**4. Conclusions**

Liquid biopsy analysis can provide a dynamic and comprehensive picture of the genomic landscape in MM. Specifically, serial analysis can provide a non-invasive approach to monitor tumour burden and genomic evolution that also incorporates characterisation of the spatial and temporal genomic heterogeneity, which predominates over time, in this multi-focal disease. Accumulating published evidence and imminent developments in the field indicate that this type of analysis will provide critical information for precision medicine and likely transform the management of more problematic sub-groups of MM including NS, OS patients and those with EM disease. In the future, instead of utilising extensive imaging and invasive and potentially misrepresentative BM biopsies, liquid biopsies could be used to inform real-time clinical decision thus further improving the outcome for MM patients.
