Martin Kaiser, MD, Royal Marsden NHS Foundation Trust, London, UK, discusses the Myeloma XI trial (NCT01554852) and stresses the urgent need for improved treatment approaches for ultra-high-risk patients with multiple myeloma, as delay can mean that they receive only modest benefit from therapies beyond second line. This interview took place at the American Society of Hematology (ASH) 2019 Annual Meeting and Exposition in Orlando, FL.