Dana-Farber reported durable, profound responses from CAR T-cell therapy in high-risk smoldering multiple myeloma through the CAR-PRISM phase 2 trial. Investigators presented results showing deep responses after treating patients at the precursor stage, aiming to intercept disease before progression to active multiple myeloma. The trial’s emphasis on early immune intervention aligns with an emerging strategy in multiple myeloma to shift the treatment goal from delaying progression to achieving long-term control. In the reported cohort, patients experienced sustained responses assessed over follow-up. If confirmed in larger cohorts, the findings could expand CAR T beyond relapsed/refractory settings and create a pathway to redefine standard-of-care for precursor disease categories.