A medic in purple gloves checks a blood-filled tubing line beside a stack of infusion pumps.

Multiple Myeloma Treatments Compared

Name: Multiple Myeloma Treatments Compared
Creator: Jason Hunter
Published: 2026-11-04

18 FDA-approved drugs in 20 forms, plus 2 in development, side by side from the current prescribing labels. Newest label Sep 2026. Checked November 4, 2026.

The full Multiple Myeloma guide, with open trials and help paying →

CAR T cell therapiesCarvykti · Abecma

Bispecific antibodiesTecvayli · Elrexfio · Talvey · Lynozyfic

Antibody-drug conjugateBlenrep

Anti-CD38 and other antibodiesDarzalex · Darzalex Faspro · Sarclisa · Sarclisa Escena · Empliciti

Proteasome inhibitorsVelcade · Kyprolis · Ninlaro

Immunomodulatory drugs and CELMoDRevlimid · Pomalyst · Thalomid · Zenbexus

XPO1 inhibitorXpovio

This page compares 18 FDA-approved multiple myeloma treatments in 7 groups, and each label is tied to a stage of treatment, from newly diagnosed myeloma to myeloma that has come back after 4 or more prior lines.

Darzalex, Darzalex Faspro, Sarclisa, Sarclisa Escena, Velcade, Revlimid and Thalomid have uses for newly diagnosed myeloma, and Revlimid is also approved alone as maintenance after a stem cell transplant.
Newer options approved after 1 prior line include Carvykti, Tecvayli with Darzalex Faspro and Zenbexus, alongside combinations built on Kyprolis, Ninlaro, Xpovio, Empliciti, Darzalex and Sarclisa, each with rules on which drugs came before. Abecma, Blenrep and Pomalyst start after 2 prior lines, and Elrexfio, Talvey, Lynozyfic and Tecvayli alone after 4.
Carvykti and Abecma are CAR T cell therapies given once. The 4 bispecific antibodies start with step-up doses and hospital stays and continue until the myeloma worsens.
Ninlaro, Revlimid, Pomalyst, Thalomid, Zenbexus and Xpovio are pills taken at home, and the other 12 are infusions or injections given by a healthcare provider.
The CAR T therapies and bispecifics carry boxed warnings for cytokine release syndrome and nerve toxicity, Blenrep for eye damage, and Revlimid, Pomalyst, Thalomid and Zenbexus for birth defects and blood clots. The Darzalex, Sarclisa, Empliciti, proteasome inhibitor and Xpovio labels have none.
No trial has compared the CAR T therapies with each other or the bispecifics with each other, so their response rates in the table do not rank them.

Latest for multiple myeloma

See all trials

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New guideMyeloma's Third CAR-T, Anito-cel, Faces a December 23rd FDA Decision Next to Carvykti and AbecmaTrial Friend
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Where are you in myeloma treatment?

All18Newly diagnosed5After 1 treatment plan11After 2 or 3 plans14After 4 or more plans17

FDA labels count treatment in lines of therapy. A line is 1 full treatment plan, such as starting drugs, a stem cell transplant and maintenance given as 1 plan, and a new line starts when the myeloma comes back or the plan has to change, for example because of side effects. Each choice shows the medicines with at least 1 FDA-approved use at that stage. Most uses also depend on which drugs came before and which drugs they are combined with, listed under Approved for, and a care team can confirm how many prior lines someone has had. The filter applies to the 3 tables and the calendar below.

Side by side

20 approved multiple myeloma treatments at a glance

How each drug is given, how often, who it is approved for and when it was first approved, from the current FDA label.

