From "Not Curable" to "May Be Curable": Joshua Richter, MD, on the New Reality of Multiple Myeloma

Richter traces his path into myeloma to his residency at St. Vincent's Hospital in New York, where he trained under Sundar Jagannath, MD, now of Mount Sinai, and watched an entire disease paradigm transform in real time. He describes a precise turning point in how he speaks to newly diagnosed patients: where he once said "myeloma is not curable," he now says "myeloma may be curable — and we may be able to cure you." That shift, he argues, is not rhetorical. It reflects emerging data, including 5-year follow-up from the CARTITUDE-1 study (NCT03548207) published in the Journal of Clinical Oncology, showing a third of patients remain off therapy, minimal residual disease—negative, years after receiving ciltacabtagene autoleucel (Carvykti). He offers a definition of cure from colleague Edward Stadtmauer, MD, of the University of Pennsylvania: the moment an oncologist shakes a patient's hand and says they don't need to be seen anymore. "We're not quite there yet," he says, "but with the tools we now have, we are soon going to be."

"My job as your physician is to kick the can down the road so far that either you are cured, or we open the paper one day and find that there is a cure — and we give it to you."

Linvoseltamab and What Approval Actually Feels Like

As co-first author on LINKER-MM1, Richter reflects on the FDA approval of linvoseltamab (lynozyfic) — and reframes what the milestone meant to him. He recalls infusing the first dose of a different investigational drug into a patient, sitting across from the developers who predicted a New England Journal of Medicine publication and approval — a drug that never made it. [Lynozyfic] Linvoseltamab did. "The win," he says, "is giving people more options."

The Trispecific Future

Looking ahead, Richter describes a future shaped by trispecific antibodies — agents designed to hit two myeloma targets simultaneously with an improved toxicity profile compared with combination bispecific regimens. Drawing on the principle that depth of remission correlates with durability, he envisions a fixed-duration treatment paradigm: 6 to 12 months of therapy achieving remissions deep enough that some patients never relapse.

The Moonlight Shift is available on YouTube and across MJH Life Sciences’ oncology platforms. New episodes, released bi-weekly, feature leading and early-career oncologists from the Tri-State corridor in peer-level conversations about where the field is going — and what it still has to work out.

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