OpenOnco · Treatment Plan

Treatment plan — Multiple Myeloma

PLAN-MM-2L-DKD-001-V1 · v1 · 2026-07-26

Patient

MM-2L-DKD-001 · Algorithm: ALGO-MM-2L

DiagnosisMultiple Myeloma

MOH / ICD-10C90.0

ICD-O-39732/3; C42.1

Clinical significance of mutations (ESCAT)

Tumor-board context — the engine does not use these tiers to rank tracks

Biomarker	Variant	ESCAT	Evidence	Clinical significance	Drugs	Sources
No clinically actionable variants matched in this profile.

Primary current-line option

Standard plan

★ DEFAULT

Indication

IND-MM-2L-DKD

Regimen

Daratumumab + Carfilzomib + Dexamethasone (DKd / D-Kd / Isa-Kd analog), 28-day cycles

Drugs + NSZU

Daratumumab (DRUG-DARATUMUMAB) 16 mg/kg IV (or 1800 mg SC fixed dose) · Weekly cycles 1-2 (days 1, 8, 15, 22), q2-weekly cycles 3-6, q4-weekly cycle 7+ · IV ⚠ NSZU — not for this indication
Carfilzomib (DRUG-CARFILZOMIB) 20 mg/m² day 1 cycle 1, then 56 mg/m² (or weekly 70 mg/m² alternative — KdW) · IV days 1, 2, 8, 9, 15, 16 of each 28-day cycle · IV ⚠ NSZU — not for this indication
Dexamethasone (DRUG-DEXAMETHASONE) 40 mg (20 mg if age >75 or frail) · PO days 1, 8, 15, 22 of each 28-day cycle · PO ✓ NSZU covered

Supportive care

SUP-HSV-PROPHYLAXIS, SUP-PJP-PROPHYLAXIS, SUP-MM-VTE-PROPHYLAXIS, SUP-MM-BONE-PROTECTION

Hard contraindications

CI-HBV-NO-PROPHYLAXIS

Reason

Primary current-line option selected by ALGO-MM-2L at step 4.

Other current-line alternatives (2 tracks)

Same treatment line; review when biomarker, access, contraindication, or patient-context assumptions change.

Aggressive plan

Indication

IND-MM-4L-TECLISTAMAB

Regimen

Teclistamab BCMA × CD3 bispecific (with step-up dosing) — continuous SC weekly

Drugs + NSZU

Teclistamab (DRUG-TECLISTAMAB) Step-up: 0.06 mg/kg SC day 1, 0.3 mg/kg SC day 4, 1.5 mg/kg SC day 7 (≥48h between doses, inpatient observation). Full dose 1.5 mg/kg SC weekly thereafter. · Weekly SC continuous (after step-up); transition to q2-weekly after ≥6 mo sustained ≥VGPR (per protocol amendment) · SC ✗ Not registered in UA

Supportive care

SUP-PJP-PROPHYLAXIS, SUP-HSV-PROPHYLAXIS, SUP-IVIG-HYPOGAMMA

Hard contraindications

CI-ACTIVE-INFECTION-FOR-ALEMTUZUMAB

Reason

Current-line alternative presented for HCP consideration

Standard plan

Indication

IND-MM-POST-ASCT-LENALIDOMIDE-MAINTENANCE

Regimen

Lenalidomide maintenance post-ASCT (CALGB 100104 / IFM 2005-02 schedule)

Drugs + NSZU

Lenalidomide (DRUG-LENALIDOMIDE) 10 mg PO daily (start 90-100 days post-ASCT); escalate to 15 mg after 3 months if tolerated · Continuous PO daily until progression OR unacceptable toxicity · PO ⚠ NSZU — not for this indication

Supportive care

SUP-MM-VTE-PROPHYLAXIS, SUP-MM-BONE-PROTECTION

Hard contraindications

CI-LENALIDOMIDE-PREGNANCY

Reason

Current-line alternative presented for HCP consideration

Pre-treatment investigations

Investigations before treatment start · critical / standard / desired · merged across tracks

