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In comparison to the contemporary approach to multiple myeloma, personalized treatment has the potential to guide more efficient drug selection and disease targeting. Although three drug regimens have repeatedly proven superior in this disease, older adults often receive two drugs to minimize treatment-related toxicities. Consequently, older adults are at risk to receive less effective treatment, contributing to their currently inferior outcomes. Here, we discuss Myeloma Drug Sensitivity Testing (My-DST) as an approach to personalized treatment for Multiple Myeloma by distinguishing relative drug sensitivity (S) versus resistance (R) to the commonly used drugs for this malignancy. Through personalized therapy to optimize the ratio of effective drugs, older persons stand to derive the most benefit if we can minimize poor responses and side effects, simultaneously improving survival and quality of life (QOL) outcomes.