eligibility_summary
Eligible: previously untreated active multiple myeloma starting VRd, DRd, or DVRd, no prior myeloma therapy, not receiving treatment for another active malignancy, within 3 months of treatment start. Exclusion: anyone not meeting all inclusion criteria.
trial_source
clinical_trials.gov from Dec 2, 2025
annotation_status
ai
ai_summary
Completed Mayo Clinic observational study compares initial therapies for newly diagnosed multiple myeloma: VRd (bortezomib+lenalidomide+dexamethasone), DRd (daratumumab+lenalidomide+dexamethasone), and DVRd (daratumumab+bortezomib+lenalidomide+dexamethasone). Drugs and mechanisms: Daratumumab—anti-CD38 IgG1 monoclonal antibody, targets CD38 on myeloma plasma cells, mediating CDC, ADCC, ADCP, apoptosis, and depleting CD38+ immunosuppressive cells. Bortezomib—small-molecule 26S proteasome inhibitor, blocks ubiquitin–proteasome pathway, causing ER stress and apoptosis in plasma cells. Lenalidomide—IMiD, binds cereblon to trigger IKZF1/IKZF3 degradation, enhancing T/NK cell activity and direct anti-myeloma effects. Dexamethasone—glucocorticoid, induces myeloma cell apoptosis via glucocorticoid receptor pathways. Targeted cells/pathways: CD38+ plasma cells, proteasome, cereblon/IKZF, immune effector activation, glucocorticoid signaling.