While there isn’t a definitive cure for multiple myeloma yet, doctors are closer than ever to making it a long-term, manageable or potentially curable disease for some patients. Advances like CAR-T cell therapy, bispecific antibodies, and targeted drug combinations are producing deep, durable remissions that last years — far longer than traditional chemotherapy ever achieved.

Some patients, especially those treated early or who respond exceptionally well to these new therapies, are showing no detectable disease for five years or more, leading researchers to describe them as being in “functional remission.” Ongoing clinical trials in 2025 are now testing whether combining these powerful treatments up front could achieve a true cure in a subset of patients. In short, while multiple myeloma remains chronic for most, a cure is beginning to look possible for some.

The time it takes for smoldering multiple myeloma (SMM) to progress to active multiple myeloma varies widely from person to person. On average, the risk of progression is about 10% per year for the first 5 years, then drops to around 3% per year for the next 5 years, and 1% per year after 10 years.

Some people remain stable for decades without ever developing active disease, while others progress much faster — especially if they meet high-risk criteria like those in the 2/20/2 rule (M-protein ≥ 2 g/dL, FLC ratio ≥ 20, bone marrow plasma cells ≥ 20%). Patients in this high-risk group have about a 50–70% chance of progressing within 2 years, which is why doctors often monitor them closely or consider early-intervention clinical trials.

The latest clinical trials for multiple myeloma are testing new ways to treat patients whose disease has relapsed or become resistant to standard therapies. Researchers are focusing on next-generation immune therapies, including bispecific antibodies and CAR-T cell treatments that target proteins like BCMA and GPRC5D on myeloma cells. Other trials are exploring combination therapies using new oral drugs (CELMoDs), as well as strategies to overcome resistance and improve long-term remission. These studies aim to make treatments more effective, durable, and personalized for each patient.

The 2/20/2 rule is a quick way doctors identify patients who may have active multiple myeloma rather than its earlier, precancerous stage called smoldering myeloma. It refers to three key lab findings:

• M-protein (monoclonal protein) level in the blood ≥ 2 g/dL

• Involved free light chain (FLC) ratio ≥ 20

• Bone marrow plasma cells ≥ 20%

If a person meets two or more of these criteria, their risk of progressing from smoldering to active multiple myeloma within two years is considered very high—often 70% or more. This “2/20/2 rule” helps doctors decide when to start treatment earlier or enroll patients in clinical trials aimed at delaying or preventing full disease progression.

In the United States, some of the top hospitals for multiple myeloma care include the Mayo Clinic, Dana-Farber Cancer Institute, MD Anderson Cancer Center, and the Memorial Sloan Kettering Cancer Center — all known for leading clinical research, advanced therapies like CAR-T and bispecific antibodies, and comprehensive patient support. Internationally, top centers include University College London Hospitals in the U.K., Heidelberg University Hospital in Germany, and Apollo Hospitals in India, each offering world-class hematology programs and access to global clinical trials. These institutions are recognized for pioneering treatments and multidisciplinary expertise in managing complex myeloma cases.

In 2025, new treatments for multiple myeloma are transforming care for patients with relapsed or hard-to-treat disease. A four-drug combination that adds a CD38 antibody to standard therapy is showing record response rates and may become the new first-line standard. CAR-T cell therapy like Carvykti continues to deliver long-term remissions, while new bispecific antibodies such as Linvoseltamab offer powerful off-the-shelf immunotherapy options. Together, these advances mark a major step forward in extending survival and improving outcomes for people with multiple myeloma.