daratumumab + lenalidomide + talquetamab + teclistamab

This combination therapy consists of four agents: **daratumumab**, **lenalidomide**, **talquetamab**, and **teclistamab**, being studied together for the treatment of **newly diagnosed multiple myeloma** in patients ineligible or not intended for autologous stem cell transplant. - **Daratumumab** is a monoclonal antibody targeting CD38, a cell surface protein highly expressed on myeloma cells. It induces direct cytotoxicity, antibody-dependent cell-mediated cytotoxicity (ADCC), and complement-dependent cytotoxicity. - **Lenalidomide** is an immunomodulatory small molecule that exerts antineoplastic effects by modulating the immune system, inhibiting angiogenesis, and directly inhibiting the proliferation of myeloma cells. - **Talquetamab** is a bispecific monoclonal antibody that targets GPRC5D on myeloma cells and CD3 on T cells, redirecting T cells to kill GPRC5D-expressing myeloma cells[2]. - **Teclistamab** is a bispecific monoclonal antibody that targets B-cell maturation antigen (BCMA) on myeloma cells and CD3 on T cells, redirecting T cells to kill BCMA-expressing myeloma cells[5]. The regimen leverages both direct antitumor effects and immune-mediated cytotoxicity, with the potential for synergistic activity among the agents. It is being evaluated in phase 3 clinical trials, notably in the MajesTEC-7 study, for its efficacy and safety in multiple myeloma.