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A four-drug combination of **teclistamab**, **daratumumab**, **lenalidomide**, and **bortezomib** used in clinical research for multiple myeloma. Teclistamab is a bispecific monoclonal antibody targeting both B-cell maturation antigen (BCMA) and CD3, redirecting T-cells to kill myeloma cells. Daratumumab is a monoclonal antibody that targets CD38, primarily expressed on myeloma cells, resulting in direct cytotoxicity and immune-mediated cell death. Lenalidomide is an immunomodulatory small molecule that enhances T-cell and NK cell activity, inhibits angiogenesis, and induces tumor cell apoptosis. Bortezomib is a small-molecule proteasome inhibitor that disrupts protein degradation in malignant cells, leading to apoptosis. Preliminary clinical studies in newly diagnosed and relapsed/refractory multiple myeloma show that combinations involving these four agents can produce deep and durable responses and high rates of minimal residual disease negativity, supporting their investigation in frontline and relapsed/refractory settings[2][5]. Teclistamab and the combination regimens are developed by Johnson & Johnson (Janssen), while daratumumab, lenalidomide, and bortezomib are commercialized by various pharmaceutical companies.
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