Study Association of Lenalidomide, Ixazomib, Dexamethasone and Daratumumab in Newly Diagnosed Standard Risk Multiple Myeloma

Inclusion Criteria:

* De novo symptomatic myeloma on the International Myeloma Working Group Diagnostic Criteria for the Diagnosis of Multiple Myeloma
* Measurable disease requiring systemic therapy defined by serum M-component ≥ 10g/l or urine M-component ≥ 200 mg/24h or involved free light level ≥ 100 mg/l
* Eastern Cooperative Oncology Group performance status 0, 1 or 2
* Eligible to high dose therapy

Exclusion Criteria:

* Previously treated with any systemic therapy for multiple myeloma
* Clinical signs of central nervous system involvement
* Renal insufficiency defined as estimated Glomerular Filtration Rate lower or equal to 40 ml/min/1.73 m2
* Hepatic impairment defined as aspartate transminase or alanine transaminase greater or equal to 3 x upper limit of normal, or Total bilirubin greater or equal to 3 x upper limit of normal
* Platelet count \< 75,000 per µL
* Absolute neutrophil count ≤ 1,000 cells/mm3
* Evidence of current uncontrolled cardiovascular conditions
* Female patients who are both lactating and breastfeeding or have a positive serum pregnancy test during the screening
* Infection requiring systemic antibiotic therapy or other serious infection within 14 days before first dose of study drug
* Grade 3 or higher peripheral neuropathy, or grade 2 with pain, on clinical examination during the screening period
* Known or suspected chronic obstructive pulmonary disease with a Forced Expiratory Volume in 1 second \< 50% of predicted normal
* Systemic treatment with strong CYP3A inducers (rifampin, rifapentine, rifabutin, carbamazepine, phenytoin, phenobarbital), or use of St. John's wort within 14 days before initiation of the study drug