ASH 2021 | Dose reduction of selinexor in combination with bortezomib and dexamethasone in multiple myeloma

Selinexor has been approved in patients with multiple myeloma who have received one to three prior lines of therapy. However, this drug is associated with significant toxicity. In this video, Sundar Jagannath, MD, Tisch Cancer Institute at Mount Sinai, New York, NY, comments on the findings of a study investigating the efficacy outcomes in patients with multiple myeloma from the BOSTON study (NCT03110562) with dose reduction of selinexor in combination with bortezomib and dexamethasone. Among the 195 patients treated with selinexor, bortezomib and dexamethasone, 126 had a dose reduction of selinexor and 69 did not. Results revealed that patients who received a lower dose of selinexor were able to stay on the drug for longer, which resulted in an improved depth of response. Overall response rates (ORR) were 82% in patients who had a dose reduction versus 67% in patients who received the full dose, and median progression-free survival (PFS) was 16.6 months in patients who had a dose reduction versus 9 months in patients who received the full dose. These findings show that reducing the dose of selinexor leads to improved patient outcomes. Dr Jagannath explains that doctors should feel comfortable reducing the dose in patients who experience selinexor-related side effects. This interview took place at the 63rd ASH Annual Meeting and Exposition congress in Atlanta, GA.