ID	Name	Priority	Category	Where to order	Needed for
TEST-BM-ASPIRATE	Bone Marrow Aspirate	Critical	histology	—	all tracks
TEST-CBC	Complete Blood Count with Differential	Critical	lab	—	all tracks
TEST-CMP	Comprehensive Metabolic Panel	Critical	lab	—	all tracks
TEST-FISH-PANEL	FISH (Fluorescence In Situ Hybridization)	Critical	genomic	CSD Lab ✓ (code TBC)	all tracks
TEST-FREE-LIGHT-CHAINS	Serum Free Light Chains	Critical	lab	—	all tracks
TEST-HBV-SEROLOGY	Hepatitis B Serology Panel (HBsAg, anti-HBc total, anti-HBs)	Critical	lab	—	all tracks
TEST-HCV-ANTIBODY	HCV Antibody	Critical	lab	—	aggressive
TEST-HIV-SEROLOGY	HIV Antibody/Antigen	Critical	lab	—	aggressive
TEST-LDH	Lactate Dehydrogenase	Critical	lab	—	all tracks
TEST-LFT	Liver Function Tests (ALT, AST, bilirubin, ALP, GGT, albumin)	Critical	lab	—	all tracks
TEST-PREGNANCY	Beta-HCG	Critical	lab	—	all tracks
TEST-SPEP-UPEP	SPEP / UPEP with IFE	Critical	lab	—	all tracks
TEST-WHOLE-BODY-MRI	Whole-Body MRI	Critical	imaging	—	desired (aggressive, standard)
TEST-B2-MICROGLOBULIN	Beta-2 Microglobulin	Standard	lab	—	all tracks
TEST-CMV-SEROLOGY	CMV IgG/IgM	Standard	lab	—	aggressive
TEST-DAT-COOMBS	Direct Antiglobulin Test	Standard	lab	—	standard
TEST-ECHO	Echocardiography	Standard	imaging	—	all tracks
TEST-IMMUNOGLOBULINS	Quantitative Immunoglobulins	Standard	lab	—	all tracks
TEST-EBV-SEROLOGY	EBV Antibody Panel	Desired	lab	—	aggressive

