eligibility_summary
Adults 18–65 with newly diagnosed, measurable MM meeting CRAB, eligible for high‑dose therapy/auto‑SCT, KPS≥50/ECOG≤2, contraception/negative pregnancy tests, French social security. Exclude: neuropathy≥G2, pulmonary disease FEV1<50%, CNS MM, PCL/WM/POEMS/AL, other active cancers, major cardiac disease/recent stroke/seizure, HIV, HBV or active HCV, malabsorption, prior MM therapy/SCT, recent surgery, plasmapheresis or live vaccine, strong CYP3A4 inducers, drug allergy, pregnancy, no NGS.
trial_source
clinical_trials.gov from Dec 2, 2025
annotation_status
ai
ai_summary
Phase 2, MRD-adapted trial in newly diagnosed multiple myeloma. Induction: D-VRd—daratumumab (anti-CD38 monoclonal antibody, ADCC/CDC/apoptosis of CD38+ plasma cells), bortezomib (proteasome inhibitor, inhibits NF-κB, induces ER stress/apoptosis), lenalidomide (IMiD, cereblon-mediated IKZF1/3 degradation, enhances T/NK function), dexamethasone (corticosteroid, lympholytic/anti-inflammatory). Maintenance by MRD status: Cohort A (MRD−, standard risk): teclistamab + lenalidomide. Cohort B (MRD+, high risk): teclistamab + talquetamab. Teclistamab: bispecific antibody (CD3×BCMA) redirecting T cells to kill BCMA+ myeloma. Talquetamab: bispecific antibody (CD3×GPRC5D) redirecting T cells to kill GPRC5D+ myeloma. Target cells/pathways: BCMA/TNFRSF17 and GPRC5D on plasma cells, CD3-driven T-cell activation, cereblon-IKZF axis, proteasome pathway, CD38+ plasma cells, innate/adaptive cytotoxicity.