News Room – What’s been happening

February 2026 UK Myeloma expert from Oxford, Professor Karthik Ramasamy, Clinical Director, SACT Clinical Reference Group for GenesisCare, based at their centre in Oxford, is leading the SECURE study, one of several major new trials exploring how myeloma develops and how it could be prevented.

Myeloma – a blood cancer affecting plasma cells in the bone marrow, is currently only treated once it becomes ‘active’. By this point, many people are already experiencing symptoms, such as bone pain, fractures, kidney problems or tiredness. 

Smouldering myeloma - an early, pre-cancerous stage of myeloma, doesn’t cause any symptoms, so is often only discovered by chance through routine health checks or blood tests. For decades, people who have been diagnosed with smouldering myeloma, have been advised  to ‘watch and wait’ and are given regular check-ups, but have no active treatment - until they develop symptoms. 

Factors which may indicate a higher risk of developing symptoms include a greater number of myeloma cells found in the bone marrow, higher levels of paraprotein in the blood, or specific genetic changes detected in the myeloma cells. Within two years of a smouldering myeloma diagnosis, less than 1 in 10 people  who are considered  lower-risk will develop active myeloma, but the figure is far more elevated for those at higher-risk - where the disease will progress in 50% of cases. 

Lead expert Professor Ramasamy says:  “Patients often tell me it’s the waiting that’s hardest. They know there’s something wrong in their blood, but they can’t do anything about it. Our goal is to change that — to move from monitoring to managing.”

The SECURE study (NCT05539079), led by Professor Ramasamy and his team in Oxford, is following hundreds of people with MGUS (monoclonal gammopathy of undetermined significance), a common precursor condition which can develop into smouldering or active myeloma. Over several years, the study will collect blood samples, lifestyle information and quality-of-life data to help doctors understand why some people progress to myeloma and others don’t.

Professor Ramasamy continues:  “We’re learning that myeloma doesn’t suddenly appear — it develops gradually over time. By understanding these early stages, we have a real opportunity to change the outlook for patients and potentially prevent this cancer before it starts.”

We’re building a national picture of early myeloma.  By combining biological data with patient experiences, we hope to develop a more precise way of identifying who needs close monitoring, who might benefit from early treatment, and who can be safely reassured.”

The SECURE study is part of a broader movement of studies in the UK and beyond, including:

• The COSMOS study, led by Professor Kwee Yong at UCLH, investigating the genetic and emotional factors which can drive progression from smouldering myeloma to active disease.
• The MODIFY trial, testing whether early immunotherapy can delay or even prevent myeloma in high-risk patients.
• And in the United States, DARZALEX FASPRO® could soon become the first approved treatment for high-risk smouldering myeloma, after a major clinical trial showed strong results from the AQUILA Phase 3 study, reducing the risk of progression or death by more than 50%.

Professor Ramasamy concludes: “The hope is that in future, people at higher risk of myeloma could receive short courses of preventive therapy or more personalised monitoring, in a similar way to screening programmes for other cancers.

“We’ve seen how early detection saves lives in breast, bowel and cervical cancer,” says Professor Ramasamy. “Myeloma could be next. The more we understand these early stages, the more we can do to stop the disease before it starts.”

About Professor Karthik Ramasamy: 

Professor Karthik Ramasamy undertook his general medical training at Nottingham University Hospitals NHS Trust (NUH) followed by early haematology training at NHS Greater Glasgow and Clyde (NHSGGC). He subsequently moved to London in 2002 and undertook a comprehensive haematology-training programme encompassing all subspecialties of haematology, including bone marrow transplantation and a PhD in myeloma studies at Kings College London (KCL). Professor Ramasamy now works at Oxford University Hospital NHS Trust and is Clinical Director of the Oxford Translational Myeloma Centre. He also practices at private cancer care provider GenesisCare in Oxford and is Clinical Director of the GenesisCare SACT Clinical Reference Group. Professor Ramasamy is a Member of UK Myeloma Society and ambassador of Myeloma UK, a patient charity. Professor Ramasamy is a Chief Investigator of UK multicentre myeloma trials and has published more than 150 peer-reviewed articles and written chapters in haemato oncology textbooks. Professor Ramasamy is also the Research Lead for Cancer and Haematology at Oxford University Hospitals. He leads the SECURE study and contributes to several UK and international clinical trials focused on improving early diagnosis, treatment, and outcomes for people with myeloma.

About GenesisCare

GenesisCare UK is the UK’s leading cancer care provider, specialising in the treatment of complex cancers and transforming cancer care with advanced diagnostics, medical oncology, radiotherapy and Theranostics. Operating 14 specialist outpatient centres, with an additional centre opening in Leeds in 2026, we provide patients with world-class care from the UK's top clinical & healthcare teams, and deliver the most advanced, safe and effective cancer care treatments. With a philosophy of treating the whole patient not just their cancer, we take an integrated approach to cancer care.  Our personalised treatment programmes are supported with wellbeing services, and support for patients with treatment-induced menopause, both delivered through our partnership with the charity Penny Brohn UK. We also provide on-site exercise medicine which is proven to deliver improved patient outcomes, and access to sleep improvement resources through our partnership with The Sleep Project. We work with universities and leading clinicians around the world, to research and design new and better ways to treat cancers and have a growing UK clinical trials programme to support bringing new therapies to more patients. Treatments are available for patients with health insurance and those paying for their own care. 

Notes to Editors

• MGUS (monoclonal gammopathy of undetermined significance) is a benign but potentially pre-malignant condition found in around 3% of adults over 50.
• Around 1 in 100 people with MGUS per year will progress to myeloma.
• Clinical trial identifiers: SECURE (NCT05539079), COSMOS (NCT05047107), MODIFY (NCT06762769), AQUILA (NCT03301220).