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Nature Reviews Clinical Oncology, Published online: 22 January 2026; doi:10.1038/s41571-026-01119-0Increased understanding of the biology of smouldering multiple myeloma (SMM) is being leveraged to improve the management of this clinically heterogeneous precursor of MM. This Review describes the current diagnostic work-up, risk stratification and management of SMM, highlighting early intervention approaches for high-risk SMM that might provide the best opportunity to convert MM into a curative disease and discussing persistent challenges in this field.

NCT01949116.