KEY TAKEAWAYS
- The STORM phase II trial aimed to analyze whether the outcomes of selinexor treatment were similar between AAs and other races.
- Pts had heavily pretreated MM, including triple-class and penta-refractory MM refractory, to the last line of therapy.
- The study found AAs with MM treated with selinexor had longer PFS than other races despite similar ORRs.
Although survival for patients (pts) with multiple myeloma (MM) has improved in the past decade, African Americans (AAs) have not seen the same improvements, possibly due to disparities in access to therapies and differences in MM biology between races.
Researchers aimed to analyze whether the outcomes of selinexor treatment were similar between AAs and other races.
The study analyzed 202 pts who received the drug. Those with extensively treated MM, including triple-class and penta-refractory cases resistant to the last treatment, were treated with selinexor (80mg) and dexamethasone (20mg) twice weekly. A retrospective analysis of racial subgroups was conducted, utilizing Cox proportional modeling to calculate the hazard ratio (HR) for MM relapse while controlling for covariates.
The study constituted 17% of pts (35 AAs, 148 White, 2 Asian, 11 other, and 6 missing). AAs were younger (median age 60.7 vs. 65.3), with more females (74.3% vs. 40.7%). Cytogenetic abnormalities and R-ISS staging were similar across races. AAs had a longer median progression-free survival (PFS) of 6.5 months (95% CI 4.7, NR) compared to 3.7 months (95% CI 2.8, 4.6; P= 0.035) in other racial groups.
Overall response rates (ORR) were comparable (25.7% [95% CI 12.5, