Sistema de Salut de Catalunya
Institut Català de la Salut
[Mateos MV] Instituto de Investigación Biomédica de Salamanca (IBSAL), Hospital Universitario de Salamanca, Salamanca, Spain. [Engelhardt M] Interdisciplinary Cancer Center, University of Freiburg, Faculty of Freiburg, Freiburg, Germany. [Leleu X] University of Potiers and CHU, Poitiers, France. [Gironella Mesa M] Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Cavo M] IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Haematology, Bologna University School of Medicine, Bologna, Italy. [Dimopoulos M] National and Kapodistrian University of Athens School of Medicine, Athens, Greece
Vall d'Hebron Barcelona Hospital Campus
2024-07-09T10:09:03Z
2024-07-09T10:09:03Z
2024-08
Bortezomib; Multiple myeloma; Proteasome inhibitor
Bortezomib; Mieloma múltiple; Inhibidor del proteasoma
Bortezomib; Mieloma múltiple; Inhibidor del proteasoma
Objectives To analyze the impact of prior therapies on outcomes with selinexor, bortezomib, and dexamethasone (SVd) versus bortezomib and dexamethasone (Vd) in 402 patients with relapsed/refractory multiple myeloma (RRMM) in the phase 3 BOSTON trial. Methods Post hoc analysis of progression-free survival (PFS), overall survival (OS), and safety for lenalidomide-refractory, proteasome inhibitor (PI)-naïve, bortezomib-naïve, and one prior line of therapy (1LOT) patient subgroups. Results At a median follow-up of over 28 months, clinically meaningful improvements in PFS were noted across all groups with SVd. The median SVd PFS was longer in all subgroups (lenalidomide-refractory: 10.2 vs. 7.1 months, PI-naïve: 29.5 vs. 9.7; bortezomib-naïve: 29.5 vs. 9.7; 1LOT: 21.0 vs. 10.7; p < .05). The lenalidomide-refractory subgroup had longer OS with SVd (26.7 vs. 18.6 months; HR 0.53; p = .015). In all subgroups, overall response and ≥very good partial response rates were higher with SVd. The manageable safety profile of SVd was similar to the overall patient population. Conclusions With over 2 years of follow-up, these clinically meaningful outcomes further support the use of SVd in patients who are lenalidomide-refractory, PI-naïve, bortezomib-naïve, or who received 1LOT (including a monoclonal antibody) and underscore the observed synergy between selinexor and bortezomib.
The BOSTON trial was sponsored by Karyopharm Therapeutics. This subgroup analysis was supported by the Menarini Group.
Article
Published version
English
Avaluació de resultats (Assistència sanitària); Quimioteràpia combinada; Mieloma múltiple - Tractament; ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Therapeutics::Therapeutics::Drug Therapy::Antineoplastic Protocols::Therapeutics::Drug Therapy::Antineoplastic Combined Chemotherapy Protocols; DISEASES::Neoplasms::Neoplasms by Histologic Type::Neoplasms, Plasma Cell::Multiple Myeloma; Other subheadings::Other subheadings::Other subheadings::/drug therapy; ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Diagnosis::Prognosis::Treatment Outcome; TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::terapéutica::terapéutica::farmacoterapia::protocolos antineoplásicos::terapéutica::farmacoterapia::protocolos de quimioterapia antineoplásica combinada; ENFERMEDADES::neoplasias::neoplasias por tipo histológico::neoplasias de células plasmáticas::mieloma múltiple; Otros calificadores::Otros calificadores::Otros calificadores::/farmacoterapia; TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::diagnóstico::pronóstico::resultado del tratamiento
Wiley
European Journal of Haematology;113(2)
https://doi.org/10.1111/ejh.14223
Attribution-NonCommercial 4.0 International
http://creativecommons.org/licenses/by-nc/4.0/
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