Maria-Victoria Mateos, MD, PhD, University of Salamanca, Salamanca, Spain, discusses the effect of refractory status to lenalidomide on the safety and efficacy of selinexor, bortezomib and dexamethasone (XVd) versus bortezomib and dexamethasone (Vd) in patients with previously treated multiple myeloma. Post-hoc analyses of the Phase III BOSTON trial (NCT03110562) indicated that progression-free survival (PFS), overall response rate (ORR) and time to next treatment (TTNT) were significantly improved with the addition of selinexor, regardless of documented refractory status to any immunomodulatory drug (IMiD). These findings are consistent with those from previous trials. This interview took place at the virtual European Hematology Association (EHA) Congress 2021.