Global Experts Define Consensus Criteria for Cure in Multiple Myeloma

The International Myeloma Society (IMS) and International Myeloma Working Group (IMWG) unveiled a consensus definition for cure in multiple myeloma, marking the first time global experts have agreed on rigorous, measurable criteria for classifying a long-term remission as a cure.¹ Nikhil C. Munshi, MD, presented the definition on behalf of both organizations during the IMS 23rd Annual Meeting, held September 23 to 26 in Glasgow, Scotland.

Under the new criteria, patients with newly diagnosed or relapsed myeloma may be considered cured after 5 years in complete remission without any myeloma treatment, counted from the date treatment ends regardless of how long the patient had been disease-free while still receiving therapy.

Defining the Criteria

To meet the definition, patients must have at least 4 negative measurable residual disease (MRD) tests, including one at the 5-year mark, with no positive result recorded in between. Testing must use next-generation sequencing or next-generation flow sensitive enough to detect 1 myeloma cell among 1 million cells. Advanced imaging with PET/CT or diffusion-weighted whole-body MRI must also show no disease at the start and end of the 5-year period, with no positive scan in between if additional imaging is performed.

The off-treatment requirement is intended to distinguish a durable response from disease that is simply being held in check by ongoing therapy, and the 5-year window reflects data suggesting relapse risk drops substantially once a patient has been off treatment that long, although late relapse remains possible. Investigators noted that relapse beyond 5 years in remission is similarly uncommon in Hodgkin lymphoma and testicular cancer, 2 diseases where the term cure is already used.

Myeloma was described as a uniformly fatal disease when it was first identified in 1844 and was considered incurable for most of its history.² Munshi told attendees that the field's growing confidence in a cure stems from continued improvements in survival over the past 2 decades, rising rates of deep MRD negativity, and follow-up data showing that a meaningful proportion of patients remain treatment-free and disease-free 5 or more years after therapy.

Clinical Context and Limitations

Long-term follow-up studies discussed by Munshi estimate that the proportion of patients who may have been cured with older therapies ranges from 5% to 30%, with wide variation by treatment regimen, age, and disease risk.¹ In one study, 32 of 97 patients with heavily pretreated myeloma were alive and progression-free at least 5 years after a single CAR T-cell therapy infusion given without maintenance treatment. Munshi said today's therapies could improve on those historical cure rates, but that additional follow-up is needed to know by how much.

Munshi explained that the consensus required convergence across 3 separate domains before a declaration of cure could be considered credible. "We had decided that to declare cure, it required convergence of 3 domains, and when all 3 align, we can have a credible declaration of cure," Munshi said during his presentation. "It is statistical, clinical, and biological."

The new definition builds on discussions from the IMS Myeloma Cure Summit held earlier this year and is intended to give clinicians and investigators a common standard for determining which long-term responses—including those seen with newer combination regimens and cellular therapies—meet the full criteria for cure.

The announcement came as roughly 4000 researchers and clinicians from more than 75 countries gathered for the IMS Annual Meeting at the Scottish Event Campus in Glasgow, a program that includes more than 635 research abstracts and 35 late-breaking presentations on new immunotherapies, earlier treatment approaches, and advances in myeloma monitoring.

REFERENCES

1. Global myeloma experts define cure for a disease long considered incurable. News release. International Myeloma Society. September 23, 2026. Accessed September 23, 2026. https://www.myelomasociety.org/events/23rd-ims-annual-meeting/

2. Munshi NC. Defining cure in multiple myeloma: IMS/IMWG consensus. Presented at: International Myeloma Society 23rd Annual Meeting; September 23-26, 2026; Glasgow, Scotland.