eligibility_summary
Incl: Age 18–69 with newly diagnosed measurable MM, ≥2 high‑risk cytogenetics, ECOG ≤2 (≤3 if bone disease), adequate marrow/renal/hepatic function, no prior MM therapy except ≤14 d steroids, can take prophylactic anticoagulants, women: contraception, neg test. Excl: PCL, amyloidosis, CNS MM, allo‑HSCT, ≥grade 3 neuropathy, cardiac disease/QTc, uncontrolled DM/HTN, active HIV/HBV/HCV, pregnancy/lactation, malabsorption, recent cancer, recent surgery/live vaccine, or compliance issues.
trial_source
clinical_trials.gov from Dec 2, 2025
annotation_status
ai
ai_summary
DVRd regimen: daratumumab (anti-CD38 IgG1 monoclonal antibody, depletes CD38+ myeloma plasma cells via ADCC, CDC, ADCP and apoptosis, modulates immune microenvironment), bortezomib (proteasome inhibitor, blocks 26S proteasome, increases misfolded proteins, inhibits NF-κB, triggers ER-stress–mediated apoptosis), lenalidomide (IMiD, binds cereblon, promotes IKZF1/3 degradation, enhances T/NK function, anti-angiogenic, direct tumor cytotoxicity), dexamethasone (glucocorticoid, induces lymphoid/plasma-cell apoptosis, anti-inflammatory). Targets: malignant plasma cells, CD38 antigen, ubiquitin–proteasome pathway/NF-κB signaling, cereblon E3 ligase pathway (Ikaros/Aiolos), immune effector activation (NK/T cells), glucocorticoid receptor–mediated apoptosis. MRD-guided maintenance post-ASCT in newly diagnosed double-hit high-risk MM.