Multiple Myeloma treatments compared: route, schedule, approved use and approval date
Drug	How it is given	How often	Approved for	First approved
Carvykti ciltacabtagene autoleucel Janssen (Johnson & Johnson) with Legend Biotech	One-time IV infusion of the patient's own engineered T cells at a treatment center	Given once, after cell collection and 3 days of lymphodepleting chemotherapy (cyclophosphamide and fludarabine); dose 0.5 to 1.0 million CAR-positive T cells per kg, up to 100 million, infused 5 to 7 days after chemotherapy starts. The label asks people to stay near the treatment center for at least 2 weeks and not drive for 2 weeks	Adults with relapsed or refractory myeloma after at least 1 prior line that included a proteasome inhibitor and an immunomodulatory agent, whose myeloma is refractory to lenalidomide	February 28, 2022
Abecma idecabtagene vicleucel Bristol Myers Squibb (Celgene), developed with 2seventy bio	One-time IV infusion of the patient's own engineered T cells at a treatment center	Given once, after cell collection and 3 days of lymphodepleting chemotherapy (cyclophosphamide and fludarabine); dose 300 to 510 million CAR-positive T cells, infused 2 days after chemotherapy ends. The label asks people to stay near the treatment center for at least 1 week and not drive for 1 week	Adults with relapsed or refractory myeloma after 2 or more prior lines that included an immunomodulatory agent, a proteasome inhibitor and an anti-CD38 antibody	March 26, 2021
Tecvayli teclistamab-cqyv Janssen (Johnson & Johnson)	Injection under the skin by a healthcare provider, after step-up doses with hospital stays	Weekly after step-up doses, later every 2 or 4 weeks; step-up doses of 0.06mg/kg and 0.3mg/kg, then 1.5mg/kg. With Darzalex Faspro: 1.5mg/kg weekly in weeks 2 to 8, 3mg/kg every 2 weeks in weeks 9 to 24, then every 4 weeks from week 25. Alone: 1.5mg/kg weekly, with a move to every 2 weeks after a complete response lasting at least 6 months. 48-hour hospital stay after step-up doses 1 and 2	Adults with relapsed or refractory myeloma: with Darzalex Faspro after at least 1 prior line that included a proteasome inhibitor and an immunomodulatory agent, or alone after at least 4 prior lines that included a proteasome inhibitor, an immunomodulatory agent and an anti-CD38 antibody	October 25, 2022
Elrexfio elranatamab-bcmm Pfizer	Injection under the skin by a healthcare provider, after 2 step-up doses with hospital stays	Weekly 76mg after step-up doses, later every 2 or 4 weeks; step-up doses of 12mg on day 1 (48-hour hospital stay) and 32mg on day 4 (24-hour stay), then 76mg weekly through week 24. People who respond for at least 2 months move to every 2 weeks, and to every 4 weeks from week 49 if the response holds	Adults with relapsed or refractory myeloma after at least 4 prior lines that included a proteasome inhibitor, an immunomodulatory agent and an anti-CD38 antibody (accelerated approval)	August 14, 2023
Talvey talquetamab-tgvs Janssen (Johnson & Johnson)	Injection under the skin by a healthcare provider, after step-up doses with hospital stays	Weekly at 0.4mg/kg or every 2 weeks at 0.8mg/kg, after step-up doses; step-up doses of 0.01mg/kg and 0.06mg/kg (and 0.4mg/kg on the every-2-week schedule). 48-hour hospital stay after each dose in the step-up schedule	Adults with relapsed or refractory myeloma after at least 4 prior lines that included a proteasome inhibitor, an immunomodulatory agent and an anti-CD38 antibody (accelerated approval)	August 9, 2023
Lynozyfic linvoseltamab-gcpt Regeneron	IV infusion by a healthcare provider, after 2 step-up doses with hospital staysAbout 30 minutes per dose	Weekly at first, every 2 weeks from week 14, and every 4 weeks for people with a very good partial response or better at or after week 24 who have had at least 17 full doses; step-up doses of 5mg (day 1) and 25mg (day 8), each with a 24-hour hospital stay, then 200mg	Adults with relapsed or refractory myeloma after at least 4 prior lines that included a proteasome inhibitor, an immunomodulatory agent and an anti-CD38 antibody (accelerated approval)	July 2, 2025
Blenrep belantamab mafodotin-blmf GSK	IV infusion over about 30 minutes at an infusion center, with an eye exam before every doseAbout 30 minutes per dose	2.5mg/kg every 3 weeks; with bortezomib and dexamethasone for cycles 1 to 8, then Blenrep alone. Doses are often paused or lowered to 1.9mg/kg (every 3 weeks, then every 8 weeks) for eye problems	Adults with relapsed or refractory myeloma after at least 2 prior lines that included a proteasome inhibitor and an immunomodulatory agent, with bortezomib and dexamethasone	August 5, 2020
Darzalex daratumumab (IV) Janssen (Johnson & Johnson)	IV infusion at a clinic, about 7 hours the first time and about 3 hours later onAbout 180 minutes per dose	16mg/kg weekly for weeks 1 to 8, every 2 weeks for weeks 9 to 24, then every 4 weeks (with lenalidomide, pomalidomide or carfilzomib, or alone); schedules differ with bortezomib-based combinations. The first dose can be split over 2 days	Adults with myeloma in 7 uses. Newly diagnosed: with lenalidomide and dexamethasone or with bortezomib, melphalan and prednisone (no transplant), or with bortezomib, thalidomide and dexamethasone (transplant eligible). After at least 1 prior therapy: with lenalidomide and dexamethasone, or bortezomib and dexamethasone. After 1 to 3 prior lines: with carfilzomib and dexamethasone. After at least 2 prior therapies including lenalidomide and a proteasome inhibitor: with pomalidomide and dexamethasone. Alone after at least 3 prior lines including a proteasome inhibitor and an immunomodulatory agent, or when the myeloma is refractory to both	November 16, 2015
Darzalex Faspro daratumumab and hyaluronidase-fihj (under the skin) Janssen (Johnson & Johnson)	Injection under the skin of the belly by a healthcare provider, over about 3 to 5 minutesAbout 5 minutes per dose	1,800mg fixed dose weekly for weeks 1 to 8, every 2 weeks for weeks 9 to 24, then every 4 weeks (with lenalidomide, pomalidomide or carfilzomib, or alone); schedules differ with bortezomib-based combinations and in smoldering myeloma	Adults with myeloma in 9 uses: the 7 Darzalex combinations and uses (with pomalidomide and dexamethasone after at least 1 prior line including lenalidomide and a proteasome inhibitor, rather than 2), plus bortezomib, lenalidomide and dexamethasone for newly diagnosed myeloma whether or not a transplant is planned. Also high-risk smoldering myeloma, alone	May 1, 2020
Sarclisa isatuximab-irfc (IV) Sanofi	IV infusion at a clinic, weekly at first, then every 2 or 4 weeksAbout 75 minutes per dose	10mg/kg weekly in cycle 1, then every 2 weeks (with pomalidomide or carfilzomib); with bortezomib, lenalidomide and dexamethasone, every 2 weeks through cycle 17 and every 4 weeks from cycle 18	Adults with myeloma, always in combination: with bortezomib, lenalidomide and dexamethasone when newly diagnosed and a transplant is not an option; with carfilzomib and dexamethasone after 1 to 3 prior lines; with pomalidomide and dexamethasone after at least 2 prior therapies including lenalidomide and a proteasome inhibitor	March 2, 2020
Sarclisa Escena isatuximab-irfc (under the skin) Sanofi	Injection under the skin of the belly by a healthcare provider, by syringe or an on-body injectorAbout 6 minutes per dose	1,400mg fixed dose weekly in cycle 1, then every 2 weeks (with pomalidomide or carfilzomib); with bortezomib, lenalidomide and dexamethasone, every 2 weeks in cycles 2 to 12 and every 4 weeks from cycle 13	Adults with myeloma, always in combination: with bortezomib, lenalidomide and dexamethasone when newly diagnosed and a transplant is not an option; with carfilzomib and dexamethasone after 1 to 3 prior lines; with pomalidomide and dexamethasone after at least 1 prior line including lenalidomide and a proteasome inhibitor	July 9, 2026
Empliciti elotuzumab Bristol Myers Squibb	IV infusion at a clinic, weekly at first, then every 2 or 4 weeks	10mg/kg weekly for cycles 1 and 2, then 10mg/kg every 2 weeks (with lenalidomide) or 20mg/kg every 4 weeks (with pomalidomide), in 28-day cycles	Adults with previously treated myeloma, in combination: with lenalidomide and dexamethasone after 1 to 3 prior therapies, or with pomalidomide and dexamethasone after at least 2 prior therapies including lenalidomide and a proteasome inhibitor	November 30, 2015
Velcade bortezomib (generics and Boruzu also approved) Takeda; generics from several makers	Injection under the skin or into a vein by a healthcare provider	1.3mg/m2 in cycles, at least 72 hours apart; with melphalan and prednisone in 9 cycles of 6 weeks when newly diagnosed (twice weekly, then weekly), or twice weekly for 2 weeks of each 3-week cycle when relapsed, with a weekly option after 8 cycles	Adults with multiple myeloma at any stage, from newly diagnosed to relapsed, with no limit on prior therapy	May 13, 2003
Kyprolis carfilzomib Amgen	IV infusion over 10 or 30 minutes at a clinic	Once or twice weekly in 3 of every 4 weeks, depending on the combination: 20/70mg/m2 once weekly, 20/56mg/m2 twice weekly, or 20/27mg/m2 twice weekly (alone or with lenalidomide and dexamethasone)	Relapsed or refractory myeloma: in adults after 1 to 3 prior lines, with lenalidomide and dexamethasone, with dexamethasone, with daratumumab (IV or Darzalex Faspro) and dexamethasone, or with isatuximab and dexamethasone; alone after 1 or more prior lines	July 20, 2012
Ninlaro ixazomib Takeda	Capsule by mouth once a week at home, on an empty stomach	4mg on days 1, 8 and 15 of each 28-day cycle, with lenalidomide 25mg on days 1 to 21 and dexamethasone 40mg on days 1, 8, 15 and 22	People with myeloma after at least 1 prior therapy, with lenalidomide and dexamethasone. Not recommended for maintenance or newly diagnosed myeloma outside controlled trials	November 20, 2015
Revlimid lenalidomide (generics from several makers) Bristol Myers Squibb (Celgene); generics from several makers	Capsule by mouth once a day at home	25mg on days 1 to 21 of each 28-day cycle with dexamethasone; or 10mg every day as maintenance after transplant, rising to 15mg after 3 cycles if tolerated	Adults with myeloma: with dexamethasone at any stage, newly diagnosed or treated before, or alone as maintenance after an autologous stem cell transplant	June 29, 2006
Pomalyst pomalidomide (generics from several makers) Bristol Myers Squibb (Celgene); generics from several makers	Capsule by mouth once a day at home, 3 weeks out of 4	4mg on days 1 to 21 of each 28-day cycle, with dexamethasone	Adults with myeloma after at least 2 prior therapies including lenalidomide and a proteasome inhibitor, whose myeloma progressed on or within 60 days of the last therapy, with dexamethasone	February 8, 2013
Thalomid thalidomide Bristol Myers Squibb (Celgene)	Capsule by mouth once a day at bedtime, at home	200mg once daily in 28-day cycles, with dexamethasone 40mg on days 1 to 4, 9 to 12 and 17 to 20	People with newly diagnosed myeloma, with dexamethasone	May 25, 2006
Zenbexus iberdomide Bristol Myers Squibb	Capsule by mouth once a day at home, 3 weeks out of 4	1mg on days 1 to 21 of each 28-day cycle, with Darzalex Faspro injections and dexamethasone	Adults with myeloma after at least 1 prior line that included a proteasome inhibitor and an immunomodulatory agent, with Darzalex Faspro and dexamethasone (accelerated approval)	August 13, 2026
Xpovio selinexor Karyopharm Therapeutics	Tablet by mouth at home, once or twice a week	100mg once a week with weekly bortezomib and twice-weekly dexamethasone; or 80mg twice a week (days 1 and 3) with dexamethasone	Adults with previously treated myeloma: with bortezomib and dexamethasone after at least 1 prior therapy, or with dexamethasone after at least 4 prior therapies when the myeloma is refractory to at least 2 proteasome inhibitors, at least 2 immunomodulatory agents and an anti-CD38 antibody	July 3, 2019

