Dr. Waxman on Selinexor in Multiple Myeloma Treatment

Adam J. Waxman, MD, MS, assistant professor of clinical medicine, Penn Medicine, University of Pennsylvania, discusses the STORM trial and using selinexor (Xpovio) to treat patients with multiple myeloma.

The phase IIb STORM trial treated patients with a combination of selinexor and dexamethasone who had been exposed to and were refractory several of the approved drugs for myeloma, explains Waxman. In July 2019, the FDA approved selinexor combined with dexamethasone in relapsed/refractory myeloma who have received ≥4 prior therapies and whose disease is refractory to ≥2 proteasome inhibitors, ≥2 immunomodulatory agents, and a CD38-targeted monoclonal antibody. About one-fourth of patients will respond to the combination and about half of those patients will have durable responses, according to Waxman.

Although the survival outcomes were promising, 18% of discontinued treatment due to adverse events. The challenge now is to address the toxicities associated with selinexor, concludes Waxman.