Although treatments for multiple myeloma (MM) are constantly improving, ~25% of patients still have poor outlooks. We spoke to Guy Pratt, MD, FRCP, FRCPath, of the University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK, about these high risk patients at the 23rd Congress of the European Hematology Association (EHA) 2018, held in Stockholm, Sweden. Dr Pratt discusses the MUK Nine b trial (NCT03188172), which aims to genetically identify high risk patients and treat them with a combination therapy of bortezomib, daratumamab and lenalidomide. The results of this trial will be compared to those of the Myeloma XI trial (NCT01554852) to identify the best treatment strategies for high risk MM.