eligibility_summary
Inclusion: adults ≥18, newly diagnosed MM, 1–2 prior IMiD+PI induction, ECOG 0–2, AHCT 100–180 d prior, clonoSEQ MRD ≥10^-5 at 60–120 d post‑AHCT, ≥PR with no progression, adequate liver/marrow/renal function (CrCl ≥40), contraception/consent. Exclusions: other plasma cell disorders, recent surgery/radiation/infection, refractoriness to CD38 mAb/carfilzomib, active HBV/HCV, major cardiac/QTc>480, CNS MM or lung disease, significant neuropathy, other serious conditions.
trial_source
clinical_trials.gov from Dec 2, 2025
annotation_status
ai
ai_summary
Phase Ib/II (NCT05434689) tests post-AHCT consolidation combos to clear MRD+ multiple myeloma: Regimen A = iberdomide + daratumumab + dexamethasone, Regimen B adds carfilzomib. Iberdomide (CC-220) is an oral CELMoD (cereblon E3 ligase modulator, small-molecule immunomodulator) that degrades IKZF1/IKZF3, downregulates IRF4/MYC, and enhances T- and NK-cell activation. Daratumumab is an anti-CD38 monoclonal antibody inducing ADCC/CDC/ADCP and apoptosis of CD38+ plasma cells while depleting CD38+ immunosuppressive cells. Carfilzomib is an irreversible proteasome inhibitor (small molecule) targeting the 20S chymotrypsin-like site to trigger proteotoxic apoptosis. Dexamethasone (corticosteroid) promotes glucocorticoid-mediated tumor cell apoptosis. Targeted cells/pathways: CRBN–IKZF axis, T/NK effectors, CD38 on malignant plasma cells, ubiquitin–proteasome system, and glucocorticoid receptor, goal: eradicate MRD.