skip to main content

Myeloma Dara-VRd Induction — RACP Adult Medicine MCQ

Instant feedback + full explanation. One question, done properly.

ModerateHaematologyMyeloma Dara-VRd InductionRACP Adult Medicine

A 60-year-old woman with newly diagnosed multiple myeloma (IgG kappa, standard risk by FISH) is eligible for autologous stem cell transplant. What is the standard first-line induction regimen before transplant?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Daratumumab + bortezomib + lenalidomide + dexamethasone (Dara-VRd)

VRd (bortezomib, lenalidomide, dexamethasone) has been the standard induction regimen for transplant-eligible myeloma patients. However, the GRIFFIN and PERSEUS trials demonstrated that adding daratumumab (anti-CD38 monoclonal antibody) to VRd (Dara-VRd) significantly improves depth of response (MRD negativity rates) and progression-free survival. Dara-VRd is now the preferred first-line induction for transplant-eligible patients and is PBS-listed in Australia. Induction is typically for 4–6 cycles, followed by autologous SCT, then lenalidomide maintenance.

Reference: eTG – 2025 – Haematology; NCCN – 2025 – Multiple Myeloma; PERSEUS Trial