Toward a cure for multiple myeloma within a decade

Cancer research · Multiple myeloma · TP53

Cure of multiple myeloma could be achieved within the next decade through early intervention, maximal depth of response, and risk‑adapted strategies

Multiple myeloma (MM), long viewed as incurable, is entering a transformative era marked by deeper remissions, prolonged survival, and the realistic prospect of cure. The greatest opportunity lies at diagnosis, before genomic heterogeneity and immune escape limit therapeutic impact. High‑risk smoldering MM provides a preclinical window where early intervention with targeted antibodies or combinations can delay progression and, as in some trials, improve survival. Refining the threshold for treatment‑entry requires integrated risk models that combine genomics, microenvironmental and immune profiling, and artificial intelligence. The therapeutic goal is sustained minimal residual disease (MRD) negativity at a sensitivity of 10⁻⁶, validated with functional imaging to exclude focal disease. Achieving two years of sustained MRD negativity in standard‑risk and three years or longer in high‑risk disease strongly predicts long‑term progression‑free survival; five years off therapy may approximate operational cure. Quadruplet induction, consolidation, and tailored maintenance regimens maximize depth and durability of response. To advance this vision, priorities include standardized MRD and imaging assays, MRD‑adapted clinical trials, strategies balancing treatment toxicity with quality of life, and equitable global access.

Improving early detection and achieving durable minimal residual disease negativity can transform multiple myeloma from a chronic, incurable disease to one with realistic prospects for long‑term remission and functional cure.

Evidence level: Irányelv / elfogadott gyakorlat. Magas szintű klinikai elfogadottság.

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