Myeloma SACT Regimens

The information contained in these regimens is a statement of consensus of NCCP and ISMO or IHS professionals regarding their views of currently accepted approaches to treatment. Any clinician seeking to apply or consult these documents is expected to use independent medical judgement in the context of individual clinical circumstances to determine any patient's care or treatment. The treatment regimen to be used should take into account factors such as histology, molecular pathology, age, performance status, co-morbidities and the patient’s preference. Each treatment regimen has advantages and disadvantages, and there may be more than one good option.  In addition, treatment choices can change over time as more evidence becomes available. Use of these documents is the responsibility of the prescribing clinician and is subject to the HSE.ie terms of use

Please email any comments or feedback on these regimens to oncologydrugs@cancercontrol.ie

For information on open clinical trials please refer to the Cancer Trials Ireland website here and also to basket trials.

Myeloma Chemotherapy Regimens

Regimen Name Indication

Bortezomib and Dexamethasone Therapy

Regimen

00270a

Treatment of adult patients with progressive multiple myeloma who have received at least one prior therapy.

Bortezomib Maintenance Therapy- 14 day

 Regimen

00435a

Maintenance treatment for patients with high risk  multiple myeloma

Bortezomib, Lenalidomide and Dexamethasone (RVD) Therapy-21 day*

Regimen

00416a

Treatment of newly diagnosed myeloma in adult patients with high risk features.

00416b

Treatment of relapsed or refractory myeloma that has received prior therapy in adult patients with high risk features.

Bortezomib, Lenalidomide and Dexamethasone (RVD) Therapy- 28 day*

Regimen

00643a

Treatment of Myeloma.

Bortezomib, Thalidomide and Dexamethasone (VTD) Induction Therapy

Regimen

00274a

Bortezomib, thalidomide and dexamethasone for induction treatment of adult patients with previously untreated multiple myeloma who are eligible for high-dose chemotherapy with haematopoietic stem cell transplantation.

Bortezomib, dexAMETHasone, Thalidomide, CISplatin, DOXOrubicin, cycloPHOSphamide and Etoposide (VDT PACE) Therapy

Regimen

00496a

Failure to achieve response or disease progression with induction therapy in patients with multiple myeloma

00496b

Relapsed or refractory myeloma patients suitable for intensive salvage chemotherapy.

00496c

Treatment of multiple myeloma in patients with primary plasma cell leukaemia or initial presentation with extra-medullary disease

Bortezomib, Melphalan and Prednisolone Therapy

Regimen

00275a

Treatment of adult patients with previously untreated multiple myeloma who are not eligible for high-dose chemotherapy with haematopoietic stem cell transplantation.

Bortezomib, Lenalidomide and dexAMETHasone (RVD-Lite) Induction Therapy

Regimen

00780a

 Treatment of newly diagnosed multiple myeloma patients who are transplant ineligible C.

Bortezomib and Lenalidomide (RVD-Lite) Consolidation Therapy

Regimen

00781a

Treatment of newly diagnosed multiple myeloma patients who are transplant ineligible after completion of RVD-lite induction therapy.

Cyclophosphamide 2000mg/m2 For Stem Cell Mobilisation

Regimen

00438a

Mobilisation of peripheral blood stem cells for future stem cell rescue following high dose chemotherapy

cycloPHOSphamide 1500mg/m2 For Stem Cell Mobilisation

Regimen

00795a

Mobilisation of peripheral blood stem cells for future stem cell rescue following high dose chemotherapy.

Carfilzomib and dexAMETHasone (Kd) Therapy-28day

Regimen

00566a

Carfilzomib in combination with dexAMETHasone for the treatment of adult patients with multiple myeloma who have received at least one prior therapy

Carfilzomib (20/70mg/m2 once Weekly) Dexamethasone (Kd) Therapy-28 day

Regimen

00595a

Carfilzomib In combination with dexAMETHasone is indicated for the treatment of adult patients with multiple myeloma who have received at least one prior therapy

Carfilzomib (56mg/m2  once weekly) Lenalidomide and Dexamethasone (KRd) Therapy -  28 day

 Regimen

00598a

Carfilzomib,  lenalidomide and dexamethasone therapy is indicated  for the treatment of adult patients with multiple myeloma who have received at least one prior therapy.

Carfilzomib (27mg/m2 twice weekly), Lenalidomide and Dexamethasone (KRd) Therapy - 28 day

 Regimen

00405a

Carfilzomib,  lenalidomide and dexamethasone therapy is indicated  for the treatment of adult patients with multiple myeloma who have received at least one prior therapy

CyBorD/ Cyclophosphamide, Bortezomib, and Dexamethasone-21 day Therapy

Regimen

00273a

Treatment of newly diagnosed symptomatic multiple myeloma*

00273b

Treatment of relapsed/refractory multiple myeloma*

AL Amyloidosis: cycloPHOSphamide, Bortezomib and dexAMETHasone (CVD) 28‑Day Therapy

Regimen

00652a

Treatment of newly diagnosed systemic AL amyloidosis

00652b

Treatment of relapsed/refractory  systemic AL amyloidosis

Modified CyBord/ Bortezomib/ Cyclophosphamide and Dexamethasone – weekly therapy

 Regimen

00299a

Treatment of newly diagnosed symptomatic multiple myeloma.

00299b

Treatment of relapsed/refractory multiple myeloma.

