The panel discuss how the results of recent clinical trials have advanced our understanding of the optimal treatment for multiple myeloma. The development of new combinations containing drugs such as thalidomide, bortezomib and lenalidomide is helping clinicians achieve complete remission and reduce treatment related mortality in both young and elderly patients.A number of trials have been presented at ASH 2010 which demonstrate ways of reducing treatment toxicity profile without affecting efficacy. The panel consider if the effectiveness of new treatment programmes eliminate the need for tandem autologous stem cell transplants, discuss the options that are available for post-transplant maintenance therapy and outline the different parameters that should be considered when deciding between second line therapies.