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COMy 2026 | Evolving concepts of cure in multiple myeloma
Nikhil Munshi, MD, Dana-Farber Cancer Institute, Boston, MA, discusses evolving concepts of cure in multiple myeloma, including new consensus definitions based on sustained measurable residual disease (MRD) negativity after stopping therapy. He reviews data suggesting that a growing proportion of patients may achieve long-term remission with modern therapies and explains how MRD assessment and imaging may help define functional cure in clinical practice. This interview took place at the 12th World Congress on Controversies in Multiple Myeloma (COMy) in Paris, France.
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Transcript
So the cure has been a very important component of our discussion lately. And the reason is that we all believe that we are curing patients. So our session was focusing on this summit we had organized four months ago at the International Myeloma Society and IMWG to develop metrics of cure: when can I tell my patient that he or she is cured? And second question, are we curing patients at the moment? And in our session here, that was our main focus, and the answers are very straightforward: that we definitely believe we are curing patients, and in fact, the proportion of patients we are curing currently might range in the range of five to thirty percent, and this is some of the data is from the treatment that we gave in the past; the older treatment; with the new treatment, this number might be even higher than what I’m just quoting...
So the cure has been a very important component of our discussion lately. And the reason is that we all believe that we are curing patients. So our session was focusing on this summit we had organized four months ago at the International Myeloma Society and IMWG to develop metrics of cure: when can I tell my patient that he or she is cured? And second question, are we curing patients at the moment? And in our session here, that was our main focus, and the answers are very straightforward: that we definitely believe we are curing patients, and in fact, the proportion of patients we are curing currently might range in the range of five to thirty percent, and this is some of the data is from the treatment that we gave in the past; the older treatment; with the new treatment, this number might be even higher than what I’m just quoting. And so there was a great excitement that there is a cure in myeloma, even with the current treatment, and it’s only going to get better. The second component is how do we define cure? That’s very important, because when a patient comes to see us after getting the treatment, at what point in time might I feel comfortable telling the patient that I think you might be cured? And so our discussion ended up with a consensus on a definition that includes measurement of MRD and also without treatment. I think an important component of cure is that the patient should not relapse, but should not be taking treatment as well. And talking to patients, that’s a very important component, that they’re off therapy, they’re living their normal life, quality of life, and then the disease doesn’t come back. And so the definition ends up being that the patient should be MRD negative for five years after stopping treatment. And then we require certain frequent measurements once a year, and also do a PET scan to see that it’s not just the bone marrow, but there is no disease elsewhere. So if anybody who meets this definition, at the end of that five years, we believe that the chances of relapse are so small that we can comfortably tell that patient that he or she is cured.
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