Multiple Myeloma · line 1 · Daratumumab + Lenalidomide + Dexamethasone (D-Rd, MAIA — MM 1L transplant-ineligible)
Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.
Knowledge-base record for audit. Provisional clinical content: this is not a prescription. An oncologist must verify original sources, applicability and review status. Full rules and constraints are in the YAML.
| Line of therapy | 1 |
|---|---|
| Track | aggressive |
| Linked regimen | REG-D-RD-MAIA |
| ID | IND-MM-1L-DARA-RD |
|---|---|
| Type | Indication |
| Status | reviewed 2026-05-09 | pending_clinical_signoff |
| Diseases | DIS-MM |
| Sources | SRC-MAIA-FACON-2019 SRC-NCCN-MM-2025 |
Notes
STUB — requires clinical co-lead signoff before publication. Aggressive counterpart to IND-MM-1L-RD for two-plan output in transplant-ineligible NDMM (CHARTER §2). Major access constraint in Ukraine: daratumumab is not currently НСЗУ-reimbursed — funding pathway (clinical trial / charitable / out-of-pocket) MUST be confirmed BEFORE this Plan is finalized. Red-cell phenotyping (type and screen) BEFORE first daratumumab dose is mandatory due to anti-CD38 interference with crossmatching. MAIA trial (Facon NEJM 2019, PMID 30926586): 737 transplant-ineligible NDMM patients randomized D-Rd vs Rd. Primary endpoint PFS: HR 0.56 (95% CI 0.43–0.73), p<0.001. 5-year OS update (Facon JCO 2024): 66.3% vs 53.1% (HR 0.66, p<0.0001) — first OS benefit for an anti-CD38 doublet addition in TI-NDMM. Scope gate: fit_for_transplant: false restricts IND-MM-1L-DARA-RD to transplant-ineligible patients. For transplant-eligible aggressive-plan patients, see IND-MM-1L-DVRD (D-VRd + ASCT + dara-len maintenance). Treatment is continuous until progression or unacceptable toxicity — no fixed-duration transplant pathway. No phases block needed (single continuous regimen, no ASCT step).
Used By
Algorithms
ALGO-MM-1L- ALGO-MM-1L
Indication
IND-MM-1L-RD- IND-MM-1L-RD