Selinexor Plus Low-Dose Dexamethasone for Refractory Multiple Myeloma
Posted: Monday, August 5, 2019
Patients with triple-class refractory multiple myeloma—to immunomodulatory agents, proteasome inhibitors, and anti-CD38 monoclonal antibodies—who received oral selinexor plus low-dose dexamethasone experienced improved overall survival compared with those who did not receive the treatment. Paul D. Richardson, MD, of the Dana-Farber Cancer Institute in Boston, and colleagues presented their findings at the 2019 American Society of Clinical Oncology (ASCO) Annual Meeting in Chicago and published them in the Journal of Clinical Oncology.
Researchers analyzed data from the phase IIb STORM study as well as a retrospective cohort from the national representative Flatiron Health Analytic Database (FHAD). Patients in the STORM study represented those treated with oral selinexor plus low-dose dexamethasone, whereas patients in the FHAD represented those not treated with this combination therapy. All patients included in analysis had triple-class refractory multiple myeloma and had been exposed to bortezomib, carfilzomib, lenalidomide, pomalidomide, and daratumumab. There were 69 patients identified from the FHAD and 122 patients in STORM. Patients in the STORM population were more heavily pretreated, had a higher frequency of high-risk disease, and had higher baseline hemoglobin and platelet levels than those in FHAD.
From the patients in the STORM study, 64 of 122 had received oral selinexor plus low-dose dexamethasone as the first therapy after their disease had become triple class–refractory. These patients had an overall response rate of 32.8%. A total of 37 of 69 patients from FHAD received more than 1 therapy after their multiple myeloma became refractory. For patients receiving oral selinexor plus low-dose dexamethasone therapy, the median overall survival was 10.4 months, compared with 5.2 months for those not receiving the combination therapy (STORM vs. FHAD).
Disclosure: The study authors’ disclosure information can be found at ascopubs.org.