Red flags — PRO / CONTRA aggressive

PRO-AGGRESSIVE

Triggers that push toward the aggressive track

Multiple myeloma with malignant epidural spinal cord compression: new motor deficit, sensory level, severe back pain with vertebral plasmacytoma / lytic lesion + canal invasion — MM is a leading hematologic cause of MESCC
Per NCCN-MM + ESMO-MM 2023 + EHA-EMN-MM 2025: dexamethasone 40 mg PO/IV bolus, MRI whole spine, urgent RT (8 Gy ×1 or 20-30 Gy fractionated) ± neurosurgical decompression for instability/large mass; bortezomib- based induction begun in…
RF-MM-CORD-COMPRESSIONSRC-NCCN-MM-2025SRC-ESMO-MM-2023SRC-EHA-EMN-MM-2025
Multiple myeloma high-risk cytogenetics: any of t(4;14), t(14;16), t(14;20), del(17p)/TP53 loss, gain or amplification of 1q21 by interphase FISH on CD138-enriched plasma cells
Primary determinant for selecting quadruplet (D-VRd) over triplet (VRd) in transplant-eligible newly-diagnosed MM. R2-ISS captures most of these abnormalities; gain 1q21 is graded by copy count (≥4 copies = amp1q carries higher risk than…
RF-MM-HIGH-RISK-CYTOGENETICSSRC-NCCN-MM-2025SRC-ESMO-MM-2023
Multiple myeloma with hypercalcemia (corrected serum calcium ≥11 mg/dL or symptomatic): part of CRAB criteria; emergency when ≥14 mg/dL or symptomatic (altered mentation, AKI, arrhythmia)
Hypercalcemia is one of CRAB criteria for MM diagnosis; per ESMO-MM 2023 + NCCN-MM: aggressive IV hydration (3-4 L NS/24h), zoledronic acid 4 mg IV (renal-adjusted) or denosumab 120 mg SC; calcitonin 4 IU/kg SC q12h for first 24-48h while…
RF-MM-HYPERCALCEMIASRC-NCCN-MM-2025SRC-ESMO-MM-2023SRC-EHA-EMN-MM-2025
Multiple myeloma with hyperviscosity syndrome — uncommon but classic in IgA-MM (M-spike >5 g/dL, polymerization tendency) or biclonal gammopathy: blurred vision, retinal hemorrhage, mucosal bleeding, neurologic symptoms
Hyperviscosity is much rarer in MM than WM (IgM is intrinsically more viscous than IgG/IgA), but IgA-MM with very high M-spike (>5 g/dL) or biclonal disease can produce it. Per NCCN-MM + ESMO-MM 2023: plasmapheresis 1-2 plasma volumes…
RF-MM-HYPERVISCOSITYSRC-NCCN-MM-2025SRC-ESMO-MM-2023
Multiple myeloma with significant renal dysfunction: CrCl <60 mL/min or serum creatinine >177 µmol/L (>2 mg/dL) attributable to myeloma kidney
Direction "investigate" — triggers lenalidomide dose adjustment in BOTH VRd and D-VRd and demands further workup (24-hr urine, kidney biopsy in selected cases) to distinguish myeloma kidney from other causes. Does not shift the…
RF-MM-RENAL-DYSFUNCTIONSRC-NCCN-MM-2025SRC-ESMO-MM-2023

CONTRA-AGGRESSIVE

Hard contraindications to escalation

Alemtuzumab causes profound, prolonged CD4+ T-cell depletion (median recovery 9-12 months). Active uncontrolled infection at baseline becomes life-threatening once cellular immunity collapses. HIV-positive status is itself an absolute contraindication — alemtuzumab on top of HIV immunosuppression has unacceptable infectious mortality. CI-ACTIVE-INFECTION-FOR-ALEMTUZUMAB

What NOT to do

Explicit prohibitive rules, each grounded in a regimen / supportive care / contraindication entity

Standard plan (IND-MM-2L-DKD)

Do not prescribe without baseline ECG + ECHO + controlled hypertension — carfilzomib has 5-7% rate of cardiac AE.
Do not skip baseline DAT/Coombs + red-cell phenotyping BEFORE first dara — anti-CD38 interferes with crossmatch for months.
Do not start without HBV screening + entecavir prophylaxis in HBsAg+ or anti-HBc+.
Do not skip IV hydration (250-500 mL pre/post) for the first carfilzomib — TLS + AKI risk highest cycle 1.
Do not confirm plan without verified funding pathway — neither daratumumab nor carfilzomib are reimbursed by NSZU.
Do not use with baseline LVEF <40% — carfilzomib cardiotoxicity may become irreversible.
Do not escalate carfilzomib to full dose without cycle-1 step-up (20 mg/m² days 1-2) — risk of infusion reaction + cardiac event.

Aggressive plan (IND-MM-4L-TECLISTAMAB)

Do not start outside inpatient settings — step-up doses require ≥48h hospital observation for CRS surveillance.
Do not skip IVIG for IgG <400 — universal hypogammaglobulinemia + infectious burden is a leading cause of mortality.
Do not skip PJP + HSV/VZV prophylaxis — opportunistic infection risk is very high.
Do not continue with active uncontrolled infection — pause until resolution is mandatory.
Do not start without on-site tocilizumab (≥2 doses) for emergency CRS rescue.
Do not prescribe with baseline ECOG ≥3 — clinical trial excluded; on-treatment mortality very high in frail patients.
Do not forget about live vaccines — contraindicated during and ≥6 months after treatment.
Do not confirm plan without international referral pathway + funding — drug not available in Ukraine.

Standard plan (IND-MM-POST-ASCT-LENALIDOMIDE-MAINTENANCE)

Do not start maintenance without discussing second primary malignancy risk (skin + AML/MDS — ~5-7% absolute increase).
Do not skip VTE prophylaxis (aspirin) — IMiD-induced VTE risk persists on long-term therapy.
Do not prescribe without two methods of contraception in women of reproductive age — lenalidomide is a potent teratogen.
Do not escalate to 15 mg with ANC <1500 or platelets <100K — risk of cumulative cytopenia.
Do not continue maintenance with diagnosed second malignancy without reassessing risk-benefit.
Do not forget dose reduce at CrCl 30-60 (10 mg, do not escalate) and CrCl <30 (5 mg).
Do not stop maintenance with sustained clean responses — benefit lasts years.

Monitoring schedule

Monitoring schedule by treatment phase

Standard plan · MON-VRD-REGIMEN

Phase	Window	Tests	Checkpoints
Baseline	Within 2 weeks before cycle 1	TEST-CBC, TEST-CMP, TEST-LFT, TEST-LDH, TEST-B2-MICROGLOBULIN, TEST-IMMUNOGLOBULINS, TEST-SPEP-UPEP, TEST-FREE-LIGHT-CHAINS, TEST-HBV-SEROLOGY, TEST-FISH-PANEL, TEST-BM-ASPIRATE, TEST-BM-TREPHINE, TEST-WHOLE-BODY-MRI, TEST-ECHO	Confirm CD138+ plasma cell percentage and FISH cytogenetic risk category R-ISS / R2-ISS staging documented Confirm HBV status and prophylaxis plan if anti-CD38 or anti-CD20 in regimen Dental evaluation before zoledronate / denosumab Red-cell phenotyping BEFORE first daratumumab dose
On treatment	Day 1 of every 28-day cycle + mid-cycle CBC for high-risk patients	TEST-CBC, TEST-CMP, TEST-LFT, TEST-FREE-LIGHT-CHAINS, TEST-SPEP-UPEP	ANC ≥ 1000/µL and platelets ≥ 75K before each cycle (delay or reduce otherwise) Neuropathy grade documented at each visit (NCCN/CTCAE) Renal function trend (lenalidomide dose adjustment if CrCl drops) Glucose monitoring for steroid-induced hyperglycemia
Response assessment	After cycles 2 and 4 (before transplant) or every 2-3 cycles (transplant-ineligible)	TEST-FREE-LIGHT-CHAINS, TEST-SPEP-UPEP, TEST-IMMUNOGLOBULINS, TEST-BM-ASPIRATE, TEST-WHOLE-BODY-MRI	IMWG response criteria (sCR, CR, VGPR, PR, MR, SD, PD) MRD assessment by flow cytometry or NGS at suspected CR If <PR after cycle 2 → consider regimen change or trial enrollment
Post-transplant consolidation	Cycles 5-6 post-transplant (transplant-eligible only)	TEST-CBC, TEST-CMP, TEST-FREE-LIGHT-CHAINS, TEST-SPEP-UPEP	Recovery of counts post-transplant before consolidation start Confirm depth of response before starting maintenance
Maintenance	Lenalidomide 10-15 mg daily until progression or intolerance	TEST-CBC, TEST-CMP, TEST-FREE-LIGHT-CHAINS, TEST-SPEP-UPEP	Surveillance for second primary malignancies (annual skin / GU exam) Lenalidomide dose adjustment if cytopenias or worsening renal function Annual influenza + pneumococcal vaccination (non-live only)
Progression monitoring	On clinical or biochemical progression	TEST-FREE-LIGHT-CHAINS, TEST-SPEP-UPEP, TEST-BM-ASPIRATE, TEST-FISH-PANEL, TEST-WHOLE-BODY-MRI	IMWG progression criteria (>25% increase in M-protein, new lytic lesions, hypercalcemia, etc.) Re-do FISH on relapse — high-risk clones may emerge

Timeline

Treatment timeline — derived from regimen + monitoring schedule

Standard plan

Induction · Daratumumab + Carfilzomib + Dexamethasone (DKd / D-Kd / Isa-Kd analog), 28-day cycles

28-day cycles × Until progression or unacceptable toxicity

Aggressive plan

Induction · Teclistamab BCMA × CD3 bispecific (with step-up dosing) — continuous SC weekly

7-day cycles × Continuous until progression or unacceptable toxicity

Standard plan

Baseline

Within 2 weeks before cycle 1

Induction · Lenalidomide maintenance post-ASCT (CALGB 100104 / IFM 2005-02 schedule)

28-day cycles × Continuous until progression / intolerance / patient preference

Response assessment

After cycles 2 and 4 (before transplant) or every 2-3 cycles (transplant-ineligible)

Maintenance

Lenalidomide 10-15 mg daily until progression or intolerance

MDT brief

Discussion questions (1, 0 blocking)

OQ-LDH-CURRENT
What is the current LDH? Marker of tumor burden and transformation.
LDH is part of the prognostic indices of indolent lymphomas.
→ hematologist

MDT talk tree (2 steps)

#	Owner	Topic	Action
1	hematologist	Staging / disease burden	What is the current LDH? Marker of tumor burden and transformation.
2	clinical_pharmacist	Specialist review	Chemoimmunotherapy regimen — drug-drug interactions, dose adjustments, premedication.

Skills (recommended) — for consideration (1)

Clinical pharmacist recommended
Chemoimmunotherapy regimen — drug-drug interactions, dose adjustments, premedication.

Data quality

Usable with caveats. No critical default-track gap was found, but the MDT should review the listed caveats before final sign-off.

Biomarker coverage: 0/0 known (100%), 0 missing, 0 default-track gaps
Unevaluated RedFlags: RF-ISS-1, RF-ISS-3, RF-MM-BCMA-EXPRESSION-POS, RF-MM-CD38-EXPRESSION-DARA-CANDIDATE, RF-MM-CORD-COMPRESSION, RF-MM-FRAILTY-AGE, RF-MM-HIGH-RISK-CYTOGENETICS, RF-MM-HYPERCALCEMIA, RF-MM-HYPERVISCOSITY, RF-MM-INFECTION-SCREENING, RF-MM-T11-14-ACTIONABLE, RF-MM-TRANSFORMATION-PROGRESSION, RF-R-ISS-3-HIGH-RISK

Technical MDT skill metadata (1/16 activated in this plan)

All registered virtual specialists. ✓ — activated for this case; ○ — not activated (available for other clinical scenarios).

Specialist	skill_id	Version	Last reviewed	Domain
Cellular therapy specialist (CAR-T)	`cellular_therapy_specialist`	v0.1.0	2026-04-25	cellular_therapy
Clinical pharmacist	`clinical_pharmacist`	v0.1.0	2026-04-25	clinical_pharmacy
Hematologist / oncohematologist	`hematologist`	v0.1.0	2026-04-25	hematology_oncology
Hematopathologist (lymphoma / leukemia / myeloma)	`hematopathologist`	v0.1.0	2026-04-25	hematopathology
Infectious disease / hepatology	`infectious_disease_hepatology`	v0.1.0	2026-04-25	infectious_diseases
Medical oncologist (solid-tumor chemotherapist)	`medical_oncologist`	v0.1.0	2026-04-25	solid_oncology
Molecular geneticist / molecular oncologist	`molecular_geneticist`	v0.1.0	2026-04-25	molecular_oncology
Palliative care	`palliative_care`	v0.1.0	2026-04-25	palliative_care
Pathologist (general)	`pathologist`	v0.1.0	2026-04-25	pathology
Primary care / family physician	`primary_care`	v0.1.0	2026-04-25	primary_care
Psycho-oncologist	`psychologist`	v0.1.0	2026-04-25	psychosocial
Radiation oncologist	`radiation_oncologist`	v0.1.0	2026-04-25	radiation_oncology
Radiologist	`radiologist`	v0.1.0	2026-04-25	diagnostic_imaging
Social worker / case manager	`social_worker_case_manager`	v0.1.0	2026-04-25	psychosocial
Surgical oncologist	`surgical_oncologist`	v0.1.0	2026-04-25	surgical_oncology
Transplant specialist (BMT)	`transplant_specialist`	v0.1.0	2026-04-25	cellular_therapy

