The impact we hope to make on people’s lives is to determine whether screening for myeloma and its precursor is beneficial. We’ve seen in clinical studies for other cancers—like breast cancer and cervical cancer—that screening programs can dramatically improve outcomes. Similar research has never been done for MGUS or myeloma. That’s what we’re doing now: evaluating whether screening for MGUS can change lives.

Multiple myeloma is a cancer of the bone marrow that originates in plasma cells—the antibody-secreting cells of the body. When these cells become cancerous, they can cause various symptoms such as anemia, kidney failure, bone lesions, and fractures. What’s unique about myeloma is that it is always preceded by a precursor condition. The most common of these is MGUS (monoclonal gammopathy of undetermined significance), which can progress to smoldering myeloma, and ultimately to multiple myeloma.

Everyone diagnosed with myeloma has passed through these stages—from being healthy, to MGUS, to smoldering myeloma, to full-blown myeloma. The goal of the iStopMM study is to diagnose individuals at the MGUS stage, treat them during the smoldering phase, and prevent the progression to multiple myeloma entirely.

This is the largest nationwide clinical trial of any cancer precursor ever performed in the world. It is a massive effort, with 54% of Iceland’s population voluntarily providing informed consent to participate—a milestone that’s never been achieved before. We’ve screened over 75,000 blood samples and discovered that nearly 5% of Icelanders have MGUS.

Participants diagnosed with MGUS are then randomized into three different study arms, allowing us to rigorously evaluate whether screening is truly beneficial. Thanks to Iceland’s unique healthcare infrastructure and partnership with deCODE Genetics, which has sequenced the entire population's genomes, we are in a rare position to also assess hereditary risk factors for MGUS and its progression.

The power of this study lies not only in its scale but also in the depth of data available. We have access to national registries for prescriptions, cancer diagnoses, and genetic information, offering near-complete coverage of the population. This level of comprehensive data linkage cannot be replicated in most other countries, though the findings are still applicable to global populations.

Early results are already promising. We’re seeing that people diagnosed through screening—before developing full myeloma—experience fewer complications like kidney damage and bone fractures. This proves we are already changing lives through early detection and treatment.

Ultimately, we want to show that this model can be adopted worldwide. Screening for MGUS is easy, cost-effective, and life-saving when combined with early intervention. But to take this research further, we need support.

This study must be funded because we are now at a turning point in myeloma research. We know early intervention helps. It delays disease progression, improves survival, and reduces suffering. Yet fewer than 5% of myeloma patients are diagnosed in a precursor state, leaving most untreated until their cancer is advanced.

With iStopMM, we can change that. If we identify everyone with MGUS, follow them over time, and intervene early, we can prevent the devastating complications of myeloma. This study is our opportunity to stop myeloma before it starts.