Daratumumab Monotherapy

Regimen

00426a

As monotherapy for the treatment of adult patients with relapsed and refractory multiple myeloma whose prior therapy included a proteasome inhibitor and an immunomodulatory agent and who have demonstrated disease progression on the last therapy.

Daratumumab S/C Monotherapy

Regimen

00604a

As monotherapy for the treatment of adult patients with relapsed and refractory multiple myeloma, whose prior therapy included a proteasome inhibitor and an immunomodulatory agent and who have demonstrated disease progression on the last therapy

Daratumumab (IV), Bortezomib and Dexamethasone Therapy

Regimen

00560a

Daratumumab in combination with bortezomib and dexamethasone in adult patients with multiple myeloma who have received at least one prior therapy

Daratumumab (SC 1800mg), Bortezomib and Dexamethasone Therapy

Regimen

00609a

Daratumumab in combination with bortezomib and dexamethasone in adult patients with multiple myeloma who have received at least one prior therapy

Daratumumab (SC 1800mg), Bortezomib (weekly) and Dexamethasone Therapy

Regimen

00695a

Daratumumab in combination with bortezomib and dexamethasone in adult patients with multiple myeloma who have received at least one prior therapy

Daratumumab, Bortezomib, cycloPHOSphamide and dexAMETHasone (D-VCd) Therapy

Regimen

00779a

Daratumumab in combination with bortezomib, cycloPHOSphamide and dexAMETHasone (D-VCd) for the treatment of adult patients with newly diagnosed light chain (AL) amyloidosis.

Daratumumab SC, Lenalidomide and dexAMETHasoneTherapy

Regimen

00854a

Daratumumab in combination with lenalidomide and dexAMETHasone for the treatment of adult patients with newly diagnosed multiple myeloma who are ineligible for autologous stem cell transplant.

Daratumumab SC, Bortezomib, Thalidomide and Dexamethasone Induction Therapy

Regimen

00703a

Daratumumab in combination with bortezomib, thalidomide and dexamethasone for the treatment of adults with newly diagnosed multiple myeloma who are eligible for autologous stem cell transplant

Daratumumab SC, Bortezomib, Thalidomide and Dexamethasone Consolidation Therapy

Regimen

00755a

Daratumumab in combination with bortezomib, thalidomide and dexamethasone for the treatment of adults with newly diagnosed multiple myeloma who are eligible for autologous stem cell transplant

Daratumumab (SC), Bortezomib (Once Weekly), Thalidomide and Dexamethasone Induction Therapy

Regimen

00752a

Daratumumab in combination with bortezomib, thalidomide and dexamethasone for the treatment of adults with newly diagnosed multiple myeloma who are eligible for autologous stem cell transplant

Daratumumab (SC), Bortezomib (Once Weekly), Thalidomide and Dexamethasone Consolidation Therapy

Regimen

00756a

Daratumumab in combination with bortezomib, thalidomide and dexamethasone for the treatment of adults with newly diagnosed multiple myeloma who are eligible for autologous stem cell transplant

Ixazomib, Lenalidomide and Dexamethasone Therapy -  28 day

 Regimen

00516a

Ixazomib in combination with lenalidomide and dexamethasone for the treatment of adult patients with multiple myeloma who have received at least one prior therapy

Lenalidomide 25mg and dexAMETHasone Therapy-28 day

Regimen

00218a

Treatment of adult patients with previously untreated multiple myeloma who are not eligible for transplant.

00218b

Treatment of multiple myeloma in adult patients who have received at least one prior therapy.

Lenalidomide Maintenance Therapy (RVD-Lite)

Regimen

00782a

Indicated as single agent maintenance therapy in patients with newly diagnosed multiple myeloma patients who are transplant ineligible after completion of RVD-lite induction and consolidation therapy.

High Dose Melphalan Conditioning Therapy for Autologous Stem Cell Transplant

Regimen

00454a

Conditioning Therapy in patients with Multiple Myeloma prior to autologous stem cell transplant 

00454b

Conditioning Therapy in patients with other plasma cell dyscrasia such as AL amyloidosis

Plerixafor and G-CSF Therapy

Regimen

00536a

Is indicated in combination with granulocyte-colony stimulating factor (G-CSF) to enhance mobilisation of haematopoietic stem cells to the peripheral blood for collection and subsequent autologous transplantation in adult patients with lymphoma and multiple myeloma whose cells mobilise poorly 

Pomalidomide and Dexamethasone

Regimen

00245a

Treatment in combination with dexamethasone of adult patients with relapsed and refractory multiple myeloma who have received at least two prior treatment regimens, including both lenalidomide and bortezomib, and have demonstrated disease progression on the last therapy.

Pomalidomide, Bortezomib and dexAMETHasone (PVD) Therapy

Regimen

00601a

Pomalidomide in combination with bortezomib and dexAMETHasone for the treatment of adult patients with multiple myeloma who have received at least one prior treatment including lenalidomide

Teclistamab Monotherapy

Regimen

00865a

As monotherapy for the treatment of adult patients with relapsed and refractory multiple myeloma, who have received at least three prior therapies, including and immunomodulatory agent, a proteasome inhibitor and an anti-CD38 antibody and have demonstrated disease progression on the last therapy.
* Unlicensed indication.  See regimen for further information
** Unlicensed posology.  See regimen for further information