eligibility_summary
Eligible: newly diagnosed MM per IMWG, ECOG ≤2, renal insufficiency (eCrCl <60 mL/min via Cockcroft-Gault or on dialysis), no study-drug allergies, adequate organ function, INR/PT and aPTT ≤1.5×ULN. Exclude: HIV/HBV/HCV, COPD, moderate/severe or uncontrolled asthma, significant heart disease (recent MI/unstable), pregnancy/breastfeeding, grade 3–4 neuropathy, active malignancy, CNS involvement/plasma cell leukemia/AL, active infection, substance abuse.
trial_source
clinical_trials.gov from Dec 2, 2025
annotation_status
ai
ai_summary
Interventions: Dara-CyBorD induction (daratumumab‑hyaluronidase SC + bortezomib + cyclophosphamide + dexamethasone), with maintenance lenalidomide + daratumumab. Mechanisms/types: Daratumumab (anti‑CD38 IgG1 monoclonal antibody) binds CD38 on malignant plasma cells, inducing ADCC/CDC/ADCP and apoptosis, hyaluronidase enhances SC absorption. Bortezomib (26S proteasome inhibitor) blocks proteasomal degradation, inhibits NF‑κB, triggers apoptosis, rapidly lowers free light chains. Cyclophosphamide (alkylating chemotherapy) DNA crosslinking cytotoxicity. Dexamethasone (glucocorticoid) induces lymphoid/plasma‑cell apoptosis. Lenalidomide (IMiD) binds cereblon, degrades IKZF1/3, boosts T/NK cell activity. Targets/pathways: CD38+ plasma cells, proteasome/ubiquitin system, DNA integrity, glucocorticoid receptor, cereblon–IKZF1/3, innate/adaptive cytotoxicity.