Open AccessOverall survival with oral selinexor plus low‐dose dexamethasone versus real‐world therapy in triple‐class‐refractory multiple myeloma
Author(s) -
Richardson Paul G.,
Jagannath Sundar,
Chari Ajai,
Vogl Dan T.,
Dimopoulos Meletios A.,
Moreau Philippe,
Dingli David,
Wei LeeJen,
Richter Joshua,
Biran Noa,
Siegel David,
Reichmann William,
Li Lingling,
Tang Shijie,
SaintMartin JeanRichard,
Joshi Anita,
Kauffman Michael,
Shah Jatin,
Shacham Sharon,
Lonial Sagar
Publication year - 2021
Publication title -
ejhaem
Language(s) - English
Resource type - Journals
ISSN - 2688-6146
DOI - 10.1002/jha2.120
Subject(s) - dexamethasone , refractory (planetary science) , multiple myeloma , class (philosophy) , medicine , oncology , computer science , biology , artificial intelligence , astrobiology
Triple‐class‐refractory multiple myeloma (MM) describes MM refractory to proteasome inhibitors, immunomodulatory agents, and anti‐CD38 monoclonal antibodies. In the Phase IIb STORM study (NCT02336815), oral selinexor plus low‐dose dexamethasone (Sel‐dex) demonstrated a 26.2% overall response rate in triple‐class‐refractory MM. Here, we compare overall survival (OS) of 122 patients with triple‐class‐refractory MM who received Sel‐dex in STORM Part 2 with that of 64 similar patients treated with other available therapies in a Flatiron Health Analytic Database (FHAD) cohort. OS from the date that the patients’ MM became triple‐class‐refractory was longer in STORM versus FHAD, with an unadjusted hazard ratio (HR) of 0.43 ( P = .0002; adjusted HR 0.35 [ P = .011]). In a subset analysis of highly resistant patients receiving further therapies after their MM first became at least triple‐class‐refractory (i.e., who received Sel‐dex in STORM, n = 64, and non‐Sel‐dex in FHAD, n = 36), the OS was significantly longer in STORM with an unadjusted HR of 0.52 ( P = .0331; adjusted HR 0.33 [ P = .041]). Within the limits of this analysis, the OS of patients with at least triple‐class‐refractory MM was significantly better with Sel‐dex versus available therapies, suggesting that Sel‐dex may be associated with a meaningful OS benefit in these patients.