# VRd and Dara-VRd (myeloma induction regimens)

Source: https://onco.cc/terms/vrd/  
OnCo record `vrd` (Term). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

The alphabet soup of myeloma treatment: V (bortezomib, Velcade), R (lenalidomide, Revlimid), d (dexamethasone), Dara (daratumumab), Isa (isatuximab), K (carfilzomib). Dara-VRd, a four-drug quadruplet, is now the standard first treatment for most patients.

## Summary

VRd was the standard triplet for a decade (SWOG S0777). Adding a CD38 antibody made quadruplets standard: Dara-VRd before and after autologous transplant (PERSEUS) and in transplant-ineligible patients (CEPHEUS), Isa-VRd in IMROZ, with Dara-Rd (MAIA) for frailer patients. Bortezomib causes neuropathy and is often dropped after induction; lenalidomide continues as maintenance. MRD negativity rates above 60% with quadruplets are prompting trials of MRD-guided de-escalation and of CAR-T or bispecifics in place of transplant (CARTITUDE-5/6).

## Fields

- Kind: Term
- Last checked: 2026-09-09
- Also known as: VRd; RVd; Dara-VRd; D-VRd; Isa-VRd; Dara-Rd; DRd; KRd; Dara-KRd; VMP; Dara-VMP; VCd; bortezomib-based; lenalidomide-based; CD38 antibody + PI + IMiD; PI + IMiD + dexamethasone

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Multiple_myeloma#Treatment
- Wikipedia: https://en.wikipedia.org/wiki/Multiple_myeloma#Treatment

## Connected records

- terms: [Autologous stem cell transplant (ASCT)](https://onco.cc/terms/autologous-transplant/), [Doublet, triplet and quadruplet regimens](https://onco.cc/terms/doublet-triplet/), [Immunomodulatory drugs (IMiDs) and CELMoDs](https://onco.cc/terms/imid/), [Proteasome inhibitor (bortezomib, carfilzomib, ixazomib)](https://onco.cc/terms/proteasome-inhibitor/), [Undetectable MRD (uMRD / MRD-negative)](https://onco.cc/terms/umrd/)
- cancers: [Multiple myeloma](https://onco.cc/cancers/multiple-myeloma/), [Newly diagnosed multiple myeloma, transplant-eligible](https://onco.cc/cancers/myeloma-transplant-eligible/), [Newly diagnosed multiple myeloma, transplant-ineligible](https://onco.cc/cancers/myeloma-transplant-ineligible/)
- fronts: [Chemotherapy](https://onco.cc/fronts/chemotherapy/), [Targeted Therapy](https://onco.cc/fronts/targeted-therapy/)
- drugs: [Bortezomib](https://onco.cc/drugs/bortezomib/), [Daratumumab](https://onco.cc/drugs/daratumumab/), [Lenalidomide](https://onco.cc/drugs/lenalidomide/)
- trials: [CARTITUDE-4](https://onco.cc/trials/cartitude-4/)

---
JSON: https://onco.cc/api/v1/entities/vrd.json