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Some of the most ambitious cancer science is happening in a disease few outside of oncology can name, and its revealing a future where cancer is no longer a death sentence. Multiple myeloma (MM) is a blood cancer that affects the bodys plasma cells, causing them to mutate and grow uncontrollably in the bone marrow. These plasma cells produce abnormal antibodies called M-proteins that wreak havoc on the immune system, kidneys, and bones. MM is also relatively rare. While breast cancer saw approximately 370,000 new cases in the U.S. in 2024, multiple myeloma only saw about 31,600, per internal data from Evaluate. Even among blood cancers, MM only makes up 10% of cases. Yet, despite its rarity, multiple myeloma has become a springboard for some of the most advanced drug innovations in cancer, fostering the development of advanced gene therapies and antibody technologies. While new breakthroughs extend MM patients lifespans, treatment for the disease is exposing a new reality of navigating cancer as a chronic, high-cost condition. MYELOMAS MANY INNOVATIONS Despite only making up less than 2% of cancer diagnoses, multiple myeloma has seen an array of breakthrough treatments that have more than doubled its five-year relative survival rate since 1990. These include: Stem cell transplants, which use a patients own stem cells to rebuild healthy bone marrow after intense chemotherapy targeting cancer in the bone marrow itself Proteasome inhibitors, which kill myeloma cells by interfering with the normal break down of proteins Immunomodulatory drugs (IMiDs), which stimulate the immune system and eliminate proteins essential for the survival of myeloma cells Chimeric antigen receptor T cells (CAR-Ts), which custom-engineer a patients own T cells to target and destroy malignant plasma cells Bispecific antibodies (bispecifics), which redirect T cells to kill malignant plasma cells by bringing the two cells in close proximity Monoclonal antibodies, which precisely target specific proteins on cancer cells or in the tumor environment, and are behind some of the most promising survivability gains Though not the first cancer to see some of these novel treatments, MM is one of the first diseases to achieve approval for CAR-Ts, bispecifics, and monoclonal antibodies all at the same time. Its unique attributes unlock innovation, driving $24 billion in U.S. drug sales in 2024 alone, per Evaluate internal data. MMS UNIQUE ADVANTAGES Multiple myeloma has four key advantages that make it a sandbox for cancer innovation. MM has a high survival rate. Non-small cell lung cancer (NSCLC)one of the most common cancershas a five-year survival rate of 32% across all stages; multiple myelomas is 62%, with a median patient survival length of 810 years. Longer survival creates a bigger window to offer multiple treatments. Multiple myeloma comes with its own accelerometer. The M-protein biomarker rises and falls quickly, offering a clear sign of the cancers progression and response to treatment. Consequently, trials to develop new multiple myeloma medications show efficacy faster, so are less expensive than those for most other cancer drugs. MM can be almost completely eradicated from the body. In 2024, MM became the first cancer for which the FDA endorsed minimum residual disease as a surrogate goal or endpoint for drug trials, which qualifies many MM drugs for breakthrough therapy designation or accelerated approval. Multiple myeloma received approval for seven new drugs between 2020 and 2022, including multiple first-in-class therapies. This surge in innovation, rarely seen in oncology, is likely to continue now that minimal residual disease is accepted as a surrogate endpoint. The incentives for developers to create new MM drugs are strong. Unlike other rare diseases whose treatments only incrementally increase survival, MM treatments drastically improve length and quality of life. The latest combination of drugs being tested to treat MM has been modeled to increase survival without disease progression by a full decade among healthier patients. As a result, MM patients are more likely to spend on high-cost drug regimens to keep the disease at bay, further funding research. Multiple myelomas ability to foster innovation drives comparatively lofty drug sales for its rarity. Evaluates internal data shows that, in 2024, non-small cell lung cancer (NSCLC) saw about six times more new cases than MM, yet NSCLC drugs only brought in a third more revenue than MM drugs did that year. Drugmakers are looking to re-create MMs success in other cancers, but its innovations have proven difficult to reproduce. REPLICATING MMS ADVANCEMENTS Multiple myeloma drugs have proven more effective because