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

KRd regimen (carfilzomib, lenalidomide, dexamethasone) in myeloma

Relapsed myeloma (ASPIRE)

Updated: 28 October 20261 min read3 references

Summary for doctors

  • Relapsed myeloma after 1 to 3 previous treatments [1].
  • Carfilzomib is stopped after cycle 18 and Rd continues [2].
  • Hydration before cycle 1, and monitoring of the heart, blood pressure and kidneys [2].

Dose and schedule

KRd

Relapsed myelomaCycle length: Every 28 days

Relapsed myeloma

DrugDoseRouteSchedule
Carfilzomib20 mg/m² on days 1 and 2 of cycle 1, then 27 mg/m²IV over 10 minutesDays 1, 2, 8, 9, 15 and 16 (from cycle 13: days 1, 2, 15 and 16)
Lenalidomide25 mgOralDays 1 to 21
Dexamethasone40 mgOral or IVDays 1, 8, 15 and 22
Cycle length
Every 28 days
Duration
Carfilzomib up to cycle 18; lenalidomide and dexamethasone until progression

As in ASPIRE [1]; dose source: [2, 3].

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

  • Oral and IV hydration before the doses of cycle 1 [2].
  • Thrombosis prophylaxis (lenalidomide), aciclovir.

Monitoring and dose adjustment

  • Heart failure, hypertension, dyspnoea, kidney injury and thrombotic microangiopathy [2].
  • Adjust lenalidomide for kidney function [3].

Main evidence

Show detailsHide

ASPIRE: median progression-free survival 26.3 vs 17.6 months with Rd [1].

Related cancer types

Multiple myeloma

Treatment regimens (physicians)

VRd and D-VRd regimens in myelomaDRd regimen (daratumumab, 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 referencesClose 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
    Carfilzomib, lenalidomide, and dexamethasone for relapsed multiple myelomaStewart AK, Rajkumar SV, Dimopoulos MA, et al · N Engl J Med · 2015;372:142-52
    DOIPubMed Back to text: 1 2 3
  2. 2
    KYPROLIS (CARFILZOMIB) — Prescribing InformationOnyx Pharmaceuticals, Inc · FDA label · 2026
    Source Back to text: 1 2 3 4 5
  3. 3
    REVLIMID (LENALIDOMIDE) — Prescribing InformationCelgene Corporation · FDA label · 2026
    Source Back to text: 1 2

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/krd-myeloma/

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