Progress in the Management of Smoldering Multiple Myeloma

The landscape of trials for smoldering multiple myeloma: endpoints, trial design, and lessons learnt

“…Current definitions of SMM encompass a heterogenous group of patients, including patients whose disease process is destined to never become malignant, and simply includes disease that is similar to monoclonal gammopathy of undetermined significance, but with a larger volume of disease. However, the current definition of SMM also include patients whose disease is destined to become malignant and cause end-organ damage [11]. The current landscape of trials and recommendations for lenalidomide use as a standard of care indeed poses the risks of both over-treating patients whose disease does not need treatment, and undertreating patients who are destined to have symptomatic MM in the imminent future.…”

Applying current smouldering myeloma risk models to a UK single‐centre cohort and clinical features at progression

“…define the optimal intervention strategy, aiming to delay progression, prevent end-organ damage and improve outcomes. [3][4][5] It is therefore important to accurately define highrisk disease and scores exist to stratify patients. SMM risk scores are often based on retrospective data from a single time-point with varying concordance reported between scores.…”