title: Dilemmas in treating smoldering multiple myeloma.
abstract: Novel therapies hold promise for high-risk smoldering multiple myeloma (SMM). Recent studies suggest that modern combination approaches can be options for high-risk SMM to obtain deep molecular responses with favorable toxicity profiles. Although pioneering treatment trials based on small numbers of patients suggest progression-free and overall survival benefits, application of the data to real-life practice remains to be validated. Therapeutic modulation of disease tempo, disease burden, clonal evolution, and tumor microenvironment in SMM remains to be understood and calls for reliable biomarkers reflective of disease biology. Here, we review studies that open a new management platform for SMM, address ongoing dilemmas in practice and under investigation, and highlight emerging scientific questions in the era of SMM treatment.
authors.affiliation: Inhye Ahn and Sham Mailankody, the National Cancer Institute, National Institutes of Health, Bethesda, MD; Neha Korde and Ola Landgren, Memorial Sloan Kettering Cancer Center, New York, NY.
authors.forename: Inhye E
authors.initials: IE
authors.lastname: Ahn
authors.affiliation: Inhye Ahn and Sham Mailankody, the National Cancer Institute, National Institutes of Health, Bethesda, MD; Neha Korde and Ola Landgren, Memorial Sloan Kettering Cancer Center, New York, NY.
authors.forename: Sham
authors.initials: S
authors.lastname: Mailankody
authors.affiliation: Inhye Ahn and Sham Mailankody, the National Cancer Institute, National Institutes of Health, Bethesda, MD; Neha Korde and Ola Landgren, Memorial Sloan Kettering Cancer Center, New York, NY.
authors.forename: Neha
authors.initials: N
authors.lastname: Korde
authors.affiliation: Inhye Ahn and Sham Mailankody, the National Cancer Institute, National Institutes of Health, Bethesda, MD; Neha Korde and Ola Landgren, Memorial Sloan Kettering Cancer Center, New York, NY. landgrec@mskcc.org.
authors.forename: Ola
authors.initials: O
authors.lastname: Landgren
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D060965:Clonal Evolution / Q000187:drug effects; D018450:Disease Progression; D018572:Disease-Free Survival; D006801:Humans; D009101:Multiple Myeloma / Q000175:diagnosis / Q000188:drug therapy*; D011379:Prognosis; D016896:Treatment Outcome; D059016:Tumor Microenvironment / Q000187:drug effects*
chemical_list: D000970:Antineoplastic Agents