This Editor’s Special Episode of The HemOnc Pulse features Paul G. Richardson, MD, of Dana-Farber Cancer Institute, discussing treatment strategies for relapsed/refractory multiple myeloma and where selinexor-based regimens fit in today’s evolving landscape. Drawing from real-world cases, Dr. Richardson explores care for patients before CAR T, after CAR T relapse, and in between—highlighting how selinexor can be used flexibly across multiple lines, including as a bridge to future immunotherapies. The conversation emphasizes individualized, dynamic treatment planning to balance disease control, tolerability, and long-term goals in an increasingly complex era of myeloma care.