An analysis performed in 14 academic institutions in the U.S. showed that the median OS of patients refractory to anti-CD38 monoclonal antibodies was 8.6 months, while for “penta-refractory” patients (defined as having refractoriness to all the five main myeloma treatments, including lenalidomide, pomalidomide, bortezomib, carfilzomib, and either daratumumab or isatuximab), the median OS was only 5.6 months [50]. This evidence concerns the gene CD38 and plasma cell myeloma.