eligibility_summary
Adults 18–75 with multiple myeloma, 1–2 prior lines (incl PI/IMiD), lenalidomide‑refractory, progression ≤12 months, ECOG 0–1, adequate organ function (marrow/liver/renal/coag), SpO2>91%, LVEF≥50%, contraception and consent required. Exclude: recent HSCT/anti‑cancer therapy or immunosuppression, major cardiac/unstable disease, key drug allergies, other malignancy, CNS MM, PCL/WM/POEMS/amyloid, significant EM disease, infection, HBV/HCV/HIV/syphilis/CMV+, pregnancy, recent CNS disorder, unresolved >Gr1 toxicity.
trial_source
clinical_trials.gov from Dec 2, 2025
annotation_status
ai
ai_summary
Phase III randomized, open-label trial in lenalidomide‑refractory relapsed/refractory multiple myeloma compares: 1) Equecabtagene autoleucel (eque‑cel, autologous BCMA‑directed CAR‑T cell therapy, single infusion of gene‑modified T cells that recognize BCMA on plasma cells/B cells, triggering T‑cell activation, cytotoxicity, and myeloma cell elimination) vs 2) Standard regimens: DPd (daratumumab + pomalidomide + dexamethasone) or PVd (pomalidomide + bortezomib + dexamethasone). Mechanisms: daratumumab (anti‑CD38 mAb, ADCC/CDC/apoptosis, immune modulation), pomalidomide (IMiD, cereblon E3 ligase modulator causing IKZF1/3 degradation → ↓IRF4/MYC, T/NK activation), bortezomib (proteasome inhibitor, blocks 26S proteasome, disrupts NF‑κB/proteostasis), dexamethasone (glucocorticoid, pro‑apoptotic, anti‑inflammatory). Targets/pathways: BCMA, CD38, cereblon‑IKZF axis, ubiquitin‑proteasome/NF‑κB, goal: eradicate malignant plasma cells.