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IMS 2026 | Defining functional cure and evolving treatment goals in multiple myeloma
Rahul Banerjee, MD, FACP, Fred Hutchinson Cancer Center, Seattle, WA, discusses how he defines “functional cure” in multiple myeloma and how this concept may influence treatment goals. He highlights treatment-free remission as one aspect of cure, while also considering whether patients can live as long as they would without myeloma, and discusses emerging data suggesting that sustained disease control may increasingly allow myeloma to be managed as a chronic illness. This interview took place at the 23rd International Myeloma Society (IMS) Annual Meeting in Glasgow, UK.
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Transcript
I think functional cure, unfortunately, we haven’t yet come along with a clear word for this. I think we’re describing everything that is not cure-cure. The gold standard for cure is that you get your treatment and you are discharged from the hematologist-oncologist office. You don’t need to see them anymore, like childhood leukemia or Hodgkin’s. We are nowhere near there in myeloma...
I think functional cure, unfortunately, we haven’t yet come along with a clear word for this. I think we’re describing everything that is not cure-cure. The gold standard for cure is that you get your treatment and you are discharged from the hematologist-oncologist office. You don’t need to see them anymore, like childhood leukemia or Hodgkin’s. We are nowhere near there in myeloma. By that metric, even CAR-T is not curative by that standard because these patients are still coming back to us for M-spike checks, monitoring, second primary malignancy screening, IVIG, etc. So we work to do there. But I would say cure probably means being off treatment. So functional cure probably is number one, you’re allowed to still be on treatment as long as the side effects are manageable, if minimal. And number two, you live as long as you are going to live. I think the very interesting data presented here at the IMS meeting from Dr Niels van der Donk and colleagues, looking at the MajesTEC-3 data, which is teclistamab and daratumumab, teclistamab being a bispecific, until progression. So you’re not curing them if you’re talking about being off treatment. These patients are still on treatment. But by their modeling, 86% of patients will now live for as long as they’re going to live. Meaning that their mortality will be the same as that same twin patient with the same age, gender, race, ethnicity who does not have myeloma. By that metric, it becomes almost like a chronic illness. And so if you’re turning myeloma into a chronic illness, I would call that functional cure, especially if you’re going to live as long as you’re going to live. That is statistical modeling. You know, there’s some caveats in there. So we have work to do. But I think the goalposts are there. Like our goal should be going forward to functionally cure at least everybody and cure a good subset of them by stopping treatment.
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