The calendar

A year on each multiple myeloma treatment

Every dose in a year, drawn to the label schedule, so you can see at a glance how often each one is given.

Carvykti

One-time gene therapy, at a clinic

Given once

Abecma

One-time gene therapy, at a clinic

Given once

Tecvayli

Injection, at a clinic

Weekly after step-up doses, later every 2 or 4 weeks (no fixed yearly count)

Elrexfio

Injection, at a clinic

Weekly 76mg after step-up doses, later every 2 or 4 weeks (no fixed yearly count)

Talvey

Injection, at a clinic

Weekly at 0.4mg/kg or every 2 weeks at 0.8mg/kg, after step-up doses (no fixed yearly count)

Lynozyfic

Infusion, at a clinic

Weekly at first, every 2 weeks from week 14, and every 4 weeks for people with a very go... (no fixed yearly count)

Blenrep

Infusion, at a clinic

17 doses a year

Darzalex

Infusion, at a clinic

13 doses a year

Darzalex Faspro

Injection, at a clinic

13 doses a year

Sarclisa

Infusion, at a clinic

10mg/kg weekly in cycle 1, then every 2 weeks (with pomalidomide or carfilzomib) (no fixed yearly count)

Sarclisa Escena

Injection, at a clinic

1,400mg fixed dose weekly in cycle 1, then every 2 weeks (with pomalidomide or carfilzom... (no fixed yearly count)

Empliciti

Infusion, at a clinic

10mg/kg weekly for cycles 1 and 2, then 10mg/kg every 2 weeks (with lenalidomide) or 20m... (no fixed yearly count)

Velcade

Injection, at a clinic

1.3mg/m2 in cycles, at least 72 hours apart (no fixed yearly count)

Kyprolis

Infusion, at a clinic

Once or twice weekly in 3 of every 4 weeks, depending on the combination: 20/70mg/m2 onc... (no fixed yearly count)

Ninlaro

By mouth, at home

39 doses a year

Revlimid

By mouth, at home

25mg on days 1 to 21 of each 28-day cycle with dexamethasone (no fixed yearly count)

Pomalyst

By mouth, at home

274 doses a year

Thalomid

By mouth, at home

365 doses a year

Zenbexus

By mouth, at home

274 doses a year

Xpovio

By mouth, at home

100mg once a week with weekly bortezomib and twice-weekly dexamethasone (no fixed yearly count)

Counts follow the label schedule for a full year on the maintenance dose. Drugs given in cycles or adjusted to blood tests have no fixed count, so their schedule is written out instead.

