为了改善多发性骨髓瘤（MM）这种无法治愈的血液肿瘤患者的疗效，一个关键的范式包括通过初期治疗迅速建立疾病控制，然后通过维持治疗保证治疗反应的持久性并降低毒性。然而，患者在复发后的预后变差，并且随后的治疗线路中疾病负担和药物毒性通常更具挑战性。因此，对于新诊断的多发性骨髓瘤（NDMM）患者接受最佳的一线治疗尤为重要。利来多米德、硼替佐米和地塞米松（RVd）的联合疗法一致表现出可接受的安全性，以及显著且临床意义重大的益处，包括深度和持久的治疗反应、改善NDMM患者的生存率，而不受移植适应症的影响。此外，比较研究评估这种三联疗法与双联疗法和其他三联疗法之间的差异已经建立了RVd作为一线治疗的标准，其显著而一致的疗效也得到认可。鉴于广泛的临床数据、医生的熟悉程度、纳入治疗指南以及RVd联合四联疗法的潜在优势，RVd有望继续成为NDMM治疗的重要基石，并且在MM的初期治疗中其作用可能会不断增大。

To improve patient outcomes in the otherwise incurable hematologic malignancy of multiple myeloma (MM), a key paradigm includes initial treatment to establish disease control rapidly followed by maintenance therapy to ensure durability of response with manageable toxicity. However, patient prognosis becomes worse after relapse, and the disease burden and drug toxicities are generally more challenging with subsequent lines of therapy. It is therefore particularly important that patients with newly diagnosed multiple myeloma (NDMM) receive optimal frontline therapy. The combination of lenalidomide, bortezomib, and dexamethasone (RVd) has consistently demonstrated a tolerable safety profile with significant and clinically relevant benefit, including deep and durable responses with improved survival in patients with NDMM regardless of their transplant eligibility. Furthermore, comparative studies evaluating this triplet against both doublets and other triplet regimens have established RVd as a standard of care in this setting based upon its remarkable and concordant efficacy. Given the breadth of clinical data, physician familiarity, inclusion in treatment guidelines, and the emerging potential of RVd-containing quadruplet regimens, RVd will likely continue as a key cornerstone of NDMM therapy, and its role will therefore likely continue to grow as a therapeutic backbone in the initial treatment of MM.