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Prashant Kapoor, MD, FACP


Induction Regimens in Myeloma: VRd Versus KRd

By: Julia Fiederlein Cipriano, MS
Posted: Tuesday, October 17, 2023

Patients with newly diagnosed multiple myeloma experienced improved progression-free and event-free survival, with a trend toward improved overall survival, from induction therapy with lenalidomide and dexamethasone plus carfilzomib (KRd) versus bortezomib (VRd), according to Neha Korde, MD, of Memorial Sloan Kettering Cancer Center, New York, and colleagues. These results, which were published in Blood Cancer Journal, seemed to be primarily driven by benefits in the high-risk population.  

Using an in-house data query platform, the investigators retrospectively identified patients who received induction therapy with VRd (n = 198) or KRd (n = 191). The median duration of progression-free survival was not reached in either group, with 5-year rates of 56% and 67%, respectively (P = .027). The estimated 5-year event-free survival rate was 34% with VRd and 52% with KRd (P < .001); treatment with VRd also resulted in a lower 5-year overall survival rate (80% vs. 90%; P = .053).

Standard-risk patients achieved 5-year progression-free survival rates of 68% and 75% (P = .20) and overall survival rates of 87% and 93% (P = .13) with VRd and KRd, respectively. In high-risk patients, the median duration of progression-free survival was 41.0 months with VRd versus 70.9 months with KRd (P = .016). This population experienced 5-year overall survival rates of 69% and 88% (P = .044) and progression-free survival rates of 35% and 58%, respectively, with these triplet regimens.

“[This real-world data analysis] provides clinically important information for treating physicians and patients with newly diagnosed multiple myeloma,” the investigators concluded. “Future studies are needed to investigate the role of added monoclonal antibodies to these combination therapies and to investigate the role of measurable residual disease testing for clinical decision-making.”

Disclosure: For full disclosures of the study authors, visit

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