The evidence

What the pivotal multiple myeloma trials showed

The primary result from the trial each FDA approval rests on, as reported on the label.

Before you compare

How to read the multiple myeloma trial results

1
Single-arm response rates are not a ranking
Elrexfio, Talvey, Lynozyfic and Tecvayli alone were approved on single-arm trials, where everyone got the drug and the result is the share of people who responded. Most other rows come from randomized trials that measured how long people lived without the myeloma getting worse, against a comparison regimen. A response rate and a progression-free survival result measure different things in different people, so neither column ranks the drugs.
2
Most results belong to a combination
Many rows report what happened when a drug was added to a backbone such as lenalidomide, bortezomib or pomalidomide with dexamethasone. That result belongs to the regimen against its own comparison group, not to the added drug on its own. Side effect rates also include the other drugs in the combination, and each label says rates from different trials cannot be compared.
3
The head-to-head trials compared regimens
A few randomized trials did test regimens built on drugs in this table against each other: ENDEAVOR (Kyprolis vs Velcade), DREAMM-7 (Blenrep vs Darzalex, each with bortezomib), EXCALIBER-RRMM (Zenbexus vs bortezomib, each with Darzalex Faspro) and MajesTEC-3 and CARTITUDE-4 against daratumumab or pomalidomide combinations. Each result applies to those regimens in the people enrolled, who often had not stopped responding to the comparison drugs. COLUMBA and IRAKLIA compared the under-the-skin and IV forms of the same antibody and found response rates no worse.
4
REMS programs and treatment centers
Tecvayli and Talvey share 1 REMS safety program, and Elrexfio, Lynozyfic and Blenrep each have their own, so only certified prescribers and sites can give them. Revlimid, Pomalyst, Thalomid and Zenbexus also need a REMS because of the risk of birth defects, with pregnancy testing and birth control rules. Carvykti and Abecma have had no REMS since June 2025, but they are given at treatment centers, and their labels ask people to stay nearby after the infusion, for at least 2 weeks with Carvykti and at least 1 week with Abecma.
5
Accelerated approvals can still change
Elrexfio, Talvey, Lynozyfic and Zenbexus hold accelerated approval, which rests on early results such as response rates and depends on confirmatory trials. Blenrep shows why that matters: its 2020 single-agent approval was withdrawn in 2023, and its 2025 approval is a different use based on a randomized trial.

