eligibility_summary
Adults 18–75 with NDMM and measurable disease (M‑protein/FLC), ineligible or deferring upfront ASCT, BCMA+ marrow, adequate labs (TBIL<2×ULN, AST/ALT<3×ULN, CrCl≥30, WBC≥1.5, ANC≥1.0, Hb≥70 g/L, PLT≥75 or ≥50×10^9/L if BMPC≥50%), can take prophylactic anticoagulation. Exclude plasma cell leukemia, amyloidosis, prior BCMA/CAR‑T, PN>G2, drug intolerance, HIV/HBV/HCV, pregnancy/breastfeeding, GI malabsorption, recent major surgery/live vaccine, serious illness/contraindications, noncompliance.
trial_source
clinical_trials.gov from Dec 2, 2025
annotation_status
ai
ai_summary
Phase II, single-arm study in transplant-ineligible newly diagnosed multiple myeloma using VRd induction → autologous BCMA-directed CAR-T infusion → VR consolidation → lenalidomide maintenance. Interventions and mechanisms: Bortezomib (proteasome inhibitor, blocks 26S proteasome, inhibits NF-κB, induces myeloma apoptosis), Lenalidomide (IMiD/CRBN modulator, degrades IKZF1/3, downregulates IRF4/MYC, boosts T/NK function, anti-angiogenic), Dexamethasone (glucocorticoid, GR-mediated lympholysis, pro-apoptotic, anti-inflammatory), BCMA CAR-T (autologous engineered T cells targeting BCMA/TNFRSF17 on plasma cells to deliver perforin/granzyme cytotoxicity). Targets/pathways: BCMA+ malignant plasma cells, ubiquitin–proteasome pathway, cereblon–IKZF1/3 axis, glucocorticoid receptor signaling, and T-cell effector/cytokine activation.