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. 2025 May 15;25(1):878.
doi: 10.1186/s12885-025-14295-6.

Efficacy and safety of selinexor-based regimens as first-line treatments for elderly patients with diffuse large B-cell lymphoma: a real-world study

Jing Li #  1 , Jingjing Ge #  2 , Tingting Chen #  2 , Jianghua Cao  2 , Xiaohua He  3 , Shulan Wang  2 , Hang Yang  2 , Yu Wang  2 , Peng Sun  2 , Jiajia Huang  2 , Shan Liu  4 , Zhiming Li  5
Affiliations

Efficacy and safety of selinexor-based regimens as first-line treatments for elderly patients with diffuse large B-cell lymphoma: a real-world study

Jing Li et al. BMC Cancer. .

Abstract

Purpose: This study aimed to evaluate the efficacy and safety of selinexor-based regimens as first-line treatments for elderly patients with diffuse large B-cell lymphoma (DLBCL).

Methods: A retrospective analysis of 16 elderly patients with DLBCL who received selinexor-based regimens as first-line treatments at Sun Yat-sen University Cancer Center from November 2021 to September 2023 was conducted. The primary endpoint was the objective response rate (ORR), while the secondary endpoints included progression-free survival (PFS), duration of response (DOR), and safety.

Results: Among the 16 elderly patients, 7 were male (43.8%), and 9 were female (56.2%). The median age was 70.5 years (range, 60-80). The ORR was 93.8%, and 13 patients (81.3%) achieved a complete response (CR), 2 patients (12.5%) achieved a partial response (PR) and 1 patient had progressive disease (PD). It is noteworthy that all 5 patients who received chemotherapy-free regimens achieved CR. The median follow-up was 8.5 months (range, 2.7-22.9). The median PFS was not reached, and the 1-year PFS rate was 79.6%. A total of 81.3% of the patients maintained a response for at least 6 months, and 25% maintained a response for at least 12 months. All 3 patients aged ≥ 75 years achieved CR (100%). Haematologic AEs, including leukopenia (n = 15, 93.8%), neutropenia (n = 13, 81.3%), anaemia (n = 8, 50.0%) and thrombocytopenia (n = 4, 25.0%), were common. The most common nonhaematologic AEs were nausea and vomiting (n = 6, 37.5%), fatigue (n = 5, 31.3%) and decreased appetite (n = 5, 31.3%), most of which were limited in severity to grades 1 or 2 and improved with standard supportive care.

Conclusions: In the real world, selinexor-based regimens demonstrate good efficacy and controllable safety as first-line treatments for elderly patients with DLBCL.

Keywords: Diffuse large B-cell lymphoma; Efficacy; Elderly patients; Safety; Selinexor.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The study involving human participants was reviewed and approved by the ethics committee of the Sun Yat-sen University Cancer Center (B2023-633–01). This study’s protocol complied with the Declaration of Helsinki. The patients provided written informed consent to participate in this study. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Swimmers plot illustrating a summary of clinical courses for the 16 patients
Fig. 2
Fig. 2
PFS for the 16 patients
See this image and copyright information in PMC

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