Novel Therapy Treats Triple-Class Refractory Multiple Myeloma

The combination of selinexor and dexamethasone seems effective in treating patients with multiple myeloma that has not responded to standard therapies, according to a study published in the issue of the New England Journal of Medicine.

Ajai Chari, M.D., of the Tisch Cancer Institute at the Icahn School of Medicine at Mount Sinai in New York City, and colleagues recruited a total of 122 patients for a phase 2b, multicenter, open-label study. The patients had a median of seven previous treatments and were aged a median of 65 years. Fifty-three percent of patients also had high-risk cytogenetic abnormalities. Patients received 80 mg of oral selinexor and 20 mg of dexamethasone twice weekly in four-week cycles.

The researchers found that 26 percent of patients achieved a partial response or better, and two patients achieved complete remission. Thirty-nine percent of patients achieved a minimal response or better. Overall, the median duration of response was 4.4 months, median progression-free survival was 3.7 months, and median overall survival was 8.6 months. Most adverse events were grade 1 or 2, including fatigue and nausea, but 73 percent of patients experienced thrombocytopenia.

"This study is meaningful for patients with multiple myeloma who haven't had success on multiple other therapies," Chari said in a statement. "An increasing number of patients have resistance to the standard drugs used in the treatment of multiple myeloma, and the overall survival in these patients is short, sometimes less than three months."

Several authors disclosed financial ties to pharmaceutical companies, including Karyopharm Therapeutics, which manufactures selinexor and sponsored the study.

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