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SOHO 2024 | The evolving use of selinexor in multiple myeloma
Meletios Dimopoulos, MD, National and Kapodistrian University of Athens School of Medicine, Athens, Greece, discusses the use of selinexor in the treatment of multiple myeloma, highlighting its initial challenges with gastrointestinal toxicity. However, recent use of selinexor at lower doses in combination with bortezomib and dexamethasone (SVd) has shown to be both effective and relatively well-tolerated, and could be used for patients with limited access to other treatments. This interview took place at the Twelfth Annual Meeting of the Society of Hematologic Oncology (SOHO 2024) congress in Houston, TX.
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Transcript
Selinexor is an interesting drug with a different mechanism of action. At the initial evaluation of the drug, where it was given as monotherapy with low dose dexamethasone, the high doses given on two consecutive days were associated with excessive gastrointestinal toxicity, asthenia, loss of appetite and essentially this precluded many patients for getting the drug. However, more recently selinexor is being used at lower doses, starting maybe at 40mg weekly in combination with bortezomib in the context of SVd regimen...
Selinexor is an interesting drug with a different mechanism of action. At the initial evaluation of the drug, where it was given as monotherapy with low dose dexamethasone, the high doses given on two consecutive days were associated with excessive gastrointestinal toxicity, asthenia, loss of appetite and essentially this precluded many patients for getting the drug. However, more recently selinexor is being used at lower doses, starting maybe at 40mg weekly in combination with bortezomib in the context of SVd regimen. And this SVd combination is an active and relatively well tolerated combination that could be used for patients who are being treated previously with lenalidomide, even with anti-CD38 monoclonal antibodies, and when access to clinical trials or to other drugs is limited.
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