Jeffrey (Jeff) S. Rubin, MD, PhD: Stopping Cancer at an Early Stage, Thanks to Advances in Cancer Interception

Dr. Jeffrey (Jeff) S. Rubin dedicated his decades-long scientific career at the National Cancer Institute (NCI) to advancing medical research. Jeff, a prostate cancer survivor, also has a strong family history of cancer: His father had multiple myeloma, prostate cancer, and thyroid cancer; his mother had Waldenström macroglobulinemia, a rare blood cancer that shares certain features with multiple myeloma; and several other close relatives have been diagnosed with cancer.

Learning about Jeff’s family history of cancer during an annual physical examination, his doctor ordered a blood test that can detect abnormal proteins associated with multiple myeloma. Although the rest of Jeff’s bloodwork was normal, the test showed two abnormal protein markers that prompted further evaluation, including bone marrow biopsy and advanced genetic testing. In December 2022, Jeff was diagnosed with high-risk smoldering multiple myeloma (HR SMM).

HR SMM is a precursor of multiple myeloma that may not cause any symptoms but carries a high risk of progressing to active disease. Jeff’s test results were concerning because his abnormal plasma cells carried several genetic abnormalities associated with aggressive multiple myeloma. “My oncologist could not offer any treatment because the standard of care at the time was just surveillance,” Jeff recalled. “But he told me I should look for a clinical trial because my prognosis would be poor if or when the disease progressed.”

Jeff’s knowledge of medical science gave him confidence that research was changing the treatment landscape for HR SMM. “What made a difference was knowing I could have options,” he said. “I needed to be proactive to find out what would be available and go for it.” He contacted former colleagues at NCI and learned about a newly opened clinical trial for patients with HR SMM. In April 2023, just a few months after his diagnosis, he enrolled in the trial.

The clinical trial reflected an emerging concept in cancer care known as cancer interception. Instead of waiting for abnormal plasma cells to progress to active multiple myeloma, researchers were testing whether treating patients earlier could delay or even prevent that progression. “In this sort of trial, there is often not an expectation of a cure. The idea is to minimize disease and continue to monitor it as appropriate,” Jeff said.

Participants in the study received an established multiple myeloma treatment regimen consisting of 3 drugs (daratumumab, carfilzomib, and dexamethasone) given for 8 cycles, followed by treatment with daratumumab (Darzalex) alone to keep the disease in check, also called maintenance therapy. Over the course of treatment, Jeff’s abnormal blood proteins steadily declined, and testing after completion of the 3-drug treatment phase showed no evidence of measurable residual disease, which means that abnormal plasma cells could no longer be detected with available tests. After 2 years of maintenance therapy, only a very small number of multiple myeloma cells were detectable in Jeff’s bone marrow, and the abnormal proteins were still absent from his blood.

Jeff says he tolerated treatment well. Despite experiencing mild fatigue following some of the early treatments, he was able to maintain his healthy routines of jogging multiple times each week and hiking with his wife. He also made time for family and friends.

Receiving treatment at the same institution where he had spent much of his professional life made the experience especially meaningful. During his career helping advance research, Jeff saw firsthand how clinical trial volunteers contributed to medical progress; now he was one of them, and he viewed the study as an opportunity to give something back.

Jeff and his wife have now moved to Chicago to be closer to their daughter, son-in-law, and three young grandchildren. He continues to enjoy jogging, hiking, and nature photography. He also follows the progress of cancer research as a scientist and as someone whose own life has been shaped by it.

In November 2025, daratumumab was approved specifically for patients with HR SMM, the first FDA-approved treatment for this early stage of the disease, giving physicians the ability to intervene before progression to active multiple myeloma. More research is still needed to determine which patients are most likely to benefit from early treatment, but the approval is a major milestone in the growing field of cancer interception.

“We’ve made quite a bit of progress in my lifetime in reducing death from cancer. I’m glad that there’s now an FDA-approved treatment for HR SMM, but more work needs to be done. It’s really a partnership of the government and the companies that invest in treatments based on the research that academic scientists have done.”