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Effect of age and frailty on the efficacy and tolerability of once-weekly selinexor, bortezomib, and dexamethasone in previously treated multiple myeloma

HW. Auner, M. Gavriatopoulou, S. Delimpasi, M. Simonova, I. Spicka, L. Pour, MA. Dimopoulos, I. Kriachok, H. Pylypenko, X. Leleu, V. Doronin, G. Usenko, R. Hajek, R. Benjamin, TK. Dolai, DK. Sinha, CP. Venner, M. Garg, DA. Stevens, H. Quach, S....

. 2021 ; 96 (6) : 708-718. [pub] 20210503

Jazyk angličtina Země Spojené státy americké

Typ dokumentu srovnávací studie, časopisecké články

Perzistentní odkaz   https://www.medvik.cz/link/bmc21018478

Elderly and frail patients with multiple myeloma (MM) are more vulnerable to the toxicity of combination therapies, often resulting in treatment modifications and suboptimal outcomes. The phase 3 BOSTON study showed that once-weekly selinexor and bortezomib with low-dose dexamethasone (XVd) improved PFS and ORR compared with standard twice-weekly bortezomib and moderate-dose dexamethasone (Vd) in patients with previously treated MM. This is a retrospective subgroup analysis of the multicenter, prospective, randomized BOSTON trial. Post hoc analyses were performed to compare XVd versus Vd safety and efficacy according to age and frailty status (<65 and ≥65 years, nonfrail and frail). Patients ≥65 years with XVd had higher ORR (OR 1.77, p = .024), ≥VGPR (OR, 1.68, p = .027), PFS (HR 0.55, p = .002), and improved OS (HR 0.63, p = .030), compared with Vd. In frail patients, XVd was associated with a trend towards better PFS (HR 0.69, p = .08) and OS (HR 0.62, p = .062). Significant improvements were also observed in patients <65 (ORR and TTNT) and nonfrail patients (PFS, ORR, ≥VGPR, and TTNT). Patients treated with XVd had a lower incidence of grade ≥ 2 peripheral neuropathy in ≥65 year-old (22% vs. 37%; p = .0060) and frail patients (15% vs. 44%; p = .0002). Grade ≥3 TEAEs were not observed more often in older compared to younger patients, nor in frail compared to nonfrail patients. XVd is safe and effective in patients <65 and ≥65 and in nonfrail and frail patients with previously treated MM.

Alexandra Hospital School of Medicine National and Kapodistrian University of Athens Athens Greece

Baylor University Medical Center Dallas Texas USA

Charles University and General Hospital Prague Czech Republic

CHU Lille Service des Maladies du Sang F 59000 Lille France

City Clinical Hospital 40 Moscow Russian Federation

City Clinical Hospital No 4 of Dnipro City Council Dnipro Ukraine

Cross Cancer Institute University of Alberta Edmonton Alberta Canada

Dana Farber Cancer Institute Boston Massachusetts USA

Department of Hemato oncology University Hospital Ostrava University of Ostrava Ostrava Czech Republic

Department of Hematology Cherkassy Regional Oncological Center Cherkassy Ukraine

Department of Hematology CHU la Miletrie and Inserm CIC 1402 Poitiers France

General Hospital Evangelismos Athens Greece

Hospital Universitario de Salamanca Salamanca Spain

Institute of Blood Pathology and Transfusion Medicine of National Academy of Medical Sciences of Ukraine Lviv Ukraine

Karyopharm Therapeutics Inc Newton Massachusetts USA

Kings College Hospital NHS Foundation Trust London UK

Medical University of Silesia Katowice Poland

National and Kapodistrian University of Athens School of Medicine Athens Greece

National Cancer Institute Ukraine Kiev Ukraine

Nil Ratan Sircar Medical College and Hospital Kolkata India

Norton Cancer Institute Louisville Kentucky USA

Seràgnoli Institute of Hematology Bologna University School of Medicine Bologna Italy

Simmons Comprehensive Cancer Center UT Southwestern Medical Center Dallas Texas USA

State Cancer Institute Indira Gandhi Institute of Medical Sciences Patna India

The Hugh and Josseline Langmuir Centre for Myeloma Research Imperial College London London UK

Tisch Cancer Institute Icahn School of Medicine at Mount Sinai New York New York USA

University Hospital Brno Brno Czech Republic

University Hospital Hotel Dieu Nantes France

University Hospitals of Leicester NHS Trust Leicester UK

University of Calgary Charbonneau Cancer Research Institute Calgary Alberta Canada

University of Maryland Greenebaum Comprehensive Cancer Center Baltimore Maryland USA

University of Melbourne St Vincent's Hospital Melbourne Victoria Australia

Citace poskytuje Crossref.org

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