Efficacy and safety of selinexor-pomalidomide-dexamethasone in patients with released/refractory multiple myeloma

Dr Muhamed Baljevic is a haematologist at the Vanderbilt University Medical Center, in Nashville, Tennessee (USA). During ASH 2024 he presented data from a phase 1b/2 study evaluating the combination of pomalidomide-dexamethasone (Pd) with different doses of selinexor (S) in patients with relapsed/refractory multiple myeloma (RRMM). In this trial, the all-oral SPd regimen showed promising signs of efficacy and was generally well-tolerated in RRMM patients who previously received multiple treatment lines, including an anti-CD38 antibody. While the 60mg qw dose of selinexor was associated with a higher response rate than the 40mg qw dose, the median progression-free survival (PFS) proved to be longer among patients who received the 40mg qw dose. The latter can be explained by the fact that the 40mg dose came with a lower rate of adverse events, resulting in a longer treatment exposure and a higher relative dose intensity. As such, this study provides valuable information for future studies with selinexor-based regimens in RRMM.