The end of the study will occur approximately 5 years after the last participant is randomized in the second phase of the study. The total duration for each participant in the study will be approximately 138 weeks. The study will include a 28-Day Screening Phase, a Treatment Phase of 6 treatment cycles (each cycle is 4 weeks in duration for total period of 30 weeks), and a Follow up Phase of 2 years. All responders will then be re-randomized (assigned by chance) to one of 2 treatment groups to receive maintenance treatment with daratumumab only or observation (no treatment).
Participants will be randomized (assigned by chance) to one of 2 treatment groups to either receive daratumumab plus bortezomib, thalidomide and dexamethasone or bortezomib, thalidomide and dexamethasone for induction (before transplantation) and consolidation (after transplantation) treatment. This is a randomized, open-label (identity of assigned treatment will be known to participants and study staff), 2-arm (2 treatment groups), multicenter study of daratumumab in participants diagnosed with previously untreated Multiple Myeloma who are eligible for high dose chemotherapy and autologous stem cell transplantation (transplantation of own bone marrow). Why Should I Register and Submit Results?.This shell would have been created when the unexploded star blew away an irregular wind of gas particles at the end of its life. They suspect that the shock wave collided with a shell of gas particles. The collision scenario was also investigated recently by an Italian group with whom Vink collaborates.
Short clip with English explanation of the discovery that the inner remnants of Cassiopeia A do not expand evenly.
"Exactly as we have measured," says Vink. The computer models predict that after a collision, the shock first decreases in speed but then accelerates. Or the nebula has collided with something." From the models of Vink and his colleagues, a collision appears most likely. "Either there is a hole somewhere, a kind of vacuum, in the supernova material, causing the hot shell to suddenly move inwards locally. "The backward movement in the west can mean two things," says Jacco Vink. This outer shock wave turned out to accelerate in the west instead of decelerating as was expected. The researchers also took measurements of the acceleration or deceleration of the outer shock wave. The scientists observed that on the western side of Cassiopeia A, the inner regions of the explosion nebula are not expanding, but moving inwards. This is an American X-ray satellite with Dutch spectrometers that orbits the Earth in a high elliptical orbit. The researchers, led by Jacco Vink (University of Amsterdam, the Netherlands) analyzed 19 years of data from the Chandra X-ray Observatory. Cassiopeia A is now about 16 light years across. The expansion is most likely occurring in gas that was blown out by the star long before the explosion. The Cassiopeia A explosion nebula is expanding at an average rate of 4,000 to 6,000 kilometers per second and has a temperature of about 30 million degrees Celsius.
However, there was too much gas and dust around the star for the explosion to be seen with the naked eye or with the then very basic telescopes. Light from the explosion should have reached Earth for the first time around 1670. Cassiopeia A is the remnant of an exploded star in the Cassiopeia constellation, about 11,000 light years away from us.