carfilzomib + pomalidomide + dexamethasone + daratumumab

This regimen is a quadruplet combination of the proteasome inhibitor carfilzomib, the immunomodulatory imide drug (IMiD) pomalidomide, the corticosteroid dexamethasone, and the anti-CD38 monoclonal antibody daratumumab, used in relapsed or relapsed/refractory multiple myeloma. Phase 1/2 and 2 studies have evaluated Dara-KPd/D-KPd and weekly dara wKPd schedules, showing very high overall response rates and deep responses in predominantly lenalidomide-refractory, high‑risk populations, building on the established activity of KPd and daratumumab-based triplets.[1][3][11] Carfilzomib irreversibly inhibits the 20S proteasome, leading to accumulation of misfolded proteins and apoptosis of myeloma cells; pomalidomide exerts direct antimyeloma, antiangiogenic, and immunostimulatory effects; dexamethasone is a glucocorticoid that induces lymphoid apoptosis and enhances partner agents; and daratumumab targets CD38 on plasma cells, mediating complement-dependent cytotoxicity, antibody-dependent cellular cytotoxicity and phagocytosis, and direct apoptosis, together providing a highly active, multi-mechanistic antimyeloma platform.[2][11]

Other names

Dara-KPdD-KPddara wKPddaratumumab + carfilzomib + pomalidomide + dexamethasone