eligibility_summary
Inclusion: adults >18 with newly diagnosed, measurable MM needing therapy, ECOG 0–2, limited prior induction, adequate counts and organ function, AHCT‑eligible, contraception/no gamete donation. Exclusion: other plasma cell disorders, prior anti‑BCMA/CD38, recent trial/vaccine/radiation/chemo/cell tx, CNS MM, most other active cancers, serious lung/heart disease, HIV/HBV/active HCV, recent major surgery, neuropathy, uncontrolled infection/autoimmune/psychiatric disease or noncompliance.
trial_source
clinical_trials.gov from Dec 2, 2025
annotation_status
ai
ai_summary
Interventions: Induction with Dara‑VRd—daratumumab (anti‑CD38 monoclonal antibody), bortezomib (proteasome inhibitor), lenalidomide (IMiD/cereblon E3 ligase modulator), dexamethasone (glucocorticoid). MRD‑negative: randomized to additional Dara‑VRd then Dara‑R (daratumumab+lenalidomide) maintenance vs autologous hematopoietic cell transplantation (AHCT, high‑dose melphalan, an alkylating agent) then Dara‑R. MRD‑positive: AHCT then teclistamab+daratumumab (Tec‑Dara, bispecific anti‑BCMA×CD3 T‑cell engager plus anti‑CD38 mAb) for consolidation/maintenance vs AHCT then Dara‑R. Targets/pathways: CD38 on malignant plasma cells (ADCC/CDC/ADCP, immune modulation), BCMA on plasma cells with CD3 on T cells (redirected T‑cell cytotoxicity), proteasome/proteostasis and NF‑κB (bortezomib), cereblon‑IKZF1/3 degradation and immune activation (lenalidomide), glucocorticoid‑induced apoptosis (dexamethasone), DNA crosslinking (melphalan).