ASH 2019: Addition of Selinexor to Treatment Regimen for Resistant Myeloma
Posted: Monday, December 16, 2019
The oral combination of dexamethasone, pomalidomide, and the selective inhibitor of nuclear export selinexor was reported to provide a durable and active response, extending the progression-free survival observed with pomalidomide and dexamethasone alone in patients with relapsed or refractory multiple myeloma. These study findings were presented at the 2019 American Society of Hematology (ASH) Annual Meeting & Exposition in Orlando, Florida, by Christine I. Chen, MD, of the Princess Margaret Cancer Centre in Toronto (Abstract 141).
The STOMP trial is a multicenter, open-label, phase I/IIb study that enrolled 48 patients with relapsed or refractory multiple myeloma. Patients were given oral selinexor in two different dosing schedules, either once weekly or twice weekly, along with escalating doses of pomalidomide and low-dose dexamethasone. The median age of patients enrolled was 64 years, and patients had received a median of four prior treatments.
Of the 44 patients evaluable for response, 27 patients were lenalidomide-refractory/pomalidomide-naive, 4 patients were lenalidomide-treated/pomalidomide-naive, 13 patients were refractory to pomalidomide and lenalidomide, and 19 patients were refractory to lenalidomide and bortezomib. Among the 31 patients who were pomalidomide-naive, the overall response rate was 58%, with 7 very good partial responses and 11 partial responses. The median progression-free survival for this group was 12.2 months. Patients who were refractory to lenalidomide and pomalidomide saw an overall response rate of 31%, with a median progression-free survival of 4.2 months.
A total of eight dose-limiting toxicities were observed across all cohorts of patients. Common grade 3 or higher treatment-related adverse events included neutropenia (54% of patients), thrombocytopenia (33%), anemia (29%), leukopenia (15%), fatigue (10%), and vomiting (2%). There were lower rates of grade 3 thrombocytopenia and anemia observed with the once-weekly dosing than the twice-weekly dosing.
Disclosure: For full disclosures of the study authors, visit ash.confex.com.
