Standard dose (MTD) versus AT for an IgD MM patient with initial serum level of 1,400mg/dl. Patient was treated with lenalidomide until month 6, when dexamethasone was added. (A) Serum m-protein level (black squares) was used to fit a computational model of the tumor burden. 50 possible solutions are shown as curves, and a validation data point is shown as a green square. (B) Each of the models was simulated under AT, the actual m-protein levels are shown for reference. (C) The simulation that best fit the validation data points shows that the majority of the burden was composed of lenalidomide-sensitive cells, which are eradicated after 4 months of treatment (red), allowing growth of a multidrug-resistant clone (orange). (D) AT prevents the growth of the MDR clones by maintaining the sensitive clone at a manageable level. (E) The models predict that under AT this patient would have a 95% of chance of being under the initial burden, compared to 5% under MTD, after 48 months.