The management of multiple myeloma, a condition 2-3 times more incident in Black than in White individuals, was revolutionized in the past 15 years by the development of a large number of new agents, longer, more complex and costly therapy. Therefore, multiple myeloma presents as excellent scenario to study disparities in clinical trial participation and outcomes. Although individuals of racial-ethnic minorities are under-represented in clinical trials for new drug registration in multiple myeloma, when enrolled their outcome is the same or even better than in other patient groups. This session will discuss available data on minority participation in myeloma trials, explore possible root causes and provide recommendations to assure representation of minority patients such as prospective enrollment goals and eligibility criteria which permit inclusion of real-world patients. Reforming the new drug development paradigm will allow for assessing both efficacy and toxicity of novel agents in an inclusive, real-world multiple myeloma patient population.