA]
    • Anti-CD38 mAb-exposed (Lenalidomide-exposed/refractory)
      • Preferred / Alternatives (Anti-CD38 mAb-exposed)
        Preferred: 1st choice: Tec-Dara* [MajesTEC-3] 2nd choice: Cilta-cel [CARTITUDE-4] 3rd choice: Tal-Dara* (Pom) [MonumenTAL-3] *While BsAbs have been approved as continuous therapy until progression, it is reasonable to discontinue after 12-18 months in responding patients. Alternatives/Less Preferred: Bela-Vd [DREAMM-7] Bela-Pd [DREAMM-8] Dara-Kd [CANDOR] Isa-Kd [IKEMA]
    • Anti-CD38 mAb-refractory (Lenalidomide-exposed/refractory)
      • Preferred / Alternatives (Anti-CD38 mAb-refractory)
        Preferred: Cilta-cel [CARTITUDE-4] or Teclistamab [MajesTEC-9] Alternatives/Less Preferred: Mezi-Kd [SUCCESSOR-2] Bela-Pd [DREAMM-8]
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