A Study of PVX-410, a Cancer Vaccine, and Citarinostat +/- Lenalidomide for Smoldering MM

Inclusion Criteria: * Patient has confirmed SMM according to a definition derived from the International Myeloma Working Group (IMWG) definition (International Working Group, 2003): serum M-protein ≥3 g/dL or BMPC \>10%, or both, along with normal organ and marrow function (CRAB) within 4 weeks before baseline. * C: Absence of hypercalcemia, evidenced by a calcium \<10.5 mg/dL. * R: Absence of renal failure, evidenced by a creatinine \< 1.5 mg/dL (177 µmol/L) or calculated creatinine clearance (using the Modification of Diet in Renal Disease \[MDRD\] formula) \>50 mL/min. * A: Absence of anemia, evidenced by a hemoglobin \>10 g/dL. * B: Absence of lytic bone lesions on standard skeletal survey. * Patient is at higher than average risk of progression to active MM, defined as having 2 or more of the following features: * Serum M-protein ≥3 g/dL. * BMPC \>10%. * Abnormal serum FLC ratio (0.26-1.65). * Patient is aged 18 years or older. * Patient has a life expectancy of greater than 6 months. * Patient is HLA-A2+ * Patient has an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1. * Patient has adequate bone marrow function, evidenced by a platelet count ≥75×109/L and an absolute neutrophil count (ANC) ≥1.0×109/L within 2 weeks before baseline. * Patient has adequate hepatic function, evidenced by a bilirubin ≤2.0 mg/dL and an alanine transaminase (ALT), and aspartate transaminase (AST) ≤2.5×ULN within 2 weeks before baseline. * If of child-b…