In late 2024, the MMRF launched the Horizon Clinical Trials Program through the Multiple Myeloma Research Consortium® (MMRC), a collaborative research network of leading myeloma treatment centers. Horizon uses an innovative trial design called an adaptive platform, which makes it possible to test multiple therapies at the same time to determine the best combination, sequence, and duration of treatment to get the best outcomes for patients. The adaptive design also allows researchers to work together and move faster than they can in a traditional clinical trial model.
For the first trial within the Horizon program (Horizon One), we are enrolling patients with relapsed and refractory myeloma across 13 sites to study dosing approaches with Tecvayli® (teclistamab), a bispecific antibody treatment. The second platform trial of the program, Horizon Two, is scheduled to launch soon and enroll high-risk, newly diagnosed patients.
Horizon Two will reimagine how we treat high-risk newly diagnosed multiple myeloma. We spoke with Dr. Sham Mailankody of Memorial Sloan Kettering (MSK) Cancer Center about what patients can expect — and why this moment marks a turning point in myeloma research.
Dr. Sham Mailankody, Memorial Sloan Kettering (MSK) Cancer Center
Over the past 25 years, treatments for multiple myeloma have improved a lot, especially for patients with what we call “standard-risk” disease. But people with high-risk myeloma haven’t seen those same benefits. About 1 in 4 newly diagnosed patients fall into this high-risk category, and unfortunately, these patients either do not respond to their initial therapy, or relapse within two years — whereas most patients are in remission for at least four or five years after their first therapy.
Horizon Two is a national clinical trial created specifically for people who are newly diagnosed with high-risk myeloma. In the past, this group was often left out of research. The trial is designed to be flexible and patient-friendly. It allows multiple treatment options to be tested at once, and new ones can be added over time. Even patients who have already started their first cycle of treatment may still qualify. This approach helps us learn faster and include more people in the process.
We’re looking at advanced treatments called immunotherapies — including CAR T-cell therapy and bispecific antibodies. These therapies have already worked well for patients with advanced or relapsed myeloma. Now we’re testing whether using them earlier, right after diagnosis, might lead to stronger and longer-lasting responses.
Absolutely. Some treatment arms in the trial will explore time-limited therapy, meaning patients could stop treatment after a certain amount of time if they’re doing well. We’re also collecting direct feedback from patients and advocates to guide future parts of the study. Better treatment doesn’t just mean controlling the disease — it means improving how patients feel and live.
Horizon Two is available at many locations across the country — not just at large academic hospitals, but also at regional and community centers that work closely with myeloma experts. For example, patients don’t have to travel to Manhattan to take part in the trial at MSK; there may be a site closer to home. This setup helps reduce travel time and costs, making it easier for people, including those in rural or underserved areas, to access cutting-edge research and care.
It’s absolutely necessary. Horizon Two is the result of years of collaboration through the MMRF and MMRC. It brings together top cancer centers, patient advocates, drug companies, and government regulators. Everyone plays a role: from designing the trial to enrolling patients. This kind of teamwork is what makes real progress possible.
Our biggest goal is to close the gap in outcomes between high-risk and standard-risk patients. If we can do that, we may one day no longer need the term “high-risk.” That would be a huge step forward for more effective treatments and for a more equitable future for everyone living with myeloma.
