Beyond the Clone: Rethinking Myeloma as a Network of Neoplastic Ecosystems

Multiple myeloma is increasingly recognized as a complex neoplastic ecosystem in which malignant plasma cells interact dynamically with immune, stromal, vascular, and bone marrow microenvironmental networks that influence disease progression, therapeutic response, and resistance. This session will examine emerging insights from single-cell, spatial transcriptomic, and multi-omics studies that are reshaping our understanding of myeloma biology beyond tumor-intrinsic genetics. Faculty will review how immune dysfunction, spatially organized resistance mechanisms, and microenvironmental remodeling contribute to treatment outcomes, particularly in high-risk and extramedullary disease. Recent clinical and translational data evaluating immune-redirection strategies, dual-target therapies, and microenvironment-modulating approaches will be discussed. Attendees will gain practical perspectives on incorporating ecosystem-based concepts into risk assessment, therapeutic decision-making, and future precision myeloma care.