Multiple Myeloma Death Rates Decline as Targeted Therapies Transform Survival

Death rates are falling as treatments improve

Death rates from multiple myeloma in the United States have declined significantly over time, with the most dramatic improvements occurring in recent years, according to a study published in Oncotarget. Researchers analyzed national SEER data from 1975 to 2023 and found that mortality increased for decades before beginning a steady decline as more effective treatments were introduced. The most notable improvement occurred between 2021 and 2023, when death rates dropped sharply, reflecting the impact of newer therapies entering clinical use.

Targeted therapies are changing how multiple myeloma is treated

A major driver of improved survival has been the shift from older, less effective treatments to targeted therapies that act more precisely on cancer cells. Earlier approaches, such as chemotherapy and steroids, provided limited benefit and were associated with rising mortality rates through the mid-1990s. The introduction of stem cell transplantation marked an initial turning point, but the most meaningful and sustained improvements came with the development of targeted drugs in the early 2000s.

These therapies — including immunomodulatory drugs, proteasome inhibitors and monoclonal antibodies — work in different ways to control the disease. Some help the immune system recognize and attack myeloma cells, while others interfere with cancer cell survival or trigger cell death. Because they target specific pathways, these treatments have been more effective at controlling disease and extending survival compared with older options. Their introduction aligns with the steady decline in mortality observed over the past two decades.

New immunotherapies are driving the most recent gains

More recently, advances in immunotherapy have accelerated progress even further. Treatments such as CAR T-cell therapy and bispecific antibodies use the immune system in highly targeted ways, either by engineering a patient’s own immune cells to attack cancer or by helping immune cells directly engage and destroy myeloma cells. These approaches have shown strong and durable responses, even in patients who have already received multiple prior treatments.

The study found that the steepest decline in death rates occurred during the same period that these therapies became more widely available, suggesting they are playing an important role in improving outcomes. At the same time, these newer treatments are being added to an already expanding range of options, allowing doctors to tailor therapy and adjust treatment over time based on how the disease responds.

Combination therapy and long-term treatment are extending survival

Another important factor in improving outcomes is the use of combination therapy, where multiple drugs are given together to target the cancer in different ways. These regimens have been shown to improve response rates and help keep the disease under control for longer periods. In addition, maintenance therapy — ongoing treatment after an initial response — has become more common and helps delay disease progression.

As a result, many patients are now treated across multiple lines of therapy over time, rather than relying on a single approach. This has contributed to longer survival and has shifted multiple myeloma toward being managed as a long-term condition for many patients.

Longer survival brings new challenges for patients

While these advances are helping patients live longer, they also introduce new challenges. Many patients remain on treatment for extended periods, which can lead to cumulative side effects such as low blood counts, infections, nerve damage and cardiovascular issues. Managing these side effects is an important part of care, especially as treatment durations increase.

In addition, the cost of newer therapies continues to rise, particularly for advanced treatments like CAR T-cell therapy. Access to these options can vary depending on factors such as insurance coverage, geographic location and availability of specialized treatment centers. These barriers may prevent some patients from benefiting fully from recent advances.

What this means for patients

Overall, the study shows that advances in targeted therapies and immunotherapy are translating into real-world improvements in survival for patients with multiple myeloma. Patients now have more treatment options than ever before, and many are living longer as a result. However, ensuring that these benefits are accessible, affordable and manageable over the long term remains an important focus for the future of care.

Reference

1. Kahlon N, et al. Targeted therapeutics and U.S. population-level mortality trends in multiple myeloma: A SEER-based analysis from 1975 to 2023. Oncotarget. 2026.

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