Pim expression in MM correlates with advanced disease, and clinical studies of LGH447 in relapsed/refractory MM are ongoing with data reporting impressive single agent activity.71 Other survival signaling pathways are simultaneously active in advanced disease and combining Pim inhibition with inhibitors of the PI3K/Akt/mTOR pathway in this setting constitutes another application for Pim inhibitors in MM. Here, PIM1 is linked to Miyoshi myopathy.