Sources cited

SRC-ESMO-MM-2023: ESMO Clinical Practice Guideline on Multiple Myeloma (2023)
SRC-MAJESTEC-1-MOREAU-2022: Teclistamab in Relapsed or Refractory Multiple Myeloma (2022)
SRC-NCCN-MM-2025: NCCN Clinical Practice Guidelines in Oncology: Multiple Myeloma (v.X.2025)

Experimental options (clinical trials)

Third plan track — open-enrollment trials from ClinicalTrials.gov. Render-time metadata; engine selection is not affected by this block (CHARTER §8.3). Last synced: 2026-07-26.

NCT	Title	Phase	Status	Sponsor	UA	Signals
NCT01676805	Tissue Collection for Studies of Lymph Cancer	N/A	RECRUITING	National Cancer Institute (NCI)	—	—
NCT06904066	Autologous T Cells Transduced With Retroviral Vectors Expressing TCRs for Participant-specific Neoantigens in Patients With Hematologic Malignancies	PHASE1	RECRUITING	National Cancer Institute (NCI)	—	Phase 1 only Single country
NCT02727803	Personalized NK Cell Therapy in CBT	PHASE2	RECRUITING	M.D. Anderson Cancer Center	—	Surrogate endpoint only Single country
NCT06993675	Engaging T-cells to Eliminate MRD in Newly Diagnosed Myeloma Optimizing Response With Talquetmab and Teclistamab (ROTATE)	PHASE2	RECRUITING	Noffar Bar	—	Single country
NCT06245629	Bortezomib-bendamustine-melphalan vs Melphalan for Multiple Myeloma	N/A	RECRUITING	Uppsala University	—	Single country
NCT06235229	A Study of GC012F in Patients With Relapsed/Refractory Multiple Myeloma	PHASE1 / PHASE2	RECRUITING	Gracell Biotechnologies (Shanghai) Co., Ltd.	—	Surrogate endpoint only Single country
NCT05561387	Comparing Combinations of Drugs to Treat Newly Diagnosed Multiple Myeloma (NDMM) When a Stem Cell Transplant is Not a Medically Suitable Treatment	PHASE3	RECRUITING	SWOG Cancer Research Network	—	Single country
NCT07032129	Sequential CAR-T Cells Targeting BCMA/GPRC5D in Patients With Relapsed/ Refractory Multiple Myeloma	PHASE1 / PHASE2	RECRUITING	Essen Biotech	—	Single country
NCT06934044	A Study Evaluating the Pharmacokinetics, Safety, and Efficacy of Cevostamab in Chinese Participants With Relapsed or Refractory Multiple Myeloma	PHASE1	RECRUITING	Hoffmann-La Roche	—	Phase 1 only Small N (<50) Single country
NCT03858205	Low-Dose Radiotherapy in Treating Painful Bone Metastases in Patients With Multiple Myeloma	NA	RECRUITING	University of Southern California	—	Single country

Verify recruitment status directly with the trial site. ctgov data can lag behind current UA-site status.

Option availability in Ukraine

Per-track UA registration · NSZU · cost · access pathway. Render-time metadata; engine selection does not depend on these fields (CHARTER §8.3).

