Dr. Martin on Selinexor in Triple-Class Refractory Multiple Myeloma

Thomas G. Martin, MD, clinical professor of medicine, Adult Leukemia and Bone Marrow Transplantation Program, associate director, Myeloma Program, University of California, San Francisco, and co-leader, Hematopoietic Malignancies Program, Helen Diller Family Comprehensive Cancer Center, discusses the use of selinexor (Xpovio) in patients with triple-class refractory multiple myeloma.

Patients with multiple myeloma who are triple refractory to immunomodulatory drugs, proteasome inhibitors, and CD38-targeted monoclonal antibodies typically have an overall survival of <1 year, leaving a significant unmet need in this patient population, explains Martin. Not many therapeutics are approved for use currently, but the selective inhibitor of nuclear export (SINE) selinexor is approved for use in this patient population in combination with dexamethasone.

SINE blocks the XPO1 protein and turns the cancer cell into a normal cell so it can undergo apoptosis when given in combination with other medications, such as dexamethasone. The combination of selinexor and dexamethasone had an overall response rate (ORR) of 26% in this triple-class refractory patient population. No other combination of agents, aside from chemotherapy, elicits that type of an ORR, concludes Martin.