Daratumumab + Lenalidomide maintenance post-ASCT (PERSEUS schedule)
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.
| Components | DRUG-DARATUMUMAB DRUG-LENALIDOMIDE |
|---|
| ID | REG-DARA-LEN-MAINTENANCE |
|---|---|
| Type | Regimen |
| Status | reviewed 2026-05-09 | pending_clinical_signoff |
| Diseases | None declared |
| Sources | SRC-NCCN-MM-2025 SRC-PERSEUS-SONNEVELD-2024 |
Notes
PERSEUS maintenance arm (Sonneveld NEJM 2024, PMID 38084760): after D-VRd × 4 induction + ASCT + D-VRd × 2 consolidation, patients received daratumumab SC q4w (first 6 cycles then q8w) + lenalidomide 10 mg d1-21 until progression. Median maintenance duration ~38 months. Distinct from: (1) REG-LENALIDOMIDE-MAINTENANCE (len-only, no daratumumab — CALGB 100104 / IFM 2005-02 schema); (2) MRD-guided approaches (investigational). Key PERSEUS maintenance outcomes: 48-month PFS 84.3% (D-VRd arm) vs 67.7% (VRd arm); MRD-negativity (10⁻⁵) at 12 months post-consolidation 75.2% vs 47.5%. The PFS benefit was consistent across transplant-eligible subgroups including high-risk cytogenetics (del17p, t[4;14], t[14;16]). Daratumumab dosing transition in PERSEUS: q4w during consolidation and first 6 maintenance cycles → q8w thereafter. Some Ukrainian centers may default to q4w throughout for simplicity; both schedules are documented. Second primary malignancy (SPM) risk: the combination of ASCT + extended lenalidomide increases SPM risk (MDS/AML ~2-3% at 5 yr, solid tumors). Must be included in pre-consent discussion. Risk-benefit favors maintenance in standard-risk and high-risk NDMM given the magn...
Used By
Indication
IND-MM-1L-DVRD- IND-MM-1L-DVRD