Comparing Bispecific Antibody Treatment to Autologous Stem Cell Transplant for Newly Diagnosed, Standard Risk Multiple Myeloma

This phase II/III trial compares the usual treatment (daratumumab and hyaluronidase, lenalidomide, bortezomib and dexamethasone \[DaraRVd\] regimen followed by autologous stem cell transplant \[ASCT\] followed by maintenance therapy) to DaraRVd treatment followed by bispecific antibody therapy (teclistamab and/or talquetamab) followed by maintenance therapy in treating patients with newly diagnosed, standard risk multiple myeloma. Daratumumab is in a class of medications called monoclonal antibodies. Daratumumab and hyaluronidase works by helping the body to slow or stop the growth of cancer cells. Hyaluronidase is an endoglycosidase. It helps to keep daratumumab in the body longer so that the medication will have a greater effect. Lenalidomide is in a class of medications called immunomodulatory agents. It works by helping the bone marrow to produce normal blood cells and by killing abnormal cells in the bone marrow. Bortezomib blocks several molecular pathways in a cell and may cause cancer cells to die. It is a type of proteasome inhibitor and a type of dipeptidyl boronic acid. Dexamethasone is in a class of medications called corticosteroids. It is used to reduce inflammation and lower the body\'s immune response to help lessen the side effects of chemotherapy drugs. Teclistamab and talquetamab are bispecific monoclonal antibodies that can bind to targets on both cancer cells and immune cells (T-cells) that may help the body\'s immune system attack the cancer, and may interfere with the ability of cancer cells to grow and spread. Giving DaraRVd followed by teclistamab and/or talquetamab may work better in increasing the likelihood of reducing the cancer burden to the point that it is undetectable, and prolonging the time until the cancer returns compared to DaraRVd followed by ASCT.