Multiple Myeloma (MM) Clinical Trials

About Multiple Myeloma (MM) trials

Multiple myeloma trials are stratified by cytogenetics, prior therapy exposure, and surface marker targets. The mutational genes (KRAS, NRAS, BRAF, TP53, FGFR3, CCND1) reflect cytogenetic and mutational features that drive prognosis and trial stratification. FGFR3 is associated with the t(4;14) translocation and CCND1 with t(11;14). The surface targets (BCMA / TNFRSF17, GPRC5D, CD38, SLAMF7, CD19) are the molecules that immune-based therapies recognize. CD38 has been the foundational target since anti-CD38 antibodies entered standard care, while BCMA and GPRC5D drive most current bispecific antibody and CAR-T cell trials. SLAMF7 and CD19 expand the surface target set in select trials.

Active trials in multiple myeloma split by line of therapy and target class. Newly diagnosed myeloma (NDMM) trials test induction intensification: adding new agents to the VRd or DaraVRd backbones, evaluating MRD-guided continuation strategies, and bringing immune therapies into earlier lines. Transplant-eligible and transplant-ineligible NDMM trials are typically run as separate cohorts. Maintenance trials test post-transplant or post-induction strategies. R/R trials are heavily target-driven and split by line: 1-3 prior lines, 4+ prior lines, and penta-refractory subsets each have their own trial sets. BCMA-directed trials (CAR-T cells, bispecific antibodies, ADCs) lead the R/R activity, with GPRC5D bispecifics emerging as the next major target class. Trials for high-risk myeloma (TP53 abnormalities, del(17p), 1q+, t(4;14)) often run as prespecified subgroups within larger studies. MRD-guided trials test whether achieving and maintaining MRD-negative disease can shorten treatment duration without compromising outcomes.

Most myeloma trials screen on prior therapy exposure, line of therapy, and cytogenetic risk. Prior therapy exposure: most trials specify which drug classes patients have received (proteasome inhibitor, immunomodulatory drug or IMiD, anti-CD38 antibody) and how many lines. Many R/R trials require triple-class refractory or penta-refractory status. Prior BCMA exposure has become a defining axis as BCMA therapies multiply: many trials are BCMA-naïve only, while others enroll BCMA-pretreated patients specifically. Cytogenetic risk classification (high-risk by t(4;14), t(14;16), del(17p), 1q gain, or TP53 mutation) appears in many trial inclusion or stratification criteria. ECOG performance status of 0 to 2 is common. Renal function with calculated creatinine clearance is screened on most trials, with some trials accepting impaired renal function. Adequate hematologic function and end-organ measures (CRAB criteria) define progression in measurable-disease trials.

Biomarkers tested in Multiple Myeloma (MM) trials

These are the molecular markers most commonly required or evaluated in Multiple Myeloma (MM) eligibility criteria. OncoMatch extracts them from each trial's protocol and matches them against your test results.