Despite therapeutic advances including the introduction of ImmunoModulatory Drugs (IMiDs), proteasome inhibitors (PIs), monoclonal antibodies and most recently selinexor, a Selective Inhibitor of Nuclear Export (SINE) that binds and inactivates exportin-1 (XPO1) [13], the B Cell Maturation Antigen (BCMA) targeting antibody-drug-conjugate (ADC) belantamab-mafodotin [14], and BCMA-directed CAR-T cells [9], the management of MM remains challenging, mainly due to the development of drug resistance. This evidence concerns the gene XPO1 and Miyoshi myopathy.