Applying the IMS/IMWG Definition of Cure in Community Myeloma Practice

Hans C. Lee, MD, discussed how community oncologists who lack the MRD testing infrastructure of academic centers can think about a functional cure for their patients with multiple myeloma in an interview with CancerNetwork® at the 23rd Annual International Myeloma Society (IMS) Meeting & Exposition. Lee is director of myeloma research at Sarah Cannon Research Institute and a medical oncologist at SCRI Oncology Partners in Nashville, Tennessee.

At the meeting, the IMS and the International Myeloma Working Group (IMWG) presented a consensus definition of cure in multiple myeloma. Under the definition, patients with newly diagnosed or relapsed disease may be considered cured after 5 years in complete remission without any multiple myeloma therapy, with the clock starting when treatment ends. Patients must also have at least 4 negative MRD assessments at a sensitivity of 10⁻⁶ during that period, including 1 at the 5-year mark, with no positive result in between. PET-CT or diffusion-weighted whole-body MRI must also be negative at both the start and the end of the observation period.

Lee said most practices can obtain functional imaging, but serial bone marrow MRD testing is less widely available in community settings. He pointed to peripheral blood–based MRD testing as a way to broaden access.

Transcript:

CancerNetwork: How should community oncologists, who do not always have the same MRD testing infrastructure as academic centers, think about a "functional cure" for their own patients?

Lee: Within the provisional definition of cure, there are some diagnostic tests required. These include serial MRD testing, specifically 4 MRD tests within that 5-year time frame, as well as functional imaging at the beginning and end of that 5-year period. I think most patients and physicians would have access to functional imaging, PET-CT, or whole-body MRI, but there are patients who may not have access to [MRD] testing in their local practice setting. Perhaps this could evolve at some point.

Practically speaking, if a patient is MRD negative at the beginning and perhaps at the end of this 5-year period, in my mind, that would be practically very similar to meeting the specific definition of cure, with multiple MRD measurements in that time period. But I think it also speaks to [the fact that], as a field, we need to think about additional, more accessible ways to measure disease burden. In the future, peripheral blood MRD testing, for instance, through blood-based markers, would be helpful. It would improve access not just to therapeutics, but to diagnostic testing that is accessible for all.

Reference

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