Despite significant advancements in multiple myeloma (MM) treatment, a quarter of newly diagnosed patients survive less than three years, particularly those with high-risk MM. This aggressive subset, representing about 20% of cases, includes patients with specific genetic abnormalities or poor outcomes despite standard therapies. Presentations at the International Myeloma Society meeting highlighted the evolving definition of high-risk MM, incorporating new genetic criteria such as biallelic deletions and multiple high-risk markers. Experts emphasized the need for improved genetic testing, including targeted panels and copy number analyses, to better identify and classify high-risk patients, ensuring more personalized treatment strategies.

Functional high-risk MM, where poor outcomes occur without identifiable genetic mutations, was also a key focus. Experts stressed using advanced diagnostic tools like gene expression profiling and blood-based testing to refine risk assessment. Promising treatment options for high-risk and early-relapsed patients include CAR T-cell therapies, which demonstrated significant progression-free survival benefits. Additionally, achieving minimal residual disease negativity through intensive, multi-drug regimens and continuous maintenance therapy emerged as a critical goal for improving outcomes.

Reference: Ahlstrom J. IMS 2024: News for High-Risk Multiple Myeloma. HealthTree Foundation. Published Oct 07, 2024. Accessed December 9, 2024. https://healthtree.org/myeloma/community/articles/ims-2024-high-risk-mm-report