Sundar Jagannath, MBBS
Selinexor (KPT-330), a novel drug that targets a tumor-suppressor “cargo” protein mechanism, is being investigated in patients with relapsed/refractory multiple myeloma (MM) who have received 1 to 3 prior treatment regimens. The BOSTON trial, which is currently enrolling participants, is seeking to assess the safety of selinexor in combination with standard-of-care treatment including a proteasome inhibitor and a glucocorticoid.
The small molecule is being administered in combination with bortezomib (Velcade) and dexamethasone in the phase III BOSTON trial (NCT03110562). Eligible patients will have documented evidence of relapsed/refractory MM after at least 1 treatment regimen but no more than 3 prior regimens, which may include bortezomib or another proteasome inhibitor. Participants must also have no central nervous system involvement.
The multicenter international trial will randomize an estimated 350 adult participants to receive either the 3 drugs in combination or bortezomib and dexamethasone alone (Figure). The primary endpoints are progression-free survival and overall response rate (ORR). Notably, patients who have progressive disease while on bortezomib and dexamethasone will have the option to cross over to the experimental arm to be treated with selinexor.
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