eligibility_summary
Eligible: adults (≥18) with symptomatic, measurable multiple myeloma per 2014 IMWG at first relapse, with first-line RVD (PI+IMiD) therapy and ≥PR to ≥1 prior regimen, consent required. WOCBP: abstinence or 2 contraceptive methods from 4 weeks pre-dose to 3 months post–last dose, negative pregnancy test at screening. Exclude: inactive MM (amyloidosis/MGUS/smoldering), relapsed or primary refractory disease, prior daratumumab/pomalidomide, recent malignancy, uncontrolled psych illness, noncompliance.
trial_source
clinical_trials.gov from Dec 2, 2025
annotation_status
ai
ai_summary
Observational, multicenter study in first-relapse multiple myeloma comparing daratumumab+pomalidomide+dexamethasone (Dara-PD) with contemporary regimens (Dara-KPD, VPd, KPd, IPd, Pd). Drugs/mechanisms: - Daratumumab: human IgG1 monoclonal antibody targeting CD38 on malignant plasma cells, mediates NK cell ADCC, macrophage ADCP, complement CDC, direct apoptosis, depletes CD38+ immunosuppressive cells (Tregs/Bregs/MDSCs), expanding T cells. - Pomalidomide: oral IMiD, binds cereblon (CRL4CRBN E3 ligase), degrades IKZF1/3, downregulates IRF4/c-MYC, enhances T/NK activation, reduces pro-angiogenic cytokines. - Dexamethasone: corticosteroid, glucocorticoid receptor-driven lymphocyte apoptosis and anti-inflammatory effects, synergizing with anti-myeloma agents. Comparators include proteasome inhibitors bortezomib (reversible), carfilzomib (irreversible), ixazomib (oral) blocking the 26S proteasome, suppressing NF-kB and inducing ER-stress apoptosis. Targets: CD38, malignant plasma cells, cereblon pathway, proteasome, complement, NK/macrophage effector pathways, T-cell repertoire.