Adequate treatment of multiple myeloma at diagnosis is a key issue for patients because their first remission is typically the longest and most durable. Dr. Luciano Costa of the University of Alabama joins Myeloma Crowd Radio to discuss a trial testing some of the best therapies for myeloma up-front: lenalidomide, dexamethasone, carfilzomib and daratumumab followed by a stem cell transplant. The same four drugs will be used after transplant as "consolidation" therapy. The goal is to understand how much treatment could be needed to get patients into a complete remission status where no myeloma is detectable (also called minimal residual disease negative or MRD status). The four drug combination will be used before transplant. If, after the transplant, the patient still has detectable multiple myeloma, they will proceed to a series of consolidation blocks, up to three, consisting of four cycles of the KRdD at specified dosages and time frames. Patients who still show detectable disease will be given more consolidation therapy while those who are MRD negative will stop treatment.  This is a key study because it will help investigators understand when treatment can be stopped and when it should be continued. Learn more about this fascinating study with Dr. Costa on April 16th.  Thanks to our episode sponsor, Celgene Corporation