In our first MCRI episode featuring the top 10 proposals for high-risk multiple myeloma, Dr. Craig Hofmeister shares his work to use the hot-topic CAR T cell approach to target a common myeloma protein, CS1. He describes that the discovery of elotuzumab helped determine that CS1 was an effective target. For this approach, CAR T cells are withdrawn from the patient, re-engineered to target the CS1 protein and then are placed back into the patient's system. Once inside, the CAR T cells replicate, target the cells that express that CS1 protein and essentially blow themselves up. He notes that CS1 was a target that was found on myeloma cells but not on many other cells in the body, making it an attractive target. It is a one-time therapy that is appropriate not only for patients with high-risk myeloma but all types of myeloma regardless of genetic features. In time, it could also be used as a preventative approach for smoldering patients. He addresses the promise of this up and coming approach and also addresses the potential safety issues of this type of therapy. This approach is not far from in-human clinical trials.