Option	UA registration	NSZU	Cost orientation	Access pathway
Standard plan Daratumumab + Carfilzomib + Dexamethasone (DKd / D-Kd / Isa-Kd analog), 28-day cycles (REG-DKD)	✓ registered	✓ covered	₴-? — verify pathway	NSZU formulary
Aggressive plan Teclistamab BCMA × CD3 bispecific (with step-up dosing) — continuous SC weekly (REG-TECLISTAMAB) 1/1 component drug(s) not registered in Ukraine +1	✗ not registered	✗ out-of-pocket	₴-? — verify pathway	not recorded
Standard plan Lenalidomide maintenance post-ASCT (CALGB 100104 / IFM 2005-02 schedule) (REG-LENALIDOMIDE-MAINTENANCE)	✓ registered	✓ covered	₴-? — verify pathway	NSZU formulary
Trial · NCT01676805 Tissue Collection for Studies of Lymph Cancer No UA site listed — international referral required	— unknown	— unknown	self-pay: ₴0/course	Trial sponsor
Trial · NCT06904066 Autologous T Cells Transduced With Retroviral Vectors Expressing TCRs for Participant-specific Neoantigens in Patients With Hematologic Malignancies No UA site listed — international referral required	— unknown	— unknown	self-pay: ₴0/course	Trial sponsor
Trial · NCT02727803 Personalized NK Cell Therapy in CBT No UA site listed — international referral required	— unknown	— unknown	self-pay: ₴0/course	Trial sponsor
Trial · NCT06993675 Engaging T-cells to Eliminate MRD in Newly Diagnosed Myeloma Optimizing Response With Talquetmab and Teclistamab (ROTATE) No UA site listed — international referral required	— unknown	— unknown	self-pay: ₴0/course	Trial sponsor
Trial · NCT06245629 Bortezomib-bendamustine-melphalan vs Melphalan for Multiple Myeloma No UA site listed — international referral required	— unknown	— unknown	self-pay: ₴0/course	Trial sponsor
Trial · NCT06235229 A Study of GC012F in Patients With Relapsed/Refractory Multiple Myeloma No UA site listed — international referral required	— unknown	— unknown	self-pay: ₴0/course	Trial sponsor
Trial · NCT05561387 Comparing Combinations of Drugs to Treat Newly Diagnosed Multiple Myeloma (NDMM) When a Stem Cell Transplant is Not a Medically Suitable Treatment No UA site listed — international referral required	— unknown	— unknown	self-pay: ₴0/course	Trial sponsor
Trial · NCT07032129 Sequential CAR-T Cells Targeting BCMA/GPRC5D in Patients With Relapsed/ Refractory Multiple Myeloma No UA site listed — international referral required	— unknown	— unknown	self-pay: ₴0/course	Trial sponsor
Trial · NCT06934044 A Study Evaluating the Pharmacokinetics, Safety, and Efficacy of Cevostamab in Chinese Participants With Relapsed or Refractory Multiple Myeloma No UA site listed — international referral required	— unknown	— unknown	self-pay: ₴0/course	Trial sponsor
Trial · NCT03858205 Low-Dose Radiotherapy in Treating Painful Bone Metastases in Patients With Multiple Myeloma No UA site listed — international referral required	— unknown	— unknown	self-pay: ₴0/course	Trial sponsor

Cost information is orientation. Verify with a specific pharmacy / foundation / trial site. Status updated: 2026-07-26.

plan_id: PLAN-MM-2L-DKD-001-V1 | version: 1 | generated: 2026-07-26T09:28:48.083595+00:00

Per FDA non-device CDS positioning (CHARTER §15): Outpatient oncology treatment planning to support tumor-board discussion. Not a medical device; not for autonomous clinical decision-making.

Per FDA non-device CDS positioning (CHARTER §15): Both treatment options below are presented for review. The engine's selection of a 'recommended' default does not constitute a clinical decision. Final treatment selection requires HCP judgment incorporating information not available to the system.

This document is an informational resource supporting tumor-board discussion (per CHARTER §11). It is not a system that makes clinical decisions. Every recommendation must be verified by the treating physician.