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在波马利多米德和甲组合疗法中降低塞利尼克索剂量会引起较少的副作用,同时对复发性/逆转性多发性髓瘤具有相似的有效性

Liying Peng¹, Tiantian Shan¹, Xinyi Zhou¹

¹Department of Hematology, Myeloma and Lymphoma Center, Shanghai Changzheng Hospital, Shanghai, 200003, People's Republic of China.

OncoTargets and therapy

|June 11, 2025

概括

与利多米德和甲相结合的较低剂量 (40毫克) 的塞利尼克索与较高剂量 (60毫克) 相比,在复发性/耐药性多发性骨髓瘤 (RRMM) 患者中显示出相似的疗效和更好的耐受性. 这表明RRMM的临床适用性更高的治疗选择.

科学领域:

在瘤学瘤学.
血液学血液学血液学
临床药理学临床药理学

背景情况:

作为口服Exportin 1 (XPO1) 抑制剂的Selinexor在复发性/耐药性多发性骨髓瘤 (RRMM) 中表现出有效性,但较高剂量 (80-100 mg) 的耐受性较差.
优化塞利尼克索尔剂量对于改善RRMM治疗结果至关重要.

研究的目的:

在RRMM患者中,评估两种不同剂量的selinexor (60mg与40mg相比) 与利多米德和德克萨米他联合使用时的疗效和安全性.
为了确定最佳的塞利尼克索尔剂量,在RRMM治疗中平衡疗效和耐受性.

主要方法:

一项涉及21名RRMM患者的临床研究,这些患者接受了塞利尼克索 (60毫克或每周40毫克) 加上波马利多米德和德克萨米的治疗.
患者被分为SPD-60 (n=6) 和SPD-40 (n=15) 组,对客观反应率 (ORR),无进展生存率 (PFS),总生存率 (OS) 和不良事件进行了评估.

主要成果:

在SPD-60的ORR为33.3%,在SPD-40的ORR为46.7% (P=0.773).
SPD-60的PFS中位数为4.3个月,SPD-40的PFS中位数为8.0个月 (P=0.618). 一年后的OS率为SPD-60的66.7%,为SPD-40的85.1% (P=0.308).
与SPD-60组 (83.3%) 相比,SPD-40组 (40%) 的疲劳和恶心明显较少.

结论:

在RRMM患者中,塞林克索尔40毫克疗程 (SPD-40) 的疗效与60毫克疗程 (SPD-60) 的疗效相当.
SPD-40疗法表现出更有利的安全性,副作用较少,这表明它是一种更具临床适用性的治疗选择.

关键词:

德克萨米他是一种利多化的使用方法复发性/耐药性多发性髓瘤这就是Selinexor.

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