Smouldering multiple myeloma: lines of therapy
3 standard-of-care settings across 2 lines and 2 biomarker subgroups. Rows come from the cancer page's standard of care; the grid places each on its line and subgroup.
Early / localised
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| Risk group | High-risk (Mayo 20/2/20 or IMWG high risk) | Daratumumab monotherapy for up to three years (AQUILA), or lenalidomide with or without dexamethasone (E3A06), or a clinical trial; monitoring remains acceptable after shared decision-making. | NCCN Guidelines: Multiple Myeloma | 91 |
Other settings
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| All comers | Trials of interception | Bispecific antibodies (linvoseltamab), isatuximab-lenalidomide-dexamethasone and curative-intent quadruplets in high-risk disease; population screening studies. | LinvoseltamabIsatuximabA Study to Compare Linvoseltamab and Daratumumab Treatment in High-Risk Smoldering Multiple Myeloma (HR-SMM)A Proof-of-Concept Trial to Study the Safety and Activity of Linvoseltamab in Adult Participants With Smoldering Multiple Myeloma at High Risk of DeveIsatuximab in Combination With Lenalidomide and Dexamethasone in High-risk Smoldering Multiple MyelomaiStopMM | 82 | |
| Risk group | Low- and intermediate-risk | Active monitoring with blood tests every three to six months and imaging when the M-protein or light chains rise; no treatment. | NCCN Guidelines: Multiple Myeloma | 32 |
Lines and subgroups are parsed from the setting text of each standard-of-care row and can misclassify an unusual phrasing; the row’s own setting is always shown. Guideline chips reflect the NCCN category and ESMO-MCBS grade recorded on the cancer page, checked on its stated date. Not medical advice.