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Repression of Multiple Myeloma Cell Growth In Vivo by Single-wall Carbon Nanotube SWCNT-delivered MALAT1 Antisense Oligos
Published on: December 13, 2018
Selinexor for the treatment of patients with relapsed or refractory multiple myeloma
Anum Babar1, Maham Babar2, Hina Zubair3
1Khyber Girls Medical College, Peshawar, Pakistan.
Objective:
Multiple myeloma cells resist standard therapies due to overexpression of the transport protein, exportin 1. Selinexor is a novel drug that targets the Exportin 1 protein in these cells.
Data Source:
A comprehensive search was done, and data showing the efficacy and safety of selinexor in relapsed/refractory multiple myeloma was collected using PubMed, Google Scholar, and clincialtrials.gov.
Data Summary:
Results from the clinical trials STORM, BOSTON, and STOMP were included. Parts I and II of the STORM trial revealed a progression-free survival (PFS) of 4.7 and 3.7 months, a median duration of response of 6.2 and 4.4 months, and an overall survival of 7.3 and 8.4 months, respectively. BOSTON trial's SVd arm (selinexor, bortezomib, and dexamethasone) had a median follow-up period of 13.2 months and an mPFS of 13.93 months. The Vd arm (bortezomib and dexamethasone) had a median follow-up duration of 16.5 months and an mPFS of 9.46 months. The STOMP trial is still active and has limited data available. The SKd arm (selinexor, carfilzomib, and dexamethasone) reported an overall response rate of 66.7% in patients with triple refractory multiple myeloma, and 82% in patients with high-risk cytogenetics. The SPd arm (selinexor, pomalidomide, and dexamethasone) shows an overall response rate of 54.30% in pomalidomide naïve-nonrefractory, 35.70% in pomalidomide refractory and 60% in those dosed at RP2D. SRd arm (selinexor, lenalidomide, and dexamethasone) shows an overall response rate of 91.7% in lenalidomide naïve and 12.5% in lenalidomide refractory patients. SVd (selinexor, bortezomib, and dexamethasone) arm reported an overall response rate of 63% in all patients while the SDd arm (selinexor, daratumumab, and dexamethasone) showed an overall response rate of 73%.
Conclusion:
To improve the outcome of patients with relapsed/refractory multiple myeloma, it is critical to develop new therapies, assess potential therapeutic synergies, and overcome drug resistance by determining the efficacy of multiple myeloma therapies across multiple disease subgroups.
Insights
Selinexor shows promise in treating relapsed/refractory multiple myeloma by targeting exportin 1. Clinical trials demonstrate its efficacy in improving progression-free survival and overall response rates when combined with other therapies.
Area of Science:
- Hematology
- Oncology
- Pharmacology
Background:
- Multiple myeloma cells exhibit resistance to conventional treatments due to elevated exportin 1 levels.
- Selinexor is a novel therapeutic agent designed to inhibit exportin 1 activity in multiple myeloma cells.
Purpose of the Study:
- To evaluate the efficacy and safety of selinexor in patients with relapsed/refractory multiple myeloma.
- To assess the therapeutic potential of selinexor in combination regimens for multiple myeloma.
Main Methods:
- A systematic literature review was conducted using PubMed, Google Scholar, and ClinicalTrials.gov.
- Data from clinical trials including STORM, BOSTON, and STOMP were analyzed for efficacy and safety outcomes.
Main Results:
- The STORM trial indicated progression-free survival (PFS) of 4.7 months (Part I) and 3.7 months (Part II).
- The BOSTON trial's selinexor, bortezomib, and dexamethasone (SVd) arm showed a median PFS of 13.93 months compared to 9.46 months for bortezomib and dexamethasone (Vd).
- Combination therapies including selinexor demonstrated overall response rates ranging from 54.3% to 91.7% across different patient subgroups.
Conclusions:
- Selinexor demonstrates significant potential in improving outcomes for patients with relapsed/refractory multiple myeloma.
- Further research into therapeutic synergies and overcoming drug resistance is crucial for optimizing selinexor-based treatments.
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