Florida Cancer Specialists & Research Institute Best Practices Program Improves Treatment Response and Survival for Patients with Multiple Myeloma

Lucio N. Gordan, MD

A best practices program developed at Florida Cancer Specialists & Research Institute (FCS) has been shown to improve outcomes for adult patients prescribed selinexor for the treatment of relapsed/refractory multiple myeloma (RRMM).

Results obtained from a one-year retrospective observational study using data collected by FCS’ Real-World Evidence team were recently published in Current Oncology. Co-authors of the study, “Impact of a Best Practices Program in Patients with Relapsed/Refractory Multiple Myeloma Receiving Selinexor,” include medical oncologists and hematologists FCS President & Managing Physician Lucio N. Gordan, MD, FCS Manager, Real-World Evidence Amanda Warner, MS, BSN, RN, OCN, CAPM, FCS Senior Vice President & Data Officer Trevor Heritage, PhD, Matthew Fink, MD, FCS Assistant Managing Physician David Wenk, MD, Shachar Peles, MD, FCS Chief Value & Procurement Officer Paul Chadwick, FCS Director of Pharmacy Clinical Services, and Rx To Go Natasha Khrystolubova, RPH, BPharm, BCOP.

Lucio N. Gordan, MD said, “At FCS, we embrace a multifaceted approach to cancer care that engages all members of the clinical and supportive care team in partnership with the patient. He added, “Our findings, as detailed in this article, support the hypothesis that a best practices program designed around specific anticancer drugs can optimize prescribing practices, leading to better disease control and improvements in a patient’s cancer care journey.”

Despite the emergence of several new therapies approved in recent years for the treatment of RRMM, most patients will relapse due to resistant tumor cells that remain in the body. Selinexor is an oral selective nuclear export inhibitor, a class of medications that suppress tumor growth, and sometimes used in combination with other medications and therapies.

The goal of the FCS program was to optimize treatment response and survival utilizing a comprehensive, proactive approach that involved educating providers on Selinexor dosing guidelines and toxicity management, keeping patients adherent and compliant with their therapy and proactively addressing adverse reactions.

An assessment of electronic medical records conducted at the conclusion of the best practice (BP) period encompassed 41 patients who received selinexor-based therapy compared to 68 patients who received selinexor-based therapy pre-BP implementation. The authors concluded, “The implementation of a BP program tailored to selinexor where patients received lower starting doses than those approved by the FDA and in combination with standardized antiemetic therapy reduced the likelihood of treatment failure, increased treatment duration and lowered the incidence of DLTs (dose limiting toxicities).”

Multiple myeloma affects white blood cells in the bone marrow. Cancerous tumors can weaken the body’s immune system, damage bones and lead to end-organ damage. MM is the second most common hematologic malignancy in the U.S. Two thirds of newly diagnosed patients are 65 years or older. There is no cure; the median age at death is 75 years.

Access the study in Current Oncology.

The FCS Real-World Evidence Team works with internal and external partners providing insights to improve treatment decisions and clinical outcomes based on evidence generated using real-world data.