Interview: Clinical Perspectives on the Evolution of Multiple Myeloma Research

Over the past decade, clinical research has profoundly transformed the treatment landscape for Multiple Myeloma.

Advances in immunotherapies, multi-agent combinations, and the growing use of innovative clinical endpoints such as minimal residual disease (MRD) negativity have not only reshaped treatment strategies but also significantly improved patient outcomes.

As part of the IRAKLIA study, Banook had the opportunity to support clinical teams working at the forefront of this evolution.

In this testimony, Dr Kumar, who is involved in the study, shares his perspective on how multiple myeloma research has progressed, which areas hold the greatest promise, and what continues to motivate him to work in advancing care for patients.

Dr Shaji KUMAR is a consultant hematologist at Mayo Clinic in Rochester (MN) and a professor of Medicine. With over 25 years of experience in his field, he specializes in multiple myeloma and plasma cell diseases. He has been involved in over 70 clinical trials as investigator, mostly in multiple myeloma, and is the first author of the IMWG criteria for response assessment in multiple myeloma.

How has clinical research on multiple myeloma evolved in recent years?

The treatment of multiple myeloma has evolved significantly over the past decade. The most recent years have seen the impact of immune therapies in this disease.

From a treatment paradigm standpoint, the studies in recent years have explored the integration of immunotherapies, both T cell redirection therapies as well as antibody drug conjugates and naked antibodies used alone or in combination with the previously available agents.

In terms of the overall approach to the disease, development of multi agent combinations have been a focus of continued clinical investigation. Aiming for deep responses including MRD negativity is being explored in several different clinical trials.

Early interception strategies in patients with high-risk smoldering myeloma is being explored in several clinical trials to potentially delay the progression to multiple myeloma as well as possible cure in the early stages.

Prolonged therapy has been the standard treatment in myeloma for quite some time, and the recent years have seen several clinical trials that have been designed to explore early discontinuation of therapy or treatment for a limited duration of time based on the depth of response. With minimal residual disease negativity being approved by regulatory agencies as an endpoint for clinical trials.

We are seeing increasing number of clinical trials that are using this early endpoint. Ongoing clinical trials continue to explore the role of autologous stem cell transplant as part of frontline therapy in multiple myeloma among those patients considered eligible for this procedure. Combinations that include bispecific antibodies as well as Cart cells are being explored as potential alternatives to an autologous stem cell transplant.

Which research areas do you consider the most promising?

Many of the ongoing research will clearly define the future treatment paradigm in this disease.

Demonstration of benefit in terms of early interception will firmly integrate use of myeloma therapy in patients with high risk monitoring multiple myeloma. This in turn will lead to studies that will help us identify the patients who should be screened for monoclonal gammopathy.

In the treatment of newly diagnosed myeloma, research will likely lead to decreased use of stem cell transplant and increased use of immunotherapies while achieving a limited duration therapy in most of the patients except for those with high-risk disease.

Use of new agents and new approaches in patients with high-risk disease whether defined by the presence of baseline cytogenetic characteristics or presence of extramedullary disease or demonstration of primary refractoriness or early relapse indicating functional high-risk disease will lead to improved outcomes among the subgroup of patients.

Routine use of minimal residual disease testing will lead to treatment changes in patients.

What motivates you on a daily basis?

The improved outcomes of patients with myeloma is the main motivator.

When I started seeing patients with myeloma the median overall survival for this disease was thought to be about 3 years period patients currently diagnosed with multiple myeloma can expect an overall survival well over 10 years based on the recent numbers.

Increasingly we are seeing myeloma becoming more of a chronic disease and this is very heartening.

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The evolution of multiple myeloma research reflects a broader shift toward more precise, patient-centered, and outcome-driven clinical trials.

As illustrated through the IRAKLIA study, innovations in study design, endpoints, and treatment strategies are paving the way for deeper responses, more personalized therapeutic decisions, and ultimately longer and better lives for patients.

At Banook, we are proud to support investigators and sponsors conducting complex oncology trials by providing digital solutions that enable high-quality data collection, operational efficiency, and meaningful collaboration across study stakeholders. Testimonies like this reinforce our commitment to advancing clinical research that truly makes a difference for patients.

👉 Contact our team today to discover how we can support your next study.