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Optimisation of induction therapy is essential to provide longer term disease control and the current standard of care for most patients incorporates an immunomodulatory agent and proteasome inhibitor, most commonly lenalidomide and bortezomib in combination with dexamethasone (RVD), with maintenance until progression. Historically there has been limited access to RVD as an induction strategy outside of the United States; fortunately, there is now increasing access worldwide. This review discusses the rationale for use of RVD as induction therapy and aims to provide guidance in prescribing this regimen in order to optimise efficacy while minimising the toxicities of treatment. We also highlight the increasing evidence for the utility of addition of a monoclonal antibody to the RVD backbone to deepen responses and potentially provide longer disease control.<\/jats:p>","DOI":"10.1111\/bjh.18295","type":"journal-article","created":{"date-parts":[[2022,7,7]],"date-time":"2022-07-07T08:36:37Z","timestamp":1657182997000},"page":"190-204","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Lenalidomide, bortezomib and dexamethasone induction therapy for the treatment of newly diagnosed multiple myeloma: a practical review"],"prefix":"10.1111","volume":"199","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4838-9022","authenticated-orcid":false,"given":"Georgia J.","family":"McCaughan","sequence":"first","affiliation":[{"name":"Department of Haematology St Vincent's Hospital  Sydney Australia"},{"name":"University of New South Wales, Medicine and Health  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Gandolfi","sequence":"additional","affiliation":[{"name":"Translational Research Program University of Helsinki  Helsinki Finland"},{"name":"Haematology Research Unit University of Helsinki and Helsinki University Hospital  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John J.","family":"Moore","sequence":"additional","affiliation":[{"name":"Department of Haematology St Vincent's Hospital  Sydney Australia"},{"name":"University of New South Wales, Medicine and Health  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul G.","family":"Richardson","sequence":"additional","affiliation":[{"name":"Dana\u2010Farber Cancer Institute, Jerome Lipper Multiple Myeloma Center, Department of Medical Oncology  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,7,7]]},"reference":[{"key":"e_1_2_20_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)31594-X"},{"key":"e_1_2_20_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1611750"},{"key":"e_1_2_20_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.15261"},{"key":"e_1_2_20_5_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2010-02-268862"},{"key":"e_1_2_20_6_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2011-11-395749"},{"key":"e_1_2_20_7_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2013.54.8164"},{"key":"e_1_2_20_8_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2019000241"},{"key":"e_1_2_20_9_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2020005288"},{"key":"e_1_2_20_10_1","doi-asserted-by":"publisher","DOI":"10.1126\/science.1244917"},{"key":"e_1_2_20_11_1","doi-asserted-by":"publisher","DOI":"10.1126\/science.1244851"},{"key":"e_1_2_20_12_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2013-07-517276"},{"key":"e_1_2_20_13_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2009.22.2679"},{"key":"e_1_2_20_14_1","doi-asserted-by":"publisher","DOI":"10.1158\/1541-7786.MCR-19-0431"},{"key":"e_1_2_20_15_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2020-140356"},{"key":"e_1_2_20_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/ejh.13349"},{"key":"e_1_2_20_17_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.19.02515"},{"key":"e_1_2_20_18_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2020-134538"},{"key":"e_1_2_20_19_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2020007522"},{"issue":"5","key":"e_1_2_20_20_1","article-title":"Longer term follow\u2010up of the randomized phase III trial SWOG S0777: bortezomib, lenalidomide and dexamethasone vs. lenalidomide and dexamethasone in patients (Pts) with previously untreated multiple myeloma without an intent for immediate autologous stem cell transplant (ASCT). 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