eligibility_summary
Adults with MM per IMWG and measurable disease, 1–3 prior lines incl ≥2 cycles anti‑CD38 mAb and ≥2 cycles lenalidomide, progressive or no response to last therapy, ECOG 0–2, women not pregnant/breastfeeding and using contraception, agree to restrictions. Exclude: prior BCMA therapy, ineligible for PVd/Kd controls (prior drug, intolerance, neuropathy, HTN, CYP3A4 inducer, not eligible for bortezomib retreatment), ≥140 mg prednisone eq <14 d, live vaccine <4 wk, CNS MM, plasma cell leukemia, WM, POEMS, AL.
trial_source
clinical_trials.gov from Dec 2, 2025
annotation_status
ai
ai_summary
Phase 3 RCT in relapsed/refractory multiple myeloma comparing: (1) Teclistamab, a subcutaneous bispecific T‑cell–redirecting antibody that binds BCMA on myeloma cells and CD3 on T cells to induce cytotoxic killing, vs (2) investigator’s choice PVd or Kd. Pomalidomide (oral IMiD) binds cereblon to degrade IKZF1/3, enhancing IL-2, T/NK-cell activation, and anti-myeloma immunity. Bortezomib (SC reversible boronate proteasome inhibitor) and carfilzomib (IV irreversible epoxyketone proteasome inhibitor) inhibit the 20S proteasome, disrupting proteostasis and NF-kB signaling to trigger apoptosis. Dexamethasone (glucocorticoid) activates the glucocorticoid receptor, causing lymphoid apoptosis and anti-inflammatory effects. Targets: BCMA+ malignant plasma cells, CD3+ T cells (immune synapse/activation), ubiquitin–proteasome pathway, CRBN-IKZF1/3 axis, NF-kB, glucocorticoid receptor pathway.