Effect of Age and Frailty on the Efficacy and Tolerability of Once-Weekly Selinexor, Bortezomib, and Dexamethasone in Previously Treated Multiple Myeloma
Author
Auner, Holger WGavriatopoulou, Maria
Delimpasi, Sosana
Simonova, Maryana
Spicka, Ivan
Pour, Ludek
Dimopoulos, Meletios A
Kriachok, Iryna
Pylypenko, Halyna
Leleu, Xavier
Doronin, Vadim
Usenko, Ganna
Hajek, Roman
Benjamin, Reuben
Dolai, Tuphan Kanti
Sinha, Dinesh Kumar
Venner, Christopher P
Garg, Mamta
Stevens, Don Ambrose
Quach, Hang
Jagannath, Sundar
Moreau, Phillipe
Levy, Moshe
Badros, Ashraf
Anderson, Larry D
Bahlis, Nizar J
Facon, Thierry
Mateos, Maria Victoria
Cavo, Michele
Chai, Yi
Arazy, Melina
Shah, Jatin
Shacham, Sharon
Kauffman, Michael G
Richardson, Paul G
Grosicki, Sebastian
Date
2021-03-23Journal
American Journal of HematologyPublisher
Wiley-BlackwellType
Article
Metadata
Show full item recordAbstract
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. © 2021 The Authors. American Journal of Hematology published by Wiley Periodicals LLC.Identifier to cite or link to this item
http://hdl.handle.net/10713/15536ae974a485f413a2113503eed53cd6c53
10.1002/ajh.26172
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