Multiple myeloma: guideline history

Standard of care today →

5 dated versions from 2019 to 2025 listing 9 changes. Pick two versions to see what changed between them; the timeline below shows every version with the event it is anchored to.

From (exclusive)To (inclusive)

+3 added0 removed↔ 1 recategorisedacross 2 versions

Recategorised
Relapsed, 1-3 prior lines
CAR-T moves from fifth line to as early as second (cilta-cel) or third (ide-cel) line.
after 4 or more lines after 1 (cilta-cel) or 2 (ide-cel) prior lines, category 1
Ciltacabtagene autoleucel Idecabtagene vicleucel CARTITUDE-4 KarMMa-3
Added
Newly diagnosed, transplant-eligible
D-VRd induction and consolidation with D-R maintenance as the preferred regimen.
Daratumumab Bortezomib Lenalidomide PERSEUS
Added
Newly diagnosed, transplant-ineligible
Isatuximab-VRd as a preferred quadruplet.
Isatuximab IMROZ
Added
Relapsed, 1 or more prior lines
Belantamab mafodotin with bortezomib-dexamethasone or pomalidomide-dexamethasone; ocular monitoring required.
Belantamab mafodotin DREAMM-7 DREAMM-8

Timeline

2019-06NCCN2019 update
Anchored to: FDA approval of daratumumab with lenalidomide-dexamethasone for transplant-ineligible patients, June 2019 (MAIA)
- addedNewly diagnosed, transplant-ineligible: Daratumumab, lenalidomide and dexamethasone as a preferred regimen.
2021-03ESMOESMO CPG multiple myeloma 2021 (Dimopoulos et al.)
Anchored to: Annals of Oncology publication, 2021
- addedNewly diagnosed, transplant-eligible: Quadruplet induction with a CD38 antibody (D-VTd) recommended before autologous transplant [I, A].
- addedNewly diagnosed, transplant-ineligible: DRd or D-VMP recommended over doublets [I, A].
2023-08NCCN2021-2023 updates
Anchored to: FDA approvals of idecabtagene vicleucel (March 2021), ciltacabtagene autoleucel (February 2022), teclistamab (October 2022), talquetamab and elranatamab (August 2023); withdrawal of melphalan flufenamide (October 2021)
- addedRelapsed or refractory, after 4 or more lines: BCMA CAR-T (ide-cel, cilta-cel) and BCMA or GPRC5D bispecifics (teclistamab, elranatamab, talquetamab) for triple-class-exposed disease.
- removedRelapsed or refractory, triple-class-refractory: Melphalan flufenamide removed after the OCEAN trial overall-survival imbalance and US withdrawal.
2024-09NCCN2024 updates
Anchored to: FDA approvals of cilta-cel in the second line and ide-cel in the third line (April 2024, CARTITUDE-4 and KarMMa-3), D-VRd (July 2024, PERSEUS) and Isa-VRd (September 2024, IMROZ)
- recategorisedRelapsed, 1-3 prior lines: CAR-T moves from fifth line to as early as second (cilta-cel) or third (ide-cel) line.after 4 or more lines → after 1 (cilta-cel) or 2 (ide-cel) prior lines, category 1
- addedNewly diagnosed, transplant-eligible: D-VRd induction and consolidation with D-R maintenance as the preferred regimen.
- addedNewly diagnosed, transplant-ineligible: Isatuximab-VRd as a preferred quadruplet.
2025-10NCCN2025 update
Anchored to: FDA re-approval of belantamab mafodotin in combination, October 2025 (DREAMM-7, DREAMM-8), after the 2022 withdrawal
- addedRelapsed, 1 or more prior lines: Belantamab mafodotin with bortezomib-dexamethasone or pomalidomide-dexamethasone; ocular monitoring required.

Other cancers

Acute myeloid leukaemia Bladder & urothelial cancer Cervical cancer Chronic lymphocytic leukaemia Colorectal cancer Diffuse large B-cell lymphoma Endometrial cancer Gastric & gastro-oesophageal junction cancer Hepatocellular carcinoma HER2-positive breast cancer HR-positive / HER2-negative breast cancer Melanoma Non-small-cell lung cancer Oesophageal cancer Ovarian cancer Prostate cancer Renal cell carcinoma Triple-negative breast cancer (TNBC)

Each entry is anchored to a dated public event and links to the guideline body’s page for the disease; NCCN “Summary of changes” pages sit behind a free login and are not reproduced. Version labels say “update” where the NCCN version number has not been verified. Corrections are welcome via the repository.