Multiple Myeloma pivotal trial results by drug
Drug	Pivotal trial	Primary result
Carvykti ciltacabtagene autoleucel Janssen (Johnson & Johnson) with Legend Biotech	CARTITUDE-4, 419 adults with 1 to 3 prior lines and lenalidomide-refractory myeloma, randomized against PVd or DPd Trial record or paper	Median progression-free survival not reached vs 12 months on standard therapy (hazard ratio 0.41); 75.9% vs 49.5% progression-free at 12 months
Abecma idecabtagene vicleucel Bristol Myers Squibb (Celgene), developed with 2seventy bio	KarMMa-3, 386 adults with 2 to 4 prior lines, randomized 2 to 1 against standard regimens Trial record or paper	Median progression-free survival 13.3 vs 4.4 months on standard regimens (hazard ratio 0.49); 71% vs 42% responded
Tecvayli teclistamab-cqyv Janssen (Johnson & Johnson)	MajesTEC-3, 587 adults with 1 to 3 prior lines, randomized against DPd or DVd (combination); MajesTEC-1, single-arm, 110 people (alone) Trial record or paper	With Darzalex Faspro: median progression-free survival not reached vs 18.1 months (hazard ratio 0.17). Alone: 61.8% responded, 28.2% complete response or better
Elrexfio elranatamab-bcmm Pfizer	MagnetisMM-3, single-arm, 97 people with at least 4 prior lines and no prior BCMA therapy Trial record or paper	Response 57.7%, 25.8% complete response or better; 90.4% of responders still responding at 6 months
Talvey talquetamab-tgvs Janssen (Johnson & Johnson)	MonumenTAL-1, single-arm, 187 people with at least 4 prior lines and no prior T-cell redirecting therapy Trial record or paper	73% responded on the weekly dose (100 people) and 73.6% on the every-2-week dose (87 people)
Lynozyfic linvoseltamab-gcpt Regeneron	LINKER-MM1, single-arm, 80 people with at least 4 prior lines Trial record or paper	70% responded, 45% complete response or better; an estimated 72% of responses were ongoing at 12 months
Blenrep belantamab mafodotin-blmf GSK	DREAMM-7, 217 adults with at least 2 prior lines, randomized against daratumumab, bortezomib and dexamethasone (DVd) Trial record or paper	Median progression-free survival 31.3 vs 10.4 months on DVd (hazard ratio 0.31); overall survival hazard ratio 0.49
Darzalex daratumumab (IV) Janssen (Johnson & Johnson)	MAIA, 737 newly diagnosed adults who could not have a transplant, randomized against lenalidomide and dexamethasone (1 of 7 randomized and single-arm trials on the label) Trial record or paper	Progression-free survival hazard ratio 0.56; at 64 months, median 61.9 vs 34.4 months. Overall survival hazard ratio 0.68
Darzalex Faspro daratumumab and hyaluronidase-fihj (under the skin) Janssen (Johnson & Johnson)	COLUMBA, 522 adults after at least 3 prior lines, randomized to Darzalex Faspro or IV Darzalex Trial record or paper	41% vs 37% responded, meeting the goal of being no worse than IV Darzalex; median progression-free survival 5.6 vs 6.1 months
Sarclisa isatuximab-irfc (IV) Sanofi	IMROZ, 446 newly diagnosed adults who could not have a transplant, randomized against bortezomib, lenalidomide and dexamethasone (also ICARIA-MM and IKEMA) Trial record or paper	Median progression-free survival not reached vs 54.3 months (hazard ratio 0.60) at 60 months' follow-up; complete response or better 75% vs 64%
Sarclisa Escena isatuximab-irfc (under the skin) Sanofi	IRAKLIA, 531 adults with relapsed myeloma, randomized to Sarclisa Escena or IV Sarclisa, each with pomalidomide and dexamethasone Trial record or paper	71.1% vs 70.5% responded, meeting the goal of being no worse than IV Sarclisa
Empliciti elotuzumab Bristol Myers Squibb	ELOQUENT-2, 646 adults with 1 to 3 prior therapies, randomized against lenalidomide and dexamethasone (also ELOQUENT-3) Trial record or paper	Median progression-free survival 19.4 vs 14.9 months (hazard ratio 0.70); 78.5% vs 65.5% responded
Velcade bortezomib (generics and Boruzu also approved) Takeda; generics from several makers	VISTA, 682 newly diagnosed adults who could not have high-dose therapy, randomized against melphalan and prednisone (also APEX in relapsed myeloma) Trial record or paper	Median time to progression 20.7 vs 15.0 months (hazard ratio 0.54); 69% vs 34% responded
Kyprolis carfilzomib Amgen	ASPIRE, 792 adults with 1 to 3 prior lines, randomized against lenalidomide and dexamethasone (also ENDEAVOR, A.R.R.O.W., CANDOR and IKEMA) Trial record or paper	Median progression-free survival 26.3 vs 17.6 months (hazard ratio 0.69); overall survival 48.3 vs 40.4 months (hazard ratio 0.79)
Ninlaro ixazomib Takeda	TOURMALINE-MM1, 722 adults with 1 to 3 prior therapies, randomized to Ninlaro or placebo, each with lenalidomide and dexamethasone Trial record or paper	Median progression-free survival 20.6 vs 14.7 months (hazard ratio 0.74); final overall survival 53.6 vs 51.6 months (hazard ratio 0.94)
Revlimid lenalidomide (generics from several makers) Bristol Myers Squibb (Celgene); generics from several makers	FIRST (MM-020), 1,623 newly diagnosed adults who could not have a transplant, randomized against melphalan, prednisone and thalidomide (MPT); also MM-009, MM-010 and 2 maintenance trials Trial record or paper	Median progression-free survival 25.5 months with continuous Revlimid and dexamethasone vs 21.2 months with MPT; 75.1% vs 62.3% responded
Pomalyst pomalidomide (generics from several makers) Bristol Myers Squibb (Celgene); generics from several makers	MM-003, 455 adults after at least 2 prior regimens including lenalidomide and bortezomib, randomized against high-dose dexamethasone Trial record or paper	Median overall survival 12.4 vs 8.0 months (hazard ratio 0.70); median progression-free survival 3.6 vs 1.8 months
Thalomid thalidomide Bristol Myers Squibb (Celgene)	THAL-MM-003 (Study 2), 470 newly diagnosed people, randomized to Thalomid or placebo, each with dexamethasone Trial record or paper	Median time to progression 97.7 vs 28.3 weeks (hazard ratio 0.43); 63% vs 46% responded
Zenbexus iberdomide Bristol Myers Squibb	EXCALIBER-RRMM, first 420 adults with 1 or 2 prior lines, randomized against Darzalex Faspro, bortezomib and dexamethasone (DVd) Trial record or paper	No detectable myeloma with a complete response (MRD-negative complete response) in 41% vs 21%
Xpovio selinexor Karyopharm Therapeutics	BOSTON, 402 adults with 1 to 3 prior therapies, randomized against bortezomib and dexamethasone (also STORM, single-arm) Trial record or paper	Median progression-free survival 13.9 vs 9.5 months (hazard ratio 0.70); 76.4% vs 62.3% responded

Safety

Multiple Myeloma treatment side effects and warnings

Carvykti, Abecma, Tecvayli, Elrexfio, Talvey, Lynozyfic, Blenrep, Revlimid, Pomalyst, Thalomid and Zenbexus carry a boxed warning, the FDA's strongest. The rest list their main precautions. Side effect rates show how many people in each drug's trials reported each one, whether or not the drug caused it.

