Toward a cure for multiple myeloma within a decade.

Area of Science:

• Hematology
• Oncology
• Immunotherapy

Background:

• Multiple myeloma (MM) was historically considered incurable.
• Recent advances offer deeper remissions and prolonged survival, with a realistic prospect of cure.

Purpose of the Study:

• To outline a transformative strategy for achieving cure in multiple myeloma.
• To define optimal treatment paradigms focusing on early intervention and sustained minimal residual disease (MRD) negativity.

Main Methods:

• Integrating genomics, microenvironmental, and immune profiling with artificial intelligence for risk stratification.
• Utilizing targeted antibodies and combination therapies for early intervention.
• Achieving sustained MRD negativity (10⁻⁶ sensitivity) validated by functional imaging.

Main Results:

• Early intervention in high-risk smoldering MM can delay progression and improve survival.
• Sustained MRD negativity for 2 years (standard-risk) or 3+ years (high-risk) predicts long-term progression-free survival.
• Five years off therapy may approximate operational cure for MM.

Conclusions:

• A cure for MM is increasingly attainable within the next decade through decisive, risk-adapted strategies.
• Key priorities include standardized MRD assays, MRD-adapted trials, balancing toxicity, and ensuring global access.
• Achieving sustained MRD negativity is central to realizing the goal of MM cure.