Mohamad Mohty, MD, PhD, from Saint-Antoine Hospital, Paris, France and Arnon Nagler, MD, from the Sheba Medical Center, Tel Hashomer, Israel, discuss the highlights from the first day of the 2016 World Congress on Controversies in Multiple Myeloma (COMy) held in Paris, France. According to Prof Nagler, many important advances have been made in recent years that have led to an improvement in overall survival (OS) from 2-3 years to 10 years. Prof Nagler and Prof Mohty further discuss the translation of clinical trials results into clinical practice and how research into myeloma is a global challenge as shown, for example, by the IFM/DFCI 2009 trial. Another point of discussion concerns treatment approaches in terms of autologous transplant, drug combinations and how approaches to treatment may differ between Europe and the USA. The possible use and cost of maintainer therapy with drugs such as lenalidomide and more generally, monoclonal antibodies and proteasome inhibitors such as ixazomib, is another topic of debate. Finally, Prof Mohty and Prof Nagler discuss the current understanding of the immune system and how in future, it may be possible to use this understanding to restore the immune system in patients. At the moment, for example, the lives of patients on the fourth or fifth line of therapy can be prolonged with checkpoint inhibitors.