Multiple Myeloma treatments: most common side effects and key warnings from the FDA labels
Drug	Most common side effects	Key warning
Carvykti ciltacabtagene autoleucel Janssen (Johnson & Johnson) with Legend Biotech	low antibody levels 94%, fever 79% and cytokine release syndrome 78%	Boxed warning Boxed warning: cytokine release syndrome, nerve toxicities including parkinsonism and Guillain-Barre syndrome, HLH/MAS, prolonged and recurring low blood counts, immune effector cell-associated enterocolitis and secondary blood cancers, including T-cell cancers. The REMS ended in June 2025.
Abecma idecabtagene vicleucel Bristol Myers Squibb (Celgene), developed with 2seventy bio	fever 91%, cytokine release syndrome 91% and fever with low neutrophils 51%	Boxed warning Boxed warning: cytokine release syndrome, nerve toxicities, HLH/MAS, prolonged low blood counts and T-cell cancers. More early deaths than standard regimens in KarMMa-3 (18% vs 11% within 9 months). The REMS ended in June 2025.
Tecvayli teclistamab-cqyv Janssen (Johnson & Johnson)	low antibody levels 84%, upper respiratory infection 79% and cytokine release syndrome 60%	Boxed warning Boxed warning: cytokine release syndrome and neurologic toxicity including ICANS, which can be life-threatening or fatal. Available only through the Tecvayli and Talvey REMS.
Elrexfio elranatamab-bcmm Pfizer	cytokine release syndrome 58%, tiredness 43% and injection site reactions 37%	Boxed warning Boxed warning: cytokine release syndrome and neurologic toxicity including ICANS. Available only through the Elrexfio REMS.
Talvey talquetamab-tgvs Janssen (Johnson & Johnson)	fever 83%, cytokine release syndrome 76% and taste changes 70%	Boxed warning Boxed warning: cytokine release syndrome and neurologic toxicity including ICANS, which can be life-threatening or fatal. Available only through the Tecvayli and Talvey REMS. Other label warnings include mouth problems and weight loss, and skin and nail changes.
Lynozyfic linvoseltamab-gcpt Regeneron	muscle and bone pain 53%, cytokine release syndrome 46% and cough 39%	Boxed warning Boxed warning: cytokine release syndrome and neurologic toxicity including ICANS. Available only through the Lynozyfic REMS.
Blenrep belantamab mafodotin-blmf GSK	reduced sharpness of vision 89%, corneal changes on eye exam 86% and blurred vision 66%	Boxed warning Boxed warning: eye toxicity, including vision loss and corneal ulcers. Eye exams before every dose; available only through the Blenrep REMS. Very low platelets are common.
Darzalex daratumumab (IV) Janssen (Johnson & Johnson)	diarrhea 57%, upper respiratory infection 52% and infusion reactions 41%	No boxed warning. Infusion reactions (37% with the first infusion), serious infections, low blood counts, and interference with blood bank tests for up to 6 months after the last dose.
Darzalex Faspro daratumumab and hyaluronidase-fihj (under the skin) Janssen (Johnson & Johnson)	upper respiratory infection 24%, diarrhea 15% and tiredness 15%	No boxed warning. Allergic and administration reactions (7% across trials), infections, low blood counts, and interference with blood bank tests.
Sarclisa isatuximab-irfc (IV) Sanofi	upper respiratory infection 65%, tiredness 55% and diarrhea 55%	No boxed warning. Infusion reactions, which can be fatal, serious infections, low neutrophils, new second cancers and interference with blood bank tests.
Sarclisa Escena isatuximab-irfc (under the skin) Sanofi	upper respiratory infection 39%, tiredness 29% and pneumonia 27%	No boxed warning. Allergic and administration reactions, serious infections, low neutrophils, new second cancers and interference with blood bank tests.
Empliciti elotuzumab Bristol Myers Squibb	tiredness 62%, diarrhea 47% and fever 37%	No boxed warning. Infusion reactions, infections, second cancers and liver injury.
Velcade bortezomib (generics and Boruzu also approved) Takeda; generics from several makers	low platelets 48%, low neutrophils 47% and nerve damage in the hands and feet 46%	No boxed warning. Nerve damage in the hands and feet (severe in 6% with the shot under the skin vs 15% into a vein), low blood pressure, heart and lung problems and low platelets. Never given into the spinal fluid.
Kyprolis carfilzomib Amgen	anemia 35%, low neutrophils 32% and diarrhea 30%	No boxed warning. Heart failure and other heart problems, kidney failure, high blood pressure, lung problems, blood clots, bleeding and liver failure, some fatal.
Ninlaro ixazomib Takeda	low platelets 85%, low neutrophils 74% and diarrhea 52%	No boxed warning. Low platelets, diarrhea and other stomach effects, nerve damage, swelling, rash and liver injury. More deaths with Ninlaro in 2 maintenance trials.
Revlimid lenalidomide (generics from several makers) Bristol Myers Squibb (Celgene); generics from several makers	diarrhea 45%, anemia 44% and low neutrophils 35%	Boxed warning Boxed warning: birth defects, low neutrophils and platelets, and blood clots, heart attack and stroke. Available only through the Lenalidomide REMS.
Pomalyst pomalidomide (generics from several makers) Bristol Myers Squibb (Celgene); generics from several makers	low neutrophils 51%, tiredness and weakness 47% and upper respiratory infection 31%	Boxed warning Boxed warning: birth defects, and blood clots, heart attack and stroke. Available only through the PS-Pomalidomide REMS.
Thalomid thalidomide Bristol Myers Squibb (Celgene)	constipation 50%, swelling of the legs 34% and tremor 26%	Boxed warning Boxed warning: severe birth defects, and blood clots in the legs and lungs with dexamethasone. Available only through the Thalidomide REMS.
Zenbexus iberdomide Bristol Myers Squibb	upper respiratory infection 54%, tiredness 36% and muscle and bone pain 35%	Boxed warning Boxed warning: harm to an unborn baby, and blood clots, heart attack and stroke. Available only through the Zenbexus REMS. Very low neutrophils are common.
Xpovio selinexor Karyopharm Therapeutics	tiredness 59%, nausea 50% and decreased appetite 35%	No boxed warning. Low platelets and neutrophils, nausea and weight loss, low sodium, serious infections, dizziness or confusion, and cataracts.

Not yet approved

Multiple myeloma treatments in Phase 3 or under FDA review

Investigational drugs with a Phase 3 trial, shown separately because their results are not from a label. Status as of the date in each row.

Multiple Myeloma drugs not FDA-approved
Drug	Status	How it works and is given	Pivotal trial	Result so far	What is next
anitocabtagene autoleucel (anito-cel) Kite (Gilead Sciences), developed with Arcellx	Under FDA reviewas of November 4, 2026	One-time BCMA-directed CAR T cell therapy made from the patient's own T cells, using a small synthetic binder called a D-DomainSingle IV infusion after lymphodepleting chemotherapy, at a target dose of 115 million CAR-positive T cells	iMMagine-1, Phase 2, single-arm, 117 treated adults after at least 3 prior lines including a proteasome inhibitor, an immunomodulatory drug and an anti-CD38 antibodyPrimary endpoint: Overall response rate by independent review ClinicalTrials.gov	96% responded and 74% reached a complete response or better at a median follow-up of 15.9 months; 82.1% progression-free at 12 months (Kite and Arcellx, December 6, 2025)	FDA decision (PDUFA date) December 23, 2026, for fourth-line relapsed or refractory myeloma Gilead, February 23, 2026
mezigdomide Bristol Myers Squibb	Under FDA reviewas of November 4, 2026	Oral CELMoD that drives fast breakdown of Ikaros and Aiolos, 2 proteins myeloma cells depend onPill (1.0mg) on days 1 to 21 of each 28-day cycle in SUCCESSOR-2, with carfilzomib and dexamethasone	SUCCESSOR-2, Phase 3, 479 adults with relapsed or refractory myeloma (median 2 prior therapies), against carfilzomib and dexamethasonePrimary endpoint: Progression-free survival ClinicalTrials.gov	Median progression-free survival 18.0 vs 8.3 months (hazard ratio 0.48); 80.2% vs 53.4% responded (The Lancet, 2026; Bristol Myers Squibb, May 29, 2026)	FDA decision (PDUFA date) May 13, 2027, for use with carfilzomib and dexamethasone Bristol Myers Squibb, July 13, 2026

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Questions

Multiple Myeloma treatment questions people ask

What is the newest treatment for multiple myeloma?

