Daratumumab, Carfilzomib, Lenalidomide and Low Dose Dexamethasone (DKRd) in Newly Diagnosed, Multiple Myeloma

"Daratumumab (16 mg/kg) will be administered as an IV infusion:~* Cycle 1-2: 16 mg/kg weekly~* Cycles 3-8: 16 mg/kg IV infusion every 2 weeks~* Cycles 9-24: 16 mg/kg IV infusion Day 1"

"Carfilzomib will be given as an IV infusion over 30 minutes:~* Cycle 1: 20 mg/m2 Days 1, 2; 36 mg/m2 Days 8, 9, 15, 16. Alternatively, intermediate dose escalation (to 27mg/m2 on days 8, 9 of cycle 1) will be allowed at the treating physician's discretion.~* Cycle 2-9: 36 mg/m2 (or best tolerated dose) Days 1, 2, 8, 9, 15 and 16~* Cycles 9-24: 36 mg/m2 (or best tolerated dose) Days 1, 2, 15 and 16"

"Lenalidomide will be taken orally as follows:~• Cycles 1-24: 25 mg (or best tolerated dose) PO Days 1-21"

"Dexamethasone will be administered prior to carfilzomib (on days that they coincide), as follows:~* Cycles 1-9: 40 mg PO (subjects ≤ 75 years) or 20 mg PO (subjects ≥ 75 years) per week~* Cycles 9-24: 20 mg PO per week~During weeks when daratumumab is given: 40 mg dexamethasone weekly, 20 mg prior to daratumumab infusion and 20 mg PO the day after~During weeks with no daratumumab, single dose of 20 mg on day 1"