Tumor suppressor gene TP53 is associated with aggressive disease activity when inactivated in a variety of tumor types, including multiple myeloma (MM). Speaking from the British Society for Haematology (BSH) 2018 Annual Meeting in Liverpool, UK, Martin Kaiser, MD, RWTH, of the Royal Marsden NHS Foundation Trust, London, UK, discusses how tumor heterogeneity in TP53 activity impacts overall disease behaviour. Using data from the Phase III Myeloma XI study (NCT01554852), Dr Kaiser explains that the existence of even small proportions of tumor cells with TP53 deletions results in a poor prognosis for patients.