Zenbexus (iberdomide), approved on August 13, 2026, is the newest myeloma medicine on this page.

What it is: A daily capsule taken 3 weeks out of 4 with Darzalex Faspro and dexamethasone, after at least 1 prior line that included a proteasome inhibitor and an immunomodulatory agent.

Approval type: Accelerated approval based on MRD-negative complete response, 41% vs 21% against Darzalex Faspro, bortezomib and dexamethasone.

Other 2026 approvals: Sarclisa Escena, an under-the-skin form of Sarclisa, on July 9, 2026, and Tecvayli with Darzalex Faspro after 1 prior line on March 5, 2026.

Under FDA review: Anito-cel, a CAR T cell therapy, has a decision due December 23, 2026, and mezigdomide, a CELMoD pill, May 13, 2027.

More: Zenbexus drug page, anito-cel and mezigdomide

Source: Zenbexus label, DailyMed, August 2026; Sarclisa Escena label, DailyMed, July 2026; FDA letter for Tecvayli, March 5, 2026; Gilead, February 23, 2026; Bristol Myers Squibb, July 13, 2026

Carvykti vs Abecma: what is the difference?

Both are one-time CAR T cell therapies made from a person's own T cells and aimed at BCMA, but their labels cover different stages of myeloma.

Who it is for: Carvykti is approved after at least 1 prior line that included a proteasome inhibitor and an immunomodulatory agent, when the myeloma is refractory to lenalidomide. Abecma is approved after 2 or more prior lines that included an immunomodulatory agent, a proteasome inhibitor and an anti-CD38 antibody.

After the infusion: The Carvykti label asks people to stay near the treatment center for at least 2 weeks, and the Abecma label for at least 1 week.

Trial results: In CARTITUDE-4, Carvykti lowered the risk of progression or death against standard pomalidomide regimens (hazard ratio 0.41). In KarMMa-3, median progression-free survival was 13.3 months on Abecma vs 4.4 months on standard regimens. The trials enrolled different people, and no trial has compared Carvykti with Abecma.

Safety: Both carry boxed warnings for cytokine release syndrome, nerve toxicities, HLH/MAS, low blood counts and T-cell cancers. Both trials saw more early deaths than the comparison arm.

More: Carvykti drug page and Abecma drug page

Source: Carvykti label, DailyMed; Abecma label, DailyMed

Tecvayli vs Elrexfio vs Talvey vs Lynozyfic: how do the bispecific antibodies differ?

All 4 are bispecific antibodies that link the immune system's T cells to myeloma cells. Tecvayli, Elrexfio and Lynozyfic target BCMA, and Talvey targets a different protein, GPRC5D.

Who it is for: All 4 are approved alone after at least 4 prior lines. Tecvayli is also approved with Darzalex Faspro after 1 prior line that included a proteasome inhibitor and an immunomodulatory agent.

How it is given: Tecvayli, Elrexfio and Talvey are injections under the skin, and Lynozyfic is an IV infusion. Each starts with step-up doses and hospital stays of 24 to 48 hours.

Trial results: In separate single-arm trials, 61.8% responded to Tecvayli, 57.7% to Elrexfio, 73% to weekly Talvey and 70% to Lynozyfic. The trials enrolled different people, so these numbers do not rank the drugs.

Safety: All 4 carry a boxed warning for cytokine release syndrome and neurologic toxicity and are given only through a REMS program. Talvey's label also warns about mouth problems, weight loss, and skin and nail changes.

More: Tecvayli, Elrexfio, Talvey and Lynozyfic

Source: Tecvayli label, DailyMed; Elrexfio label, DailyMed; Talvey label, DailyMed; Lynozyfic label, DailyMed

Darzalex vs Darzalex Faspro: what is the difference?

Both contain daratumumab, an anti-CD38 antibody, but Darzalex is an IV infusion and Darzalex Faspro is an injection under the skin with a separate label.

How it is given: Darzalex IV takes about 7 hours the first time and about 3 hours later on. Darzalex Faspro is a fixed dose injected into the belly over about 3 to 5 minutes.

Who it is for: Darzalex Faspro covers the Darzalex uses plus bortezomib, lenalidomide and dexamethasone for newly diagnosed myeloma and high-risk smoldering myeloma, and its pomalidomide combination starts after 1 prior line instead of 2.

Trial results: In COLUMBA, 41% responded to Darzalex Faspro and 37% to Darzalex IV, which met the goal of being no worse. Infusion or injection reactions occurred in 13% vs 34%.

Sarclisa too: Sarclisa Escena, approved July 9, 2026, is the under-the-skin form of the anti-CD38 antibody Sarclisa. In IRAKLIA, 71.1% responded to it and 70.5% to Sarclisa IV.

More: daratumumab drug page and isatuximab drug page

Source: Darzalex label, DailyMed; Darzalex Faspro label, DailyMed; Sarclisa Escena label, DailyMed

Which multiple myeloma treatments are pills?

Revlimid, Pomalyst, Thalomid, Zenbexus, Ninlaro and Xpovio, 6 medicines in all, are pills taken at home.

Taken with other drugs: Each is approved with dexamethasone or another myeloma medicine, except Revlimid maintenance after a stem cell transplant, which is taken alone.

Schedules: Revlimid with dexamethasone, Pomalyst and Zenbexus are taken daily for 21 days of each 28-day cycle, Thalomid every day at bedtime, Ninlaro once a week for 3 weeks of each cycle, and Xpovio once or twice a week.

