The primary endpoint was complete remission (CR) after VRd in ndMM, in correlation with mutational profile....In ndMM, treated by VRd, mutations in MAPK-pathway members (NRAS, KRAS or BRAF) were associated with reduced probability of CR (21/38, 55%)...Concerning effect of a specific mutation, NRAS p.Q61K mutant was associated with reduced probability to obtain CR in ndMM...In conclusion, activation of MAPK pathway via mutations in NRAS, KRAS and BRAF genes seems to have a negative impact on outcome in patients with ndMM treated by standard PI/IMiDs -based triplets, like VRd. Furthermore, NRAS Q61K -mutant appears to be associated with worst outcome in this setting.