Here, Shaji Kumar, MD, of the Mayo Clinic, Rochester, MN, discusses the potential benefits of early intervention and treatment to prevent the progression of smoldering myeloma to multiple myeloma. Dr Kumar mentions the Spanish trial which showed improved PFS with lenalidomide and dexamethasone, and the more recent ECOG trial which demonstrated improved PFS with lenalidomide alone. To further benefit patients, new scoring systems need to be developed to accurately identify high risk patients. This interview was recorded at the Controversies in Multiple Myeloma (COMy) 2019 meeting held in Paris, France.