Dr. Sagar Lonial, Emory University Cancer Center said: “We have never been in a better position to talk about the topic today, than we are right now. There is a fundamental difference in our field now than 10 years ago, 20 years ago.” 

The myeloma treatment landscape has changed dramatically over the last 20–25 years leading to improved survival rates. Targeted therapies like proteasome inhibitors (like bortezomib and carfilzomib), immunomodulatory drugs (like lenalidomide and pomalidomide) and monoclonal antibodies (like daratumumab and isatuximab) have transformed care. More recently, immunotherapies like CAR T-cell therapies and bispecific antibodies have shown unprecedented response rates, including in heavily pretreated patients. Today, for many patients myeloma is a long-term manageable condition, and some patients are living so long without relapse that talking about cure becomes possible.

It depends on how we define cure. Myeloma is a cancer that evolves over time and can develop treatment resistance. Whilst patients have long remissions, even if myeloma cells are undetectable (with sensitive tests such as minimal residual disease [MRD] testing), it does not mean they have been completely eradicated and that myeloma will never come back. Very late relapses can still occur. There are documented cases of relapse after long remissions (after 10 or even 20 years). Moreover, many patients will remain on continued treatment, which often comes with side-effects and impacts on quality of life. If disease control depends on treatment, can this be defined as a cure? Some physicians also prefer using the term “functional cure” with the disease being still biologically present at some microscopic level, but no longer causing symptoms or disease progression, nor impacting life expectancy. They consider the patient to be in a prolonged remission. 

Currently, if some patients might be cured and survival keeps improving, it is not the case for many patients. Talking about cure might raise false hopes and physicians are very cautious about using the term “cure”. Additionally, even “cured” patients might remain at high risk from infection and therefore need long-term supportive care to manage it.  

During the meeting, a consensus was reached and a definition of a myeloma cure was proposed. It was defined as patients who are in complete and sustained remission and are MRD negative (meaning no myeloma cell is detected in a sample of 1 million cells), confirmed by functional imaging like PET/CT scans or MRI, for a continuous period of 5 years, without any treatment. 

Considering the proposed definition of a cure, experts think a fraction (i.e. proportion) of patients (5 to 30%) are currently cured. This “cure fraction” varies depending on the type of treatment, patients’ age (advancing age was associated with lower cure fraction) and disease risk (higher risk disease might be associated with lower cure fraction). These numbers are obtained with treatments used 10 years ago. Experts predict higher numbers with current treatments. 

Experts presented different strategies that may lead to a cure. For example, using different existing treatments in a sequential manner to attack myeloma in different ways without causing drug resistance, using T-cell engaging therapies (or optimized version of them) like CAR T-cell therapies or bispecific antibody combinations, and using most efficient treatments as early as possible. 

A session of the meeting was dedicated to hearing patient voices. Dr. Vania Hungria, who works with the International Myeloma Foundation (IMF) in Latin America, stressed that the patient definition of a cure is not the same as the physician’s. She insisted that patients value being able to return to normal life, free from constant uncertainty, and able to move forward without the disease dominating their daily thoughts. She presented the results from a survey conducted on behalf of the IMF and the Grupo Brasileiro de Mieloma (myeloma patient group in Brazil) online from 11-15 February 2026. 267 Brazilian myeloma patients answered the survey which confirmed the importance of stopping treatment and not worrying about relapse. Two US patients now in long-term remission and considering themselves cured also shared on stage their diagnosis and treatment stories and answered questions from physicians. They presented their own definition of a cure: being well, having a normal life again, without treatment, and not dealing with side-effects. 

Increasing the cure fraction will rely on improving access to novel therapies and their availability to large numbers of patients, optimising efficacy and safety (especially related to infection risk) of existing and new treatments and establishing fixed treatment durations. The definition of cure is expected to evolve. 

The full content of the consensus will be soon published by the organisers of the meeting in a peer-reviewed article.