Dr. Kumar on Sequencing Selinexor-Based Combinations in Multiple Myeloma

Shaji K. Kumar, MD, a consultant in the Division of Hematology and a professor of medicine with Mayo Clinic, discusses sequencing selinexor (Xpovio)-based combinations in relapsed/refractory multiple myeloma.

Patients with multiple myeloma will likely experience multiple relapses within the course of their disease, explains Kumar. As such, novel therapies are needed to ensure options are available to patients who relapse.

Recently, therapies such as selinexor have been added to the armamentarium of triple-class refractory myeloma. Moreover, selinexor, an oral XPO1 inhibitor, plus dexamethasone has demonstrated efficacy in combination regimens with daratumumab (Darzalex), carfilzomib (Kyprolis), pomalidomide (Pomalyst), and bortezomib (Velcade), Kumar says. Notably, although selinexor-based regimens can be considered for patients after first relapse, longer-term follow-up data and durable responses have been observed with monoclonal antibodies and immunomodulatory agents (IMiDs). As such, selinexor-based regimens are more likely to be reserved for later lines of therapy after patients have been exposed to IMiDs, proteasome inhibitors, and monoclonal antibodies, concludes Kumar.