When do you consider the use of RVD lite?

FAQ Library published on November 18, 2020
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Saad Z. Usmani, MD, FACP
Division Chief, Plasma Cell Disorders Division
Director, Clinical Research in Hematologic Malignancies
Department of Hematologic Oncology & Blood Disorders
Levine Cancer Institute
Charlotte, North Carolina

Hello, and welcome to Managing Myeloma. My name is Dr. Saad Usmani, and I'm frequently asked, when do you consider the use of RVd-lite? To answer that question, let me just first elaborate on what the RVd-lite regimen is. It's a modification of the original RVd regimen that was given every two weeks out of three weeks but was deemed to be a little bit more toxic for the older myeloma patients. So my colleagues at Mass General did a phase two trial looking at the weekly Velcade (bortezomib) dosing along with a lower dose of Revlimid (lenalidomide), and they gave this treatment four out of five weeks. So the regimen was given with four weekly doses of Velcade and a reduced Revlimid dose at 15 mg along with weekly dexamethasone, and they found the efficacy to be equal into the RVd regimen and older patients actually tolerated this regimen well. In my practice, I do utilize this regimen for older myeloma patients. Sometimes we would be using a modified version of this regimen, so giving treatment every three weeks out of four instead of four out of five or four out of six. And we would be picking this regimen for patients who, for example, don't have pre-existing neuropathy or have high-risk features at the time of diagnosis.

Last modified: November 17, 2020