eligibility_summary
Eligible: Multiple myeloma, age 18–65, or 66–70 with Sorror 0 and ECOG ≤1, consent, first relapse after induction+autologous SCT (1–2) and maintenance, meeting SLiM-CRAB, negative pregnancy test, ≤1 salvage cycle pre-entry, after 3 salvage cycles: CR/PR/SD and suitable donor (HLA-ident sibling, 10/10 MUD, or 9/10 MMUD if DQB). Exclude: major organ dysfunction, active HBV/HCV or uncontrolled HIV, other active cancer, prior allo SCT, recent trial/IMP, pregnancy/breastfeeding, PD on salvage.
trial_source
clinical_trials.gov from Dec 2, 2025
annotation_status
ai
ai_summary
NCT05675319 (terminated) compares allogeneic stem cell transplantation (allo-SCT, cellular immunotherapy) vs conventional salvage in first-relapse multiple myeloma. Allo-SCT: donor hematopoietic cells, mechanism = graft-versus-myeloma via donor T/NK cell alloreactivity against malignant plasma cells (also risk of GVHD). Comparator regimens target: 1) Proteasome pathway—carfilzomib, bortezomib, ixazomib (small-molecule proteasome inhibitors) block 20S proteasome, disrupt proteostasis, induce apoptosis in myeloma cells. 2) Cereblon/IKZF1/3—lenalidomide, pomalidomide (IMiDs) bind cereblon, trigger IKZF1/3 degradation, enhance T/NK function and anti-myeloma immunity. 3) CD38—daratumumab, isatuximab (IgG mAbs) mediate ADCC/CDC/apoptosis against CD38+ myeloma and immunosuppressive cells. 4) SLAMF7—elotuzumab (mAb) activates NK cells and ADCC vs SLAMF7+ myeloma. 5) XPO1—selinexor (SINE) blocks nuclear export, restores tumor suppressor signaling. Dexamethasone (glucocorticoid) promotes lymphoid apoptosis. Autologous SCT (cellular support) allowed.