they can directly reach the diseases liquid tumors within the bloodstream. In contrast, other cancers solid tumors are embedded in dense, immunosuppressive tissue environments that can be difficult for drugs to access. Furthermore, solid tumors often lack good cell surface targets that differentiate them from surrouning healthy cells. Many companies have tried to apply MMs breakthroughs to other cancers and a few are beginning to see success in solid tumors. Gileads CAR-T therapy is showing promise in shrinking deadly brain cancer tumors, while bispecifics are beginning to show promise in treating small cell lung cancer. The trick for scientists now is to take the base-level innovations that have worked in MM and apply them with more specified targeting, delivery, and immune activation to other cancers. Meanwhile, the treatment innovations MM patients enjoy also bring new, unintended consequences. CANCERS CHRONIC FUTURE Multiple myeloma reveals a future where cancer patients not only live longer but also shoulder continual treatment expenses. A study examining Medicare claims from 20062016 found the average lifetime treatment costs for MM were $184,495, and out-of-pocket costs have only increased since then. As a result, one in four patients with MM experience financial hardship due to treatment costs, causing some to skip doses or delay care. Despite already high treatment costs, myeloma therapies continue to increase in price. Evaluates internal data reveals that Medicare coinsurance patients can expect to pay $105,700 out of pocket for cutting-edge CAR-T Carvykti. However, even the price for the most widely prescribed MM drug, Revlimid, has increased 17% in the last four years, notwithstanding cheaper, generic versions of the drug beginning to roll out in 2022. To make long-term cancer survival a viable reality for more patients, drugmakers will have to iterate on MMs playbook while U.S. hospital systems and insurance companies make innovations more accessible at scale. In the meantime, we can glimpse into the future of cancer treatment in multiple myeloma, where breakthroughs are making long-term survival the new normal. Soon, MMs innovations will spur discoveries that extend the lives of all cancer patients.
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Welcome, and thanks for reading this issue of Fast Companys Plugged In. On August 22, President Donald Trump announced via Truth Social that the U.S. federal government had acquired 10% of Intel. The chipmakers news release trumpeted the deal as historic. That it was. But it was also ignominious. In Trumps own account, he had humbled an iconic American company. Maybe even shaken it down. Fifteen days earlier, he posted to Truth Social that Intel CEO Lip-Bu Tan had ties to China, which left him highly CONFLICTED and demanded his immediate resignation. On August 11, Tan visited the White House. On August 22, the deal was official. The U.S.s ownership stake in Intel doesnt involve any new funds. Instead, its a retroactive quid pro quo for $8.9 billion the company had already been granted but not yet paid through the U.S. CHIPS and Science Act. Joe Biden signed that bill three years ago, a $280 billion gambit to reverse the decades-long flight of chip manufacturing to Asia. As Trump put it, Tan walked in wanting to keep his job, and he ended up giving us $10 billion [the approximate value of the 10% stake] for the United States.” Notably, The Wall Street Journals Robbie Whelan, Yang Jie, and Amrith Ramkumar reported that Taiwans TSMC, the worlds largest chip manufacturer, pushed back against forking over any equity to the U.S.even if declining to do so would require it to give up CHIPS Act money it was getting to help expand its production capacity in Arizona. For anyone who lived through the PCs heyday in the 1990s, seeing Intel run out of options is a stunning development. Its not just that it dominated the market for PC processors so utterly that after years of shrinkage it still has close to a 75% share. More than any other company, Intel once shaped the technologies that kept the technology business booming. In a sense, the entire PC industry became a front for it, to a degree that wasnt obvious then and has since faded into history. For instance, Intel engineers invented USB, maybe the most significant new PC technology of the 1990s. It didnt pioneer Wi-Fi, but its decision to integrate it into a processor2003s Centrinohelped make it standard equipment on every laptop. When Apples thin-and-light MacBook Air became a hit and Intel was concerned that Windows portables were clunky by comparison, it came up with the Air-like Ultrabook; PC makers merely followed its lead. Intel also supplied the motherboards many manufacturers used, allowing