The Clinical Implications of Having a “Cure” in Multiple Myeloma

The clinical implications of defining a cure in multiple myeloma will shift the treatment landscape such that patients only require a finite number of therapies, according to Sundar Jagannath, MBBS.

At the Society of Hematologic Oncology 2025 Annual Meeting, Sundar Jagannath, MBBS, delivered a presentation titled, “Is It Time to Say ‘CURE’ in Multiple Myeloma?”. CancerNetwork® spoke with him regarding the implications of defining a “cure” in multiple myeloma. One of the foremost things he mentioned was that, with a “cure” defined, when patients are diagnosed with multiple myeloma, doctors will be able to tell them that they may potentially be cured.

Jagannath, a professor of medicine specializing in hematology and medical oncology at the Icahn School of Medicine at Mount Sinai and The Tisch Cancer Institute, also said that the ongoing clinical trials that are evaluating bispecific and trispecific antibodies with CAR T-cell therapy have the potential to demonstrate high rates of complete remission, minimal residual disease (MRD)-negativity.

Transcript:

For [patients with] newly diagnosed multiple myeloma at this time, and even in [patients with] relapsed multiple myeloma—you have to remember that continuous therapy is the goal. In the [phase 3 DETERMINATION trial (NCT01208662)], they showed continuous relevant maintenance made a big difference compared with the [phase 3 IFM study (NCT01191060)]. Patients are on continuous therapy. Now, what this cure definition does is that [it makes it so] they could have a finite number of treatments—5 years—and then you will be able to stop with the confidence that they are not going to relapse. At the most, there will be 1 or 2 relapses here and there. Over 90% of the patients are going to be cured. Number 2 is that patients who are newly diagnosed, when they see the doctor and are embarking on treatment, [will be told] that they could be potentially cured. Either I’m going to cure you on the front line with a quadruplet therapy without transplant, or should you relapse, the immunotherapy, with CAR T and bispecific [antibodies] will also cure you. The third thing is that clinical trials incorporating the CAR T and bispecific or trispecific antibodies are ongoing. The physicians are now empowered to refer the patient to clinical trials, which have the potential for cure, because the complete remission MRD-negativity in these clinical trials is going to be very high—70% to 80%. It is an important advancement in the field of multiple myeloma.