Phase 1b/2: Isatuximab, Iberdomide, Bortezomib, Dexamethasone in Transplant Ineligible/Deferred Newly Diagnosed Myeloma

Inclusion Criteria: * Male or female, 18 years of age or older * Ability to understand and the willingness to sign a written informed consent document * NDMM based on IMWG criteria with clonal bone marrow plasma cells \>10% or biopsy proven bony or extramedullary disease/plasmacytoma (EMD) with any one or more CRAB-features or myeloma defining events (Rajkumar, 2024). (See Appendix G) * Ineligible for ASCT as assessed by the treating physician or eligible but prefers and agrees to defer ASCT until after induction and maintenance therapy, upon progression or at a later time * Measurable disease defined as at least one of the following: * Serum M-protein 0.5 g/dL * Urine M-protein 200 mg/24 hours * Serum FLC assay: involved FLC 10 mg/dL (100 mg/L) and an abnormal kappa to lambda FLC ratio (\< 0.26 or \> 1.65) * Eastern Cooperative Oncology Group (ECOG) performance status ≤ 2 (See Appendix A) * Screening Laboratory evaluations with the following parameters: * Absolute neutrophil count (ANC) ≥ 1,000 cells/dL (1.0 x 109/L) \--- Note: Growth factor support is not permitted within 10 days, \[14 days for pegfilgrastim\], prior to the screening hematologic test. * Platelet count ≥ 75,000 cells/dL (75 x 109/L) (without transfusions required during the 3 days prior to the screening hematologic test) * Total Bilirubin ≤ 2 X upper limit of normal (ULN) (except patients with Gilbert Syndrome, who can have total bilirubin \< 3.0 mg/dL) * AST (SGOT) and ALT (SGPT) ≤ 3.0…