ASCO 2026: What to Know About Fixed-Duration Therapy, MRD Testing, and Treatment Order

The second half of the 2026 ASCO Annual Meeting brought us research into how to best use today’s newest treatments and more promising updates on treatments in development. Researchers also shared studies highlighting the value of minimal residual disease (MRD) testing to predict long-term outcomes.

Below, read the MMRF’s takeaways.

Understanding when it is safe to stop treatment

In our previous blog, we shared data showing how sequencing of myeloma therapies  influences patient outcomes. In this update, we share data on whether patients can safely discontinue therapy without sacrificing effectiveness.

In a retrospective study, researchers reviewed existing data from 120 patients with relapsed/refractory multiple myeloma (RRMM) who were treated with Tecvayli^® (teclistimab) or Talvey^® (talquetamab). Some patients stopped treatment early (a median of 4.7 months) due to good disease control or side effects, while others continued therapy longer. Overall, most patients in both groups responded to therapy, but complete response rates were three times higher among patients who received a fixed duration of therapy.

It is important to note that patients in the fixed-duration group generally had lower-risk disease features than those who continued treatment, which may have contributed to their favorable outcomes. Even so, studies like this provide valuable insights and help guide future randomized controlled trials designed to identify the most effective treatment duration.

A phase 2 study looked at fixed duration therapy in newly diagnosed patients who could not or chose not to receive high-dose chemotherapy and a stem cell transplant. Researchers looked at a fixed treatment schedule of iberdomide, Darzalex^® (daratumumab), Velcade^® (bortezomib), and dexamethasone (IberDVd) for one year, followed by fixed iberdomide maintenance for three weeks. Iberdomide is part of a new class of oral drugs called CELMoDs, which are similar to immunomodulatory imide drugs (IMiDs) like Revlimid and Pomalyst.

While infections and neutropenia (loss of white blood cells) were common side effects in these patients, 89 percent of them went as far as 18 months without their disease progressing or getting worse. Half of the patients achieved MRD negativity, meaning that even highly sensitive tests could not find any remaining myeloma cells.

Researchers will continue to follow these patients over time to better understand how well this fixed-duration treatment approach works in the long term.

The prognostic power of MRD is growing

A retrospective study and the phase 2 FORTE clinical trial highlighted the growing value of MRD testing in multiple myeloma. MRD testing uses highly sensitive methods to detect tiny amounts of myeloma cells that may remain after treatment, helping doctors better understand how deeply a patient has responded to therapy and how likely the disease is to remain under control over time.

In the FORTE clinical trial, researchers evaluated MRD in 356 newly diagnosed multiple myeloma patients. Findings showed that patients who maintained MRD negativity for at least three years had especially strong long-term outcomes:

• Overall survival at seven years was 97 percent in these patients, compared with 69 percent in patients who did not maintain MRD negativity.
• Similarly, seven-year progression-free survival (PFS) was 85 percent in patients with sustained MRD negativity for at least three years, compared with 35 percent in those without sustained MRD negativity.
• Outcomes were even better in patients who remained MRD-negative for at least five years, with a seven-year PFS rate of 91 percent.
• Importantly, patients with high-risk disease features who maintained MRD negativity for at least three years had outcomes similar to those of standard-risk patients, suggesting that achieving deep and lasting MRD negativity may help overcome some high-risk disease features.

As patients are followed for longer periods, studies like FORTE continue to strengthen the role of MRD as a tool for predicting long-term outcomes and guiding future treatment decisions.

Treatment sequencing is important for patient success

With more treatment options now available for myeloma patients, researchers are increasingly focused on understanding the best order in which to use these therapies.

One particular study exploring treatment sequencing was especially compelling, highlighting how prior therapies may influence both effectiveness and safety.

Researchers reviewed outcomes from 389 patients with RRMM who received both CAR T-cell therapy (Abecma^® or Carvykti^®) and bispecific antibody therapy (Tecvayli^®, Talvey^®, or Elrexfio^®). Patients received the treatments in one of two sequences: CAR T followed by a bispecific antibody, or a bispecific antibody followed by CAR T.

• Patients who received CAR T-cell therapy first had significantly better outcomes. Five-year survival rates were higher in these patients (57 vs. 26 percent), and they experienced a lower overall risk of death over time, regardless of which bispecific antibody was used.
• Patients who received CAR T first also experienced fewer severe immune-related side effects that required ICU care (52 vs. 70 percent) and lower rates of cytokine release syndrome (CRS) after later receiving bispecific antibody treatment (37 vs. 56 percent).

For patients, these findings show that the order of treatment matters.

The bottom line

The research presented at ASCO 2026 has shown us how rapidly the myeloma treatment landscape is evolving, with advances in treatment and new insights offering important options for patients at every stage of disease.

For more updates on myeloma research, join us on June 24th for the next edition of our Patient Webinar Series, where we’ll review the key findings from and the 2026 European Hematology Association (EHA) Congress. The signup link will be made available on our education resource hub.