eligibility_summary
Include: age ≥65, newly diagnosed multiple myeloma per IMWG (CRAB/SLiM) with measurable disease (M-protein/FLC), survival >3 months, no active infection, able to understand and consent. Exclude: active HBV/HCV/immunodeficiency, grade ≥2 neuropathy, plasma cell leukemia or non-bone EMD, severe thrombosis, liver dysfunction (elevated AST/ALT or bilirubin), major surgery <30 days, significant neuro/psych illness, substance abuse, other trial drugs, pregnant/lactating, or investigator deems unsuitable.
trial_source
clinical_trials.gov from Dec 2, 2025
annotation_status
ai
ai_summary
A prospective, open-label cohort in elderly, transplant-ineligible newly diagnosed multiple myeloma compares DRd (daratumumab+lenalidomide+dexamethasone) vs VRd‑lite (bortezomib+lenalidomide+dexamethasone). Drug types and mechanisms: Daratumumab—anti-CD38 IgG1 monoclonal antibody depleting CD38+ plasma cells via ADCC, CDC, ADCP, apoptosis, and immune modulation. Bortezomib—reversible 26S proteasome inhibitor (β5 chymotrypsin-like site) causing proteotoxic stress and NF-κB inhibition. Lenalidomide—IMiD binding cereblon to degrade IKZF1/3, enhancing T/NK-cell cytotoxicity and anti-myeloma activity. Dexamethasone—glucocorticoid inducing lymphocyte apoptosis and anti-inflammatory effects. Targets/pathways: CD38+ plasma cells, proteasome/UPS, NF-κB, cereblon–IKZF axis, T/NK effector function.