Treatment philosophies in multiple myeloma (MM) debate the relative merits of achieving the deepest possible remissions ("curative" doctrine) vs sequential delivery of antimyeloma agents ("control" doctrine). In this paper, we highlight the relevant strengths of each doctrine in the context of modern patient selection strategies, fresh biological insights on MM pathogenesis, agents with improved safety profiles, and emerging molecular and imaging tools. Paramount fundamental questions remain unanswered that require an intense research focus as we pursue a cure for this devastating disease.