Smoldering myeloma: early intervention trials in high-risk patients (linvoseltamab vs daratumumab)
Standard of care 2026: Transplant-eligible newly diagnosed: VRd or D-VRd induction → ASCT → lenalidomide maintenance (± daratumumab). Transplant-ineligible newly diagnosed: DRd or DVRd. Relapsed: daratumumab-based combos for 1L relapse, then BCMA bispecifics (teclistamab, elranatamab, linvoseltamab) or CAR-T (ide-cel, cilta-cel) for 4+ prior lines. The 2025–2026 paradigm shift: bispecifics moving to earlier lines (1L for elderly, 2L for fit patients) — ASCO 2026 brings major Phase 3 readouts (MajesTEC-7, MagnetisMM-5, MonumenTAL-3, LINKER-MM-3).
Recruiting Trials by Treatment Setting
Newly Diagnosed — Transplant-Eligible
Induction, transplant, and maintenance trials:
NCT04566328 - Quadruplet combination (D-VRd) in newly diagnosed (Phase 3)
NCT05561387 - Comparing 1L combinations for transplant-eligible NDMM (Phase 3)
Newly Diagnosed — Transplant-Ineligible
Testing bispecifics and CELMoDs in first-line for older/unfit patients. ASCO 2026 brings the major Phase 3 readouts:
NCT05552222 - MajesTEC-7: Teclistamab + daratumumab + lenalidomide (Tec-DR) or Talquetamab + Dara + Lena (Tal-DR) vs DRd in newly diagnosed transplant-ineligible (Phase 3)
NCT06152575 - MagnetisMM-32: Elranatamab in newly diagnosed myeloma (Phase 3)
NCT06182774 - Fixed duration vs continuous anti-CD38 therapy in transplant-ineligible (Phase 3)
NCT06187441 - Treatment-free interval feasibility in NDMM treated with Dara-len (Phase 3)
Relapsed / Refractory — Early Relapse (1-3 Prior Lines)
Bispecifics and CELMoDs moving into earlier relapse settings. Belantamab mafodotin returns to Phase 3 in 2025–2026 following the 2024 reapproval discussion:
Bispecific antibodies:
NCT05243797 - Teclistamab + lenalidomide vs teclistamab alone in relapsed myeloma (Phase 3)
NCT06932562 - LINKER-MM-3: Linvoseltamab vs standard in relapsed/refractory myeloma (Phase 3)
NCT07391657 - AZD0120: Dual-target CAR-T against BCMA and CD19 in RRMM (Phase 3, the first dual-target BCMA+CD19 CAR-T to enter Phase 3; addresses BCMA-antigen-loss escape)
Other novel agents:
NCT07138209 - QLS32015 monotherapy vs Pomalidomide+Dex (Pd) or Selinexor+Dex in RRMM (Phase 3)
Bispecific combinations:
NCT06208150 - Talquetamab + pomalidomide vs talquetamab + teclistamab vs elranatamab (Phase 3)
Early intervention before progression to active myeloma — especially relevant for high-risk SMM with ≥50% PCs OR M-protein ≥2g/dL OR involved/uninvolved FLC ratio ≥20:
R-ISS stage (revised International Staging System) — combines beta-2-microglobulin, albumin, LDH, and FISH risk
Serum free light chain (FLC) ratio — key for monitoring response + smoldering risk stratification (ratio ≥20 = high-risk SMM)
Minimal residual disease (MRD) — by next-gen sequencing or flow cytometry; many newer trials use MRD-negativity as endpoint or treatment-de-escalation trigger
BCMA / GPRC5D expression — typically presumed high in MM (no testing required for current FDA-approved bispecifics), but some trials enrich by expression level
Prior treatment history — CD38-refractory, lenalidomide-refractory, BCMA-exposed status all gate specific trials
How do I find multiple myeloma clinical trials I'm eligible for?
Enter your myeloma details into ClinTrialFinder — including R-ISS stage, cytogenetic risk (t(4;14), del(17p), gain 1q, etc.), number of prior lines, transplant eligibility, and prior CD38/BCMA exposure. The AI matches you with trials based on your specific profile in minutes.
What multiple myeloma trials are currently recruiting?
There are 386 recruiting interventional multiple myeloma trials (May 2026) including 30+ Phase 3 studies. Notable: MajesTEC-7 (teclistamab + dara + len vs DRd in newly diagnosed), MagnetisMM-32 (elranatamab in newly diagnosed), LINKER-MM-3 (linvoseltamab vs standard), DREAMM-7/8-era belantamab mafodotin + LenDex (NCT06679101 — belantamab return to Phase 3), FUMANBA-03 (eque-cel CAR-T in lenalidomide-refractory RRMM, NCT06464991), AZD0120 dual-target BCMA × CD19 CAR-T (NCT07391657), and head-to-head comparisons of BCMA bispecifics, GPRC5D bispecifics (talquetamab, etentamig), CAR-T (anitocabtagene autoleucel, cilta-cel earlier-line), and CELMoDs (mezigdomide, iberdomide).
What's the difference between BCMA bispecifics and BCMA CAR-T for multiple myeloma?
Both target BCMA on myeloma cells but have different practical profiles. CAR-T (cilta-cel / Carvykti, ide-cel / Abecma) has higher response rates (~80–95% ORR) but requires leukapheresis + 3–6 week manufacturing + single-center delivery + dedicated CRS/ICANS infrastructure. Bispecifics (teclistamab / Tecvayli, elranatamab / Elrexfio, linvoseltamab / Lynozyfic) are off-the-shelf with no wait, outpatient-eligible after step-up doses, but require continuous dosing and carry sustained infection risk from immunoglobulin depletion. Trials are now testing both earlier-line in 1L/2L settings.
Are there bispecific trials for newly diagnosed myeloma (not just relapsed)?
Yes. The biggest trend in 2026 is bispecifics moving from R/R to 1L. MajesTEC-7 (teclistamab + dara + lenalidomide vs DRd) and MagnetisMM-32 (elranatamab in newly diagnosed) are both Phase 3 in transplant-ineligible newly diagnosed patients. Earlier-line CAR-T trials (CARTITUDE-5 and CARTITUDE-6 platforms) also enroll transplant-eligible newly diagnosed patients.
What if I've already had teclistamab or another bispecific and progressed?
Post-bispecific options are an active research area. Trials include switching to a different-target bispecific (e.g., GPRC5D after BCMA failure with talquetamab or etentamig), combination bispecific approaches (NCT07258511 JNJ-79635322 GPRC5D+BCMA dual-bispecific), CELMoDs (mezigdomide, iberdomide) which work via a distinct mechanism, and CAR-T which can produce deep responses even post-bispecific. Some trials specifically enroll bispecific-exposed patients.
Find Myeloma Trials Matched to Your Situation
Use ClinTrialFinder's AI-powered matching to find trials based on your specific condition.
This page is for information only and is not medical advice. ClinTrialFinder helps you find clinical trials that may match your situation, but enrollment decisions and treatment choices should always be made with your oncologist or healthcare team. Trial eligibility, recruitment status, and treatment details can change — verify directly with the trial sponsor or on ClinicalTrials.gov before acting on any information here.
