Once-Weekly Selinexor Plus Bortezomib and Dexamethasone for Multiple Myeloma
Posted: Wednesday, December 2, 2020
Patients with multiple myeloma may benefit from treatment with a once-per-week regimen of selinexor plus bortezomib and dexamethasone compared with the standard twice-per-week regimen of bortezomib plus dexamethasone, according to an ongoing multicenter study conducted by Sosana Delimpasi, MD, of the General Hospital Evangelismos, Athens, and colleagues. The findings of the phase III BOSTON trial were published in The Lancet.
“The study further confirms that selinexor is a very promising anticancer drug,” commented coauthor Holger W. Auner, MD, of the Imperial College London, United Kingdom, in an institutional press release. “While a number of ongoing studies are investigating how to best use it in different types of cancer, these results pave the way for applications to regulatory bodies to approve and fund the drug combination in multiple myeloma.”
In a 1:1 allocation ratio, a total of 402 patients with multiple myeloma were randomly assigned to receive either an experimental treatment of selinexor plus bortezomib and dexamethasone (49%) or a control treatment of bortezomib plus dexamethasone (51%). Each patient was previously treated with one to three lines of therapy, including proteasome inhibitors.
The median duration of progression-free survival appeared to be significantly longer in the experimental group than in the control group (13.9 vs. 9.5 months, respectively; P = .0075). Thrombocytopenia (experimental group: 39%; control group: 17%), fatigue (13% vs. 1%), anemia (16% vs. 10%), and pneumonia (11% vs. 11%) were among the most frequently reported grade 3 and 4 adverse events. Peripheral neuropathy of grade 2 or higher occurred in 21% of the experimental group and in 34% of the control group (P = .0013). According to the investigators, the death rate was lower in the experimental group (24%) than in the control group (30%).
Disclosure: For full disclosures of the study authors, visit thelancet.com.
