How long can we let the myeloma smolder?

Smoldering or asymptomatic multiple myeloma may be best described as a state of limbo where the patient has not developed any symptoms of disease and is being observed expectantly. With the advent of novel agents in myeloma therapy, several clinical investigations are underway to determine whether early intervention will help improve survival outcomes in this patient population. Mateos MV et al. report on the first Phase III trial in smoldering multiple myeloma that has shown overall survival benefit. The commentary discusses the study design, key results and potential implications of the study.