Onco Wiki / Indication

Multiple Myeloma · line 1 · Daratumumab + Bortezomib + Lenalidomide + Dexamethasone (D-VRd), 4-6 induction cycles

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.

Source YAML: complete record

Line of therapy1
Trackaggressive
Linked regimenREG-DARA-VRD
IDIND-MM-1L-DVRD
TypeIndication
Statusreviewed 2026-05-09 | pending_clinical_signoff
DiseasesDIS-MM
SourcesSRC-GRIFFIN-VOORHEES-2020 SRC-NCCN-MM-2025 SRC-PERSEUS-SONNEVELD-2024

Notes

STUB — requires clinical co-lead signoff before publication. Aggressive counterpart to IND-MM-1L-VRD for two-plan output (CHARTER §2). Major access constraint in Ukraine: daratumumab is not currently НСЗУ- reimbursed — funding pathway 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. Phases wired 2026-05-09 per PERSEUS protocol (§17 IndicationPhase schema): D-VRd × 4 induction → ASCT (SUR-ASCT-AUTOLOGOUS) → D-VRd × 2 consolidation → daratumumab-lenalidomide maintenance (REG-DARA-LEN-MAINTENANCE) until progression. Scoped to transplant-eligible patients (fit_for_transplant: true). TRANSPLANT-INELIGIBLE GAP: D-Rd (MAIA trial, Facon NEJM 2019; daratumumab + lenalidomide + dex until progression) or D-VRd × 6 cycles (GRIFFIN-style without ASCT) for non-transplant-eligible NDMM — not yet modeled as a separate indication entity; flag for next HEME backlog wave.

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