Unmet Clinical Needs Driving Early Intervention in High-Risk Smoldering Multiple Myeloma

This segment examines the unmet clinical needs that have driven interest in earlier treatment strategies for patients with high-risk smoldering multiple myeloma. Faculty discuss the substantial risk of early disease progression in this population and the potential for irreversible organ damage that can occur before patients meet criteria for symptomatic myeloma.

The conversation reviews prior early-intervention studies, including QuiRedex, E3A06, and CENTAURUS, highlighting the signals of clinical activity observed in these trials alongside their limitations, such as small sample sizes, variable tolerability, and challenges with generalizability. Panelists reflect on how these factors contributed to ongoing caution in adopting early treatment approaches despite encouraging outcomes.

By outlining the limitations of earlier studies and the absence of an FDA-approved option, this segment clarifies the rationale for conducting a large, long-term, progression-free survival–powered trial and provides context for the design and objectives of the AQUILA study discussed in subsequent segments.