REMS: Revlimid, Pomalyst, Thalomid and Zenbexus can cause birth defects, so they are available only through REMS programs with pregnancy testing and birth control rules.

Generics: Generic lenalidomide and pomalidomide are FDA approved and rated as substitutable for Revlimid and Pomalyst.

More: Revlimid, Pomalyst, Zenbexus, Ninlaro and Xpovio

Source: Revlimid label, DailyMed; Pomalyst label, DailyMed; Thalomid label, FDA, revised 9/2026; Zenbexus label, DailyMed; Ninlaro label, DailyMed; Xpovio label, DailyMed

Is Blenrep back on the market for multiple myeloma?

Yes. The FDA approved Blenrep again on October 23, 2025, for a different use than its first approval.

Current use: With bortezomib and dexamethasone for adults whose myeloma came back after at least 2 prior lines that included a proteasome inhibitor and an immunomodulatory agent.

What happened before: Blenrep's 2020 accelerated approval as a single drug after 4 or more prior therapies was withdrawn at the FDA's request after the DREAMM-3 trial, with a withdrawal date of February 6, 2023.

Trial results: In DREAMM-7, median progression-free survival was 31.3 months with Blenrep vs 10.4 months with Darzalex, each with bortezomib and dexamethasone. The trial left out people whose myeloma no longer responded to daratumumab or bortezomib.

Eye safety: A boxed warning covers eye damage, so an eye exam is required before every dose, and Blenrep is available only through the Blenrep REMS.

More: Blenrep drug page

Source: Blenrep label, DailyMed, October 2025; FDA, October 23, 2025; FDA withdrawn cancer accelerated approvals

Go deeper

More on Multiple Myeloma at Trial Friend

Sources

Where every number on this page comes from

Approved-drug facts are from the current FDA prescribing information on DailyMed or the FDA's own site, with the label's effective date. Investigational-drug facts are from ClinicalTrials.gov and the sources named in each row.

Carvykti (ciltacabtagene autoleucel) prescribing information, Janssen (Johnson & Johnson) with Legend Biotech, label dated Oct 2025. DailyMed. Pivotal trial: ClinicalTrials.gov
Abecma (idecabtagene vicleucel) prescribing information, Bristol Myers Squibb (Celgene), developed with 2seventy bio, label dated Nov 2025. DailyMed. Pivotal trial: ClinicalTrials.gov
Tecvayli (teclistamab-cqyv) prescribing information, Janssen (Johnson & Johnson), label dated Mar 2026. DailyMed. Pivotal trial: ClinicalTrials.gov
Elrexfio (elranatamab-bcmm) prescribing information, Pfizer, label dated May 2026. DailyMed. Pivotal trial: ClinicalTrials.gov
Talvey (talquetamab-tgvs) prescribing information, Janssen (Johnson & Johnson), label dated Oct 2025. DailyMed. Pivotal trial: ClinicalTrials.gov
Lynozyfic (linvoseltamab-gcpt) prescribing information, Regeneron, label dated Jul 2025. DailyMed. Pivotal trial: ClinicalTrials.gov
Blenrep (belantamab mafodotin-blmf) prescribing information, GSK, label dated Oct 2025. DailyMed. Pivotal trial: ClinicalTrials.gov
Darzalex (daratumumab (IV)) prescribing information, Janssen (Johnson & Johnson), label dated Sep 2026. DailyMed. Pivotal trial: ClinicalTrials.gov
Darzalex Faspro (daratumumab and hyaluronidase-fihj (under the skin)) prescribing information, Janssen (Johnson & Johnson), label dated Sep 2026. DailyMed. Pivotal trial: ClinicalTrials.gov
Sarclisa (isatuximab-irfc (IV)) prescribing information, Sanofi, label dated Jul 2026. DailyMed. Pivotal trial: ClinicalTrials.gov
Sarclisa Escena (isatuximab-irfc (under the skin)) prescribing information, Sanofi, label dated Jul 2026. DailyMed. Pivotal trial: ClinicalTrials.gov
Empliciti (elotuzumab) prescribing information, Bristol Myers Squibb, label dated Mar 2022. DailyMed. Pivotal trial: ClinicalTrials.gov
Velcade (bortezomib (generics and Boruzu also approved)) prescribing information, Takeda; generics from several makers, label dated Aug 2025. DailyMed. Pivotal trial: ClinicalTrials.gov
Kyprolis (carfilzomib) prescribing information, Amgen, label dated Jun 2025. DailyMed. Pivotal trial: ClinicalTrials.gov
Ninlaro (ixazomib) prescribing information, Takeda, label dated Aug 2026. DailyMed. Pivotal trial: ClinicalTrials.gov
Revlimid (lenalidomide (generics from several makers)) prescribing information, Bristol Myers Squibb (Celgene); generics from several makers, label dated Mar 2023. DailyMed. Pivotal trial: ClinicalTrials.gov
Pomalyst (pomalidomide (generics from several makers)) prescribing information, Bristol Myers Squibb (Celgene); generics from several makers, label dated Feb 2025. DailyMed. Pivotal trial: ClinicalTrials.gov
Thalomid (thalidomide) prescribing information, Bristol Myers Squibb (Celgene), label dated Sep 2026. FDA label. Pivotal trial: ClinicalTrials.gov
Zenbexus (iberdomide) prescribing information, Bristol Myers Squibb, label dated Aug 2026. DailyMed. Pivotal trial: ClinicalTrials.gov
Xpovio (selinexor) prescribing information, Karyopharm Therapeutics, label dated May 2026. DailyMed. Pivotal trial: ClinicalTrials.gov
anitocabtagene autoleucel (anito-cel), Kite (Gilead Sciences), developed with Arcellx: ClinicalTrials.gov record; Gilead, February 23, 2026. Checked November 4, 2026.
mezigdomide, Bristol Myers Squibb: ClinicalTrials.gov record; Bristol Myers Squibb, July 13, 2026. Checked November 4, 2026.

This page compares what the FDA labels and pivotal trials report. It is not medical advice, and no trial on this page compared these drugs with each other. Written and checked by Jason Hunter; the method is on the editorial standards page.