Multiple myeloma is always preceded by two precursor conditions known as monoclonal gammopathy of undetermined significance (MGUS) and smoldering multiple myeloma. Smoldering myeloma is associated with a higher disease burden and higher risk of progression to active disease than MGUS. The management of these precursor conditions remains unclear and the optimal timing of therapy in multiple myeloma has been a subject of debate. Whilst it would be useful to identify high-risk and asymptomatic individuals that could benefit from therapy to prevent progression to multiple myeloma, there is currently no evidence supporting the use of asymptomatic screening in clinical practice.

In this exclusive podcast recorded at the 63rd ASH Annual Meeting and Exposition Congress, Atlanta, GA, 2021, Irene Ghobrial, MD, Dana-Farber Cancer Institute, Boston, MA, and Sigurdur Kristinsson, MD, PhD, University of Iceland, Reykjavik, Iceland, explore the benefits and risks of screening for multiple myeloma precursor conditions, presenting the design and findings of the iStopMM (NCT03327597) and PROMISE (NCT03689595) studies. Dr Ghobrial and Prof. Kristinsson talk on emerging technologies to identify patients with myeloma precursor conditions and question the clinical significance of MGUS and smoldering myeloma, commenting on the mental impact of screening.