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IMS 2025 | Highlights from IMS 2025: progress in the understanding and treatment of precursor conditions
Kwee Yong, MD, PhD, FRCP, FRCPath, University College London, London, UK, discusses progress being made in the understanding and treatment of precursor conditions of multiple myeloma. Prof. Yong highlights advances in understanding the biology of precursors and recent trials that have shown a benefit to treating these conditions. This interview took place at the 22nd International Myeloma Society (IMS) Annual Meeting in Toronto, Canada.
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Transcript
I’m here in the beautiful city of Toronto at the annual meeting of the International Myeloma Society. So much wonderful data and excellent presentations, but I think my standout session was the precursor session on the first day and the first morning. For me, this is my favorite session, and that’s because I think work in the precursor space has so much to offer...
I’m here in the beautiful city of Toronto at the annual meeting of the International Myeloma Society. So much wonderful data and excellent presentations, but I think my standout session was the precursor session on the first day and the first morning. For me, this is my favorite session, and that’s because I think work in the precursor space has so much to offer. We have so many unanswered questions, and the work will really inform our understanding of the biology of precursor conditions, not just for myeloma, but also for cancer in general. But most importantly, I think this is where we can make a real game-changer for patients with multiple myeloma in terms of their outcomes and their lives. There were several talks, and what we’re learning now is to crystallize our understanding of the molecular changes, the changes in the genome and structure of the DNA, but also in terms of the microenvironment. So, Dr Dhodapkar gave a very nice talk on how we can start to understand how spatial correlates in the myeloma bone marrow change. But for me, really, the key takeaway from that session was the discussion about treatment trials and the treatment outcomes. There’s always been such equipoise between treating and not treating, and we often say we have to refine our risk models, we have to understand more about high-risk myeloma before we can decide that this is the time to treat. But now we have two trials that show an improvement in overall survival, and indeed we acknowledge that we don’t have curative options, but that should not stop us from embarking on treatment trials in order to prolong time to active myeloma and to improve quality of life for patients. I think that this is the real game-changer at the moment. I think many physicians are held back by fears of over-treating or under-treating, but in reality, these patients form only a small group of the total number of smoldering myeloma patients and high-risk smoldering myeloma patients. The majority fall in the middle, and they’re likely to benefit from interventional treatment.
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