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

Inclusion Criteria: * Newly diagnosed, previously untreated myeloma requiring systemic chemotherapy • Prior treatment of hypercalcemia or spinal cord compression or active and/or aggressively progressing myeloma with corticosteroids or lenalidomide or bortezomib-based regimens does not disqualify the patient (the treatment dose should not exceed the equivalent of 160 mg of dexamethasone in a 4 week period or not more than 1 cycle of Proteasome Inhibitor / Immunomodulatory-based therapy) * Both transplant and non-transplant candidates are eligible. * Diagnosis of symptomatic multiple myeloma as per current International Myeloma Working Group (IMWG) uniform criteria prior to initial treatment * Monoclonal plasma cells in the Bone Marrow (BM) ≥ 10% or presence of a biopsy-proven plasmacytoma * Measurable disease, prior to initial treatment as indicated by one or more of the following: * Serum M-protein ≥ 1 g/dL * Urine M-protein ≥ 200 mg/24 hours * If serum protein electrophoresis is felt to be unreliable for routine M-protein measurement, then quantitative immunoglobulin levels are acceptable * Serum freelite measurable disease as per current IMWG criteria * Bone marrow specimen will be required at study entry; available DNA sample from pre-induction BM will be used for calibration step for MRD evaluation by gene sequencing. * Males and females ≥ 18 years of age * Eastern Cooperative Oncology Group (ECOG) performance status of 0-1 * Adequate hepatic function, with …