Latest Cancer TreatmentsDr. Mohammadreza Dabiri
Dr. Mohammadreza Dabiriفارسی
Treatment regimen

DRd regimen (daratumumab, lenalidomide, dexamethasone) in myeloma

Transplant-ineligible patients (MAIA)

Updated: 28 October 20261 min read3 references

Summary for doctors

  • Newly diagnosed myeloma in transplant-ineligible patients [1].
  • Continuous treatment until progression [1].

Dose and schedule

DRd

Newly diagnosed myeloma, transplant-ineligibleEach drug’s schedule in the table

Newly diagnosed myeloma, transplant-ineligible

DrugDoseRouteSchedule
Daratumumab16 mg/kg IV (or 1800 mg subcutaneous)IV or subcutaneousWeekly in cycles 1 and 2; every 2 weeks in cycles 3 to 6; then every 4 weeks
Lenalidomide25 mgOralDays 1 to 21
Dexamethasone40 mg (20 mg over 75 years or with a BMI below 18.5)OralWeekly
Cycle schedule
Every 28 days
Duration
Until progression

As in MAIA [1].

Dose source: [2, 3].

Evidence: MAIA (2019)

Doses follow the trial protocol, guideline or official drug label (source given in the notes of each regimen). Before prescribing, check blood counts, renal and hepatic function, drug interactions and the patient’s condition, and adjust the dose according to the drug label.

Premedication and supportive care

  • Daratumumab premedication and blood group typing before starting; aciclovir; thrombosis prophylaxis.

Monitoring and dose adjustment

  • Adjust lenalidomide for kidney function; neutropenia and pneumonia are more common [1].
  • In frail older patients, dexamethasone is reduced or stopped after a few cycles.

Main evidence

Show detailsHide

MAIA: 30-month progression-free survival 70.6% with DRd vs 55.6% with Rd [1]; with longer follow-up, overall survival was also longer.

Related cancer types

Multiple myeloma

Treatment regimens (physicians)

VRd and D-VRd regimens in myelomaKRd regimen (carfilzomib, lenalidomide, dexamethasone) in myeloma

Physician tools and lessons

HCT-CI Comorbidity Index Before Stem Cell TransplantationMyeloma Staging Calculator: ISS, R-ISS and R2-ISSIndications for haematopoietic stem cell transplantation, donor selection and conditioningGraft-versus-host disease (GVHD): prophylaxis, grading and treatmentBone-modifying agents in cancer: bone metastases, adjuvant use and osteonecrosis of the jaw

References

3 references
Show all references, 1 with a study cardClose the reference list

Numbers in the text, such as [1], refer to these sources. Sources with a “Study card” button are summarised in the site’s evidence library.

  1. 1
    Daratumumab plus Lenalidomide and Dexamethasone for Untreated MyelomaFacon T, Kumar S, Plesner T, et al · N Engl J Med · 2019;380:2104-2115
    Study cardDOIPubMed Back to text: 1 2 3 4 5
  2. 2
    DARZALEX (DARATUMUMAB) — Prescribing InformationJanssen Biotech, Inc · FDA label · 2026
    Source Back to text
  3. 3
    REVLIMID (LENALIDOMIDE) — Prescribing InformationCelgene Corporation · FDA label · 2026
    Source Back to text

This page is based on reputable scientific sources and was last updated on 28 October 2026. The content of this website is for educational and informational purposes only and does not replace consultation, diagnosis or treatment by a specialist physician. Consult your treating physician about any treatment decision.

Printed from the website; the full and up-to-date version: https://drdabiri.com/en/regimens/drd-myeloma/

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