• Must understand and voluntarily sign informed consent form

• Age ≥ 65 years at the time of signing consent

• Must be able to adhere to the study visit schedule and other protocol requirements.

• Previously untreated, transplant ineligible, symptomatic multiple myeloma as defined by the criteria below.

• Both criteria a and b must be met:

‣ Clonal bone marrow plasma cells ≥10% or biopsy-proven bony or extramedullary plasmacytoma

‣ Any one or more of the following myeloma defining events (MDE):

• I. Evidence of end organ damage that can be attributed to the underlying plasma cell proliferative disorder, specifically: i.Hypercalcemia: serum calcium \>0.25 mmol/L (\>1 mg/dL) higher than the upper limit of normal or \>2.75 mmol/L (\>11 mg/dL) ii. Renal insufficiency: creatinine clearance 177 μmol/L (\>2 mg/dL) iii. Anemia: hemoglobin value of \>2 g/dL below the lower limit of normal, or a hemoglobin value \<10g/dL iv. Bone lesions: one or more osteolytic lesions on skeletal radiography, computed tomography (CT), or positron emission tomography-CT (PET-CT)

• II. Biomarker criteria or MDE:

• i. Clonal bone marrow plasma cell percentage ≥ 60% ii. Involved: uninvolved serum free light chain (FLC) ratio ≥100 (involved FLC level must be ≥100 mg/L) iii. \> 1 focal lesions on magnetic resonance imaging (MRI) studies (at least 5 mm in size)

• Must have Eastern Cooperative Oncology Group (ECOG) performance status score of 0, 1, or 2.

• Females of child-bearing potential (FCBP) must have a negative serum test and follow the guidelines in the pregnancy prevention program. FCBP and males must either commit to continued abstinence from heterosexual intercourse or must abide by birth control requirements as described in Appendix 9 for the pregnancy prevention program.

• Men must practice complete abstinence or agree to use a condom during sexual contact with a pregnant female or a female of childbearing potential while participating in the study, during dose interruptions and for at least 28 days following study drug discontinuation, even if he has undergone a successful vasectomy as described in Appendix 9 of the pregnancy prevention program.

• Life expectancy of ≥ 3 months.

• Able to take oral medications.

⁃ The following laboratory results must be met within 10 days prior to first study drug administration:

• Absolute neutrophil count (ANC) ≥ 1.0 x 109/L. Growth factors cannot be given within 10 days of study drug administration.

∙ Serum AST and ALT ≤ 1.5 x upper limit of normal (ULN).

∙ Creatinine clearance ≥ 30 mL/min either directly measured via 24-hour urine collection or calculated using MDRD (Appendix 1).

∙ Platelet count ≥ 50 x 109/L. Platelet transfusions to help subjects meet eligibility criteria are not allowed within 10 days before study enrollment.

∙ Hemoglobin ≥ 80 g/L.