Effects of refractory status to lenalidomide on safety and efficacy of selinexor, bortezomib, and dexamethasone (XVd) versus bortezomib and dexamethasone (Vd) in patients with previously treated multiple myeloma
Dr. Xavier Leleu on the BOSTON Trial
What is the background of this study?
Lenalidomide (LEN) is typically a frontline therapy for newly diagnosed multiple myeloma. Patients with multiple myeloma refractory to LEN are less likely to respond to other IMiDs and represent a signification area of unmet medical need. In the BOSTON study in the intention to treat population, selinexor, bortezomib, and dexamethasone (XVd) was associated with significant improvements in median progression-free survival (PFS), overall response rate (ORR), and rates of peripheral neuropathy, with trends in overall survival (OS) favoring XVd.
In this video:
Dr. Xavier Leleu (CHU la Miletrie and Inserm CIC 1402, Poitiers, France) explains that the BOSTON trial (NCT03110562) is a phase III randomized, controlled, open-label study of once weekly XVd vs twice weekly Vd in patients with multiple myeloma and 1-3 prior therapies. A post-hoc analyses was performed on two different subgroups to compare outcomes based on refractory status to LEN and immunomodulatory drug (IMiD) therapy. These post-hoc analyses evaluated if PFS, overall response rate (ORR), time to next treatment (TTNT), and safety was influenced by prior treatment with LEN when comparing XVd with Vd.
Conclusions:
“In patients with previously treated multiple myeloma, PFS, ORR, and TTNT were significantly improved regardless of documented refractory status to any IMiD or to LEN-specifically. These analyses support the use of the XVd combination for patients with disease refractory to LEN and likely to any IMiD.”
Clinical trial information: NCT03110562




