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. 2025 May 2;32(5):268.
doi: 10.3390/curroncol32050268.

Real-World Treatment Patterns and Survival Outcomes of Patients with Relapsed/Refractory Multiple Myeloma Treated with a Selinexor-Containing Triplet-Based Regimen

Andrew Whiteley  1 , Stephen C Ijioma  2 , David Ray  2 , Spencer S Langerman  3 , Ellen Hu  3 , Amy Pierre  3 , Tomer Mark  2 , Habte Yimer  4
Affiliations

Real-World Treatment Patterns and Survival Outcomes of Patients with Relapsed/Refractory Multiple Myeloma Treated with a Selinexor-Containing Triplet-Based Regimen

Andrew Whiteley et al. Curr Oncol. .

Abstract

Treatment for relapsed/refractory multiple myeloma (RRMM) is complex, with several classes of drugs that can be combined into doublet, triplet, or quadruplet regimens. Real-world studies can help to determine the optimal treatment sequences and dosing through observed usage of drugs outside of clinical trials. Previous clinical trials have demonstrated high rates of durable responses in the treatment of patients with triple-class-exposed RRMM with regimens containing selinexor, a first-in-class, orally available selective exportin 1 inhibitor. This study analyzed real-world treatment patterns and survival outcomes using a nationwide electronic health record-derived, deidentified database of patients with RRMM treated with an eligible selinexor-containing, triplet-based regimen, including combinations with dexamethasone and pomalidomide, bortezomib, carfilzomib, or daratumumab. Patients had a real-world overall survival (rwOS) of 14.7 months (95% CI: 10.6, 20.9) and a derived progression-free survival (dPFS) of 4.7 months (95% CI: 3.4, 6.7). Patients with previous exposure to anti-CD38 monoclonal antibodies (mAbs) in the most recent regimen prior to the selinexor treatment had numerically higher survival outcomes (rwOS, 20.9; dPFS, 8.7 months). These data suggest that, in the real-world setting, the use of selinexor triplet regimens is effective in patients with RRMM, especially those with prior exposure to an anti-CD38 mAb in the immediate prior line of therapy.

Keywords: real-world study; relapsed/refractory multiple myeloma; selinexor.

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Conflict of interest statement

Andrew Whiteley reports consulting for Karyopharm, GSK, and AstraZeneca and participating in a speaker bureau for BeiGene, Pfizer, and GSK. Stephen C. Ijioma was an employee of Karyopharm Therapeutics Inc. at the time of this study. David Ray is an employee of Karyopharm Therapeutics Inc. Spencer S. Langerman reports employment at Flatiron Health and ownership of Roche stock. Ellen Hu reports employment at Flatiron Health and ownership of Roche stock. Amy Pierre reports employment at Flatiron Health and ownership of Roche stock. Tomer Mark is an employee of Karyopharm Therapeutics, Inc. Habte Yimer reports being on the speaker bureau for Abbvie, Genmab, Pfizer, Amgen, Jenssen, Beigene, G1 therapeutics, and Karyopharm.

Figures

Figure 1
Figure 1
Study attrition. 2L, second line of therapy; MM, multiple myeloma.
Figure 2
Figure 2
Distribution of therapies prior to and after index therapy. IMiD, immunomodulatory drug; PI, proteasome inhibitor; XDd, selinexor, daratumumab, and dexamethasone; XKd, selinexor, carfilzomib, and dexamethasone; XPd, selinexor, pomalidomide, and dexamethasone; XVd, selinexor, bortezomib, and dexamethasone.
Figure 3
Figure 3
Survival. (A) Real-world overall survival. (B) Derived progression-free survival. CI, confidence interval; dPFS, derived progression-free survival; rwOS, real-world overall survival.
See this image and copyright information in PMC

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