Abstract
Multiple myeloma accounts for 10% of hematological malignancy and 1% of all cancer. It manifests with anemia, hypercalcemia, renal failure, and bone lesions, with the latter being the most common cause of morbidity. Over the last two decades, many advances were achieved in different aspects of the disease, including, but not limited to risk stratification and treatment approaches. With the approval of Chimeric antigen receptor (CAR) T-cell therapy in multiple myeloma, the main effort in clinical trials is toward studying different CAR T-cell products in different combinations at different disease stages. Although more options are becoming available, more trials are needed to compare their efficacy and safety in the long-term, as well it is essential to consider side effects and quality of life, which will be more noticeable with patients’ lives long after the myeloma diagnosis. There continue to be several unmet needs for multiple myeloma patients, including extramedullary plasmacytoma, plasma cell leukemia, CNS myeloma, and high-risk/ultra-high-risk disease. These are extremely challenging and further randomized clinical trials are highly needed.