eligibility_summary
Inclusion: 18–65, newly diagnosed measurable MM (Chinese 2022), p53 abnormality (FISH ≥20% or mutation), no prior MM therapy (brief steroids ok), ECOG 0–1, adequate labs/organ and lung function, transplant-eligible, contraception, can take prophylactic anticoagulants. Exclusion: PCL, amyloidosis, CNS MM, neuropathy ≥2, BCMA‑CAR‑T intolerance, major CV disease, HIV, active HBV/HCV, GI absorption issues, recent major surgery/live vaccine, pregnancy/breastfeeding, noncompliance.
trial_source
clinical_trials.gov from Dec 2, 2025
annotation_status
ai
ai_summary
Interventions: VRd induction/consolidation (bortezomib + lenalidomide + dexamethasone), two infusions of autologous anti‑BCMA CAR‑T cells (CART/CART2), autologous stem cell transplant (ASCT), and lenalidomide maintenance. Mechanisms/types: bortezomib (proteasome inhibitor causing proteotoxic stress and NF‑κB inhibition), lenalidomide (IMiD, binds cereblon to degrade IKZF1/3, enhances T/NK activity), dexamethasone (glucocorticoid inducing apoptosis), anti‑BCMA CAR‑T (cell therapy, engineered autologous T cells mediating BCMA‑directed cytotoxicity), ASCT (procedure to restore hematopoiesis). Targets/pathways: BCMA/TNFRSF17 on malignant plasma cells, proteasome/ER‑stress and NF‑κB signaling, cereblon‑IKZF1/3 axis and immune effector activation, glucocorticoid receptor–mediated apoptosis. Population: newly diagnosed MM with TP53 abnormalities.