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Daratumumab triggers CD38 + multiple myeloma cells [via antibody-dependent cellular cytotoxicity (ADCC), complement dependent cytotoxicity (CDC), and tumor-associated macrophages (TAMs)] in sensitive and drug-resistant patients, regulates the enzyme activity of CD38, reduces the level of adenosine and reduces adenosine-induced immunosuppression

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Certain patients naturally resist ICIs, while others show a significant reduction in treatment effectiveness or fail to respond after a set treatment period [117]