Dr. Stadtmauer on Utility of Selinexor in Multiple Myeloma

Edward A. Stadtmauer, MD, section chief, Hematologic Malignancies, Abramson Cancer Center, University of Pennsylvania, discusses the use of selinexor (Xpovio) in patients with heavily pretreated, relapsed/refractory multiple myeloma.

The agent was approved based on data from the phase II STORM trial which showed an objective response rate of 25.3% in 83 patients. According to Stadtmauer, selinexor has a novel mechanism of action that attributes to its marked activity.

However, the drug does have toxicities. In parts 1 and 2 of the trial, the most common adverse events (≥20%) were thrombocytopenia, fatigue, nausea, anemia, decreased appetite, decreased weight, diarrhea, vomiting, hyponatremia, neutropenia, leukopenia, constipation, dyspnea, and upper respiratory tract infection.

The benefit of selinexor should not be overshadowed by its side effects, Stadtmauer says. However, with proper management strategies, these side effects can be treated appropriately.

Pending future study, selinexor is likely to be used in lower doses in combination rather than in higher doses as a single agent, says Stadtmauer.