[Recent advances and future perspectives in the treatment of newly diagnosed multiple myeloma]

First-line treatment strategies for multiple myeloma (MM) have undergone a major transformation with the introduction of anti-CD38 monoclonal antibodies, leading to substantial improvements in depth of response and survival outcomes regardless of transplant eligibility. Achieving complete response and minimal residual disease (MRD) negativity has become a realistic therapeutic goal, and durable disease control, or so-called functional cure, is now actively discussed. At the same time, treatment decision-making has become increasingly complex. In particular, for transplant-ineligible patients, optimal therapy selection requires comprehensive consideration of not only efficacy but also toxicity, treatment burden, frailty, and individual patient characteristics. This review summarizes recent advances in frontline therapy for newly diagnosed MM, focusing on anti-CD38-based quadruplet regimens and evolving maintenance strategies. In addition, it discusses future perspectives and unresolved challenges, including the introduction of BCMA-targeted immunotherapies into frontline settings, MRD-guided response-oriented treatment strategies, and the potential role of genomic information in risk stratification and therapeutic decision-making, with an emphasis on implications for real-world clinical practice in Japan.