Four-Drug Therapy for Multiple Myeloma

To the Editor: In the PERSEUS trial reported by Sonneveld et al. (Jan. 25 issue),¹ transplantation-eligible patients with newly diagnosed multiple myeloma were assigned to receive either subcutaneous daratumumab combined with bortezomib, lenalidomide, and dexamethasone (VRd) induction and consolidation therapy and with lenalidomide maintenance therapy (D-VRd group) or VRd induction and consolidation therapy and lenalidomide maintenance therapy alone (VRd group). The dose of lenalidomide was the same in both groups. However, the incidence of discontinuation during the maintenance phase due to adverse events was almost three times as high in the VRd group as in the D-VRd group (20.3% vs… .