it to define a computers feature set and even its shape. In such cases, building a PC amounted to little more than filling out its platform with components such as memory and storage and wrapping a case around it. The 1991 ad that launched Intels wildly successful Intel Inside campaign [Image: Intel] The companys grip on the industry wasnt just technological. Starting in 1991, its Intel Inside campaign convinced millions of people to pay attention to the chips that powered computers. But Intel didnt just buy ads on its own. It also established a co-op fund that paid up to half the cost of ads placed by PC companies. More than 500 of them participated in the program, including brand names such as Dell, HP, IBM, Sony, and Toshiba. The co-op dollars manufacturers received were tied to the quantity of Intel processors they purchased. Naturally, ads subsidized by the fund were required to highlight the Intel Inside message. They also couldnt mention models using chips from other companiesa stipulation that put longtime Intel rival AMD at a massive disadvantage, regardless of the quality of its products. Intels co-op dollars indirectly paid for a disproportionate share of the entire PC businesss marketing budget. At first, magazines such as my former employer PC World benefited from the companys largesse. Later, when Intel instructed manufacturers to divert ad dollars to the web, the magazines felt it in the pocketbook. For a technology company, being all-powerful has its downsides. Andy Grove, Intels third employee and its CEO from 1987 to 1998, summed up his fear of resting on ones laurels in the title of his 1996 bestseller, Only the Paranoid Survive. By the early years of this century, however, Intel began to radiate not paranoia but complacency. As the world changed, it didnt. The results were disastrous. In the 1990s, for example, Intel focused on integrating graphics into its CPUs rather than designing more powerful discrete graphics processorsthe kind sold by smaller, specialized chipmakers such as Nvidia. Then Nvidia proved its graphics chips were also adept at running AI algorithms. Now its the worlds most valuable public company, with a market cap quadruple the size of Intels. And then there were phones. Intel talked to Apple about providing the processor for the first iPhone, but concluded it couldnt turn a profit on the deal. Smartphones went on to be bigger than the PC ever wasand almost none of them ever had Intel Inside. For years, Intel had been synonymous with Moores law, its cofounder Gordon Moores observation that the number of transistors that could fit on an integrated circuit doubled every two years. As techs engines of progress moved beyond the PC, even its ability to stay on the cutting edge of chip manufacturing faltered. When longtime executive Pat Gelsinger rejoined the company as CEO in 2021, it was in desperate need of a turnaround. Gelsingers ambitious strategy involved getting its manufacturing advances back on track and becoming a contract manufacturer (foundry) for chips designed by others. But Intels board ousted him after less than four years, before his vision could play out. That led to Tans appointment and, five months later, the Trump deal. How Tan intends to reset Intel once again remains fuzzy, and Trumps interest in the company may limit Tans options rather than expand them. The U.S. government doesnt have an Intel board seat or, in theory, an active role in steering the company. Yet Intels CEO said the deal is structured to prevent it from selling its foundry unit. Meanwhile, Trump says he hopes for many more instances of his administration extracting equity from businesses that need something from him. In the 1990s, Intel was a shimmeringif occasionally obnoxiousparagon of American manufacturing excellence. Today, with the U.S. tech industry dangerously dependent on Taiwan chip production, Stratecherys Ben Thompson calls its 10% government ownership solution the least bad option. Intels collapse, he argues, would be catastrophic not for the U.S.s leading semiconductor company, but for the U.S. itself. Trump must already be salivating at commandeering the credit for any dramatic turnaround. Just thinking of his triumphant Truth Social posts makes me wincebut I am rooting for him to get the opportunity nonetheless. Youve been reading Plugged In, Fast Companys weekly tech newsletter from me, global technology editor Harry McCracken. If a friend or colleague forwarded this edition to youor if you’re reading it on FastCompany.comyou can check out previous issues and sign up to get it yourself every Friday morning. I love hearing from you: Ping me at hmccracken@fastcompany.com with your feedback and ideas for future newsletters. I’m also on Bluesky, Mastodon, and