eligibility_summary
Adults (≥18) with relapsed/refractory multiple myeloma, previously treated with >1 prior therapy including an isatuximab-based regimen, with FISH results (including 1q2) at diagnosis or relapse, and able to provide informed consent. No exclusion criteria specified.
trial_source
clinical_trials.gov from Dec 2, 2025
annotation_status
ai
ai_summary
Observational study of real‑world isatuximab-based regimens in relapsed/refractory multiple myeloma, focusing on patients with 1q21+ cytogenetic aberrations. Regimens: 1) Isa‑Pd: isatuximab (anti‑CD38 IgG1 mAb) + pomalidomide (IMiD) + dexamethasone (glucocorticoid). 2) Isa‑Kd: isatuximab + carfilzomib (irreversible proteasome inhibitor) + dexamethasone. Mechanisms: Isatuximab targets CD38 on malignant plasma cells, inducing ADCC/ADCP/CDC, direct apoptosis, and inhibiting CD38 ectoenzyme activity. Pomalidomide binds cereblon, degrades IKZF1/3, lowers IRF4/MYC, and enhances T/NK activity. Carfilzomib blocks the 20S proteasome (β5), causing proteotoxic stress and apoptosis. Dexamethasone activates glucocorticoid receptor to induce lymphocyte apoptosis. Targets/pathways: CD38+ myeloma cells, NK/complement/macrophage Fc effector pathways, cereblon‑IKZF axis, ubiquitin‑proteasome system. Subgroup focus: 1q21+ MM.