[Treatment strategies for newly diagnosed multiple myeloma and the clinical significance of minimal residual disease negativity].

Multiple myeloma is an incurable hematologic malignancy; however, survival outcomes have improved with the introduction of proteasome inhibitors, immunomodulatory drugs, and anti-CD38 monoclonal antibodies. As autologous transplantation remains the standard therapy, transplant eligibility determines the treatment strategy for newly diagnosed myeloma. Quadruplet first-line regimens were approved in 2025 and became the standard of care regardless of transplant eligibility, improving clinical outcomes. Minimal residual disease (MRD) has been identified as a surrogate marker for survival, and MRD negativity is increasingly being adopted as the primary endpoint in clinical trials. Autologous transplantation is associated with higher MRD negativity rates, but its necessity for patients who achieve MRD negativity may be open to debate. Furthermore, ongoing clinical trials are comparing autologous transplantation with CAR-T cell therapy and incorporating BCMA-targeted immunotherapies, including bispecific antibody drugs, into post-transplant maintenance therapy. This review summarizes treatment strategies for newly diagnosed myeloma in the era of quadruplet combination therapy.