Patrick Daly

Urban Health Today

In a study, published in Clinical Lymphoma, Myeloma &amp; Leukemia, researchers suggested the rising use of anti-CD38 monoclonal antibody therapies in patients with newly diagnosed or early relapsed multiple myeloma (MM)—especially transplant-ineligible patients—may cause resistance to these therapies to develop earlier in the course of treatment.
Lead author Gary Schiller, MD, and colleagues assessed the safety and efficacy of selinexor-based triplet therapies in participants with relapsed or refractory MM from the <a href="https://clinicaltrials.gov/study/NCT02343042" target="_blank" rel="noopener">STOMP</a> and <a href="https://clinicaltrials.gov/study/NCT03110562" target="_blank" rel="noopener">BOSTON</a> studies who were previously treated with anti-CD38 monoclonal antibodies. They reported that selinexor-based triplet therapies appeared to be effective and well-tolerated among this population.
<h3>Selinexor Regimens May Solve Resistance to Anti-CD38 Therapy</h3>
The trial enrolled 62 patients who had a median of 4 prior lines of therapy (range, 1-11 lines). Of those patients, 90.3% were refractory to anti-CD38. The regimens consisted of selinexor with dexamethasone plus pomalidomide (SPd; n=23), bortezomib (SVd; n=16), or carfilzomib (SKd; n=23).
According to the report, the overall response rates (ORRs) were 52.2% for the SPd cohort, 56.3% for the SVd cohort, and 65.2% for the SKd cohort. Additionally, the ORR was 47.4% among patients who were previously refractory to the third agent in their selinexor triplet before being reintroduced.
The median overall survival was 9.6, 16.9, and 33.0 months and the median progression-free survival was 8.7, 6.7, and 15.0 months in the SPd, SVd, and SKd groups, respectively. The median time to discontinuation was 4.4 months for SPd patients, 5.9 months for SVd patients, and 10.6 months for SKd patients.
The most common <a href="https://urbanhealthtoday.com/post/predicting-cardiovascular-adverse-events-in-multiple-myeloma">hematologic adverse events</a> (AEs) were thrombocytopenia, anemia, and neutropenia, and nausea, fatigue, and diarrhea AEs were primarily of grade 1 or 2. Authors noted AEs were generally manageable with standard treatments and dose adjustments.
Overall, Dr. Schiller concluded “these data suggest that selinexor-based triplets may be potentially favorable options for the expanding population of patients with relapsed MM after [anti-CD38 monoclonal antibody] therapy.”
Read More Research on <a href="https://urbanhealthtoday.com/category/multiple-myeloma">Multiple Myeloma</a>

In a study, published in Clinical Lymphoma, Myeloma &amp; Leukemia, researchers suggested the rising use of anti-CD38 monoclonal antibody therapies in patients with newly diagnosed or early relapsed multiple myeloma (MM)—especially transplant-ineligible patients—may cause resistance to these therapies to develop earlier in the course of treatment.Lead author Gary Schiller, MD, and colleagues assessed the safety and efficacy of selinexor-based triplet therapies in participants with relapsed or refractory MM from the <a href="https://clinicaltrials.gov/study/NCT02343042" target="_blank" rel="noopener">STOMP</a> and <a href="https://clinicaltrials.gov/study/NCT03110562" target="_blank" rel="noopener">BOSTON</a> studies who were previously treated with anti-CD38 monoclonal antibodies. They reported that selinexor-based triplet therapies appeared to be effective and well-tolerated among this population.<h3>Selinexor Regimens May Solve Resistance to Anti-CD38 Therapy</h3>The trial enrolled 62 patients who had a median of 4 prior lines of therapy (range, 1-11 lines). Of those patients, 90.3% were refractory to anti-CD38. The regimens consisted of selinexor with dexamethasone plus pomalidomide (SPd; n=23), bortezomib (SVd; n=16), or carfilzomib (SKd; n=23).According to the report, the overall response rates (ORRs) were 52.2% for the SPd cohort, 56.3% for the SVd cohort, and 65.2% for the SKd cohort. Additionally, the ORR was 47.4% among patients who were previously refractory to the third agent in their selinexor triplet before being reintroduced.The median overall survival was 9.6, 16.9, and 33.0 months and the median progression-free survival was 8.7, 6.7, and 15.0 months in the SPd, SVd, and SKd groups, respectively. The median time to discontinuation was 4.4 months for SPd patients, 5.9 months for SVd patients, and 10.6 months for SKd patients.The most common <a href="https://urbanhealthtoday.com/post/predicting-cardiovascular-adverse-events-in-multiple-myeloma">hematologic adverse events</a> (AEs) were thrombocytopenia, anemia, and neutropenia, and nausea, fatigue, and diarrhea AEs were primarily of grade 1 or 2. Authors noted AEs were generally manageable with standard treatments and dose adjustments.Overall, Dr. Schiller concluded “these data suggest that selinexor-based triplets may be potentially favorable options for the expanding population of patients with relapsed MM after [anti-CD38 monoclonal antibody] therapy.”Read More Research on <a href="https://urbanhealthtoday.com/category/multiple-myeloma">Multiple Myeloma</a>

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New Options for MM Resistant to Anti-CD38 Therapies

Multiple Myeloma

Selinexor-based triplet regimens appeared safe and effective in patients with multiple myeloma who were refractory to anti-CD38 monoclonal antibody therapies.