Selinexor Plus Dexamethasone Induces Response in Severely Refractory Multiple Myeloma

Selinexor plus dexamethasone resulted in objective treatment responses in patients with triple-refractory multiple myeloma (MM), according to a study published in The New England Journal of Medicine.

The open-label, phase IIb STORM study included 122 (median age, 65 years) U.S. and European patients. Patients had previously received bortezomib, carfilzomib, lenalidomide, pomalidomide, daratumumab, and an alkylating agent and their disease was refractory to at least one proteasome inhibitor, one immunomodulatory agent, and daratumumab (triple-class refractory). The median number of previous regimens was seven.  Patients receivedselinexor 80 mg plus dexamethasone 20 mg twice weekly.

Responses observed with combination therapy

A quarter of patients (26%) achieved a partial response or better (95% CI, 19-35), including two stringent complete responses. Another 39% of patients had a minimal response or better.

The median duration of response was 4.4 months. The median progression-free survival was 3.7 months, and the median overall survival was 8.6 months.

The most common adverse events were fatigue, nausea, and decreased appetite. Many patients (73%) experienced thrombocytopenia, which led to grade ≥3 bleeding events in six patients.