Threads, and you can follow Plugged In on Flipboard. More top tech stories from Fast Company How large language models can reconstruct forbidden knowledgeLike a student who once designed a nuclear bomb from textbooks, today’s AI systems can stitch together public scraps of information into dangerous blueprintsat speed, at scale, and without realizing it. Read More Can artists really stop AI from stealing their work?Tools like Glaze and Nightshade aim to muddle AI training, while lawsuits and legislation target AI companies directly. But researchers warn defenses may never fully hold. Read More Emerging drone tech firms are powering the defense industry’s next chapterAgile drone technology companies are breaking into a market long dominated by defense giants, winning contracts through speed, precision, and real-world results. Read More Brands are using your inbox to get ready for a new wave of tariffs‘We don’t want to raise prices, but we will have to.’ Read More How AI is exposing the BS economyAI is revealing just how much work doesn’t need to exist in the first place. Here’s how it can help us fix work. Read More Tech billionaires are building their own private cities. Here’s who’s doing what whereElon Musk, Mark Cuban, Mark Zuckerberg, and other tech billionaires are building private towns and compounds, reshaping communities from Texas to Hawaii. Read More
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When an influencer gets married, its safe to assume much of the cost, from venue decor to personalized invitations, has been comped in exchange for content. Now brides with smaller, more modest followings want in on the action. According to The Wall Street Journal, a new trend has brides-to-be flooding brands with requests for free swag in exchange for TikTok hauls and Instagram posts. @artfromthehart Bachelorette PR | Part 7!! @Avaline @Swisspers @eezcompany @Waterboy @Nemat Perfumes @wooshbeauty @Fruit Riot @Tillamook @GOODLES @Go Mouthwash Thank you to all of these amazing companies that were so generous in sending us PR to spoil the girls! #bachelorettepr #bachelorettebags #bridalpr #bacheloretteparty #bacheloretteplanning #pr #bacheloretteideas original sound – Emily Hartung Guides on how to score freebies are popping up on wedding sites like the Knot, while spreadsheets of brand contacts and ChatGPT-generated scripts are spreading online. On TikTok, one woman admitted to emailing more than 200 companies. Others are showing off hauls of what theyve managed to secureeverything from Octobuddy phone grips for bachelorette photos to LMNT packets for post-party hangovers. @maloreemedia Bachelorette PR Haul Thank you to all the brands that made this weekend and my girls Bach bags so special. @Lotus Plant Power @Good Molecules @Craftmix @Solely: Organic Fruit Snacks @OCTOBUDDY @LesserEvil Snacks @Get Lotza #bachpr #bachelorette #brandgifts #bachelorettepr #bachelorettebags Walking Around – Instrumental Version – Eldar Kedem Some brands told The Journal that theyre happy to oblige, calling it a win-win: Brides shave costs while companies gain exposure. But smaller businesses are pushing back, frustrated by the flood of requests. @chelseyibrown Brides – please stop asking for free gifts from small businesses Also – for those who keep saying its a mistake to not send my products to influencers with tons of followers: I get more ROI sending gifts to average people who need my products!! AND I LOVE the idea of sending gifts to people who wouldnt normally get PR – especially products this meaningful This business model has worked extremely well so far!! original sound – Chelsey Brown David Maffei, owner of Halfsies Cookie Co., went viral in 2024 after posting an Instagram Reel of an exchange with a bride-to-be. She asked for free cookies to include in her bridal boxes, describing herself as a beginner influencer with fewer than 1,000 followers. Maffei declined and called her out. Influencer is a wild label,” he wrote. View this post on Instagram A post shared by Halfsies Cookie Company (@halfsiescookieco) Critics say the requests are tacky. Others argue content monetization is simply the norm now. After all, if influencers can unbox more free products than they could ever use, why shouldnt brides try too? As the saying goes: Dont ask, dont get. The financial pressures are real. Bachelorette parties have ballooned into multiday trips, with the average cost hitting $10,800 in 2023, up 40% from $7,700 in 2021, according to Bach. Social pressure, comparison culture, and rising vendor prices have pushed costs higher. And thats before the actual wedding. With the stakes so high, its not hard to see why brides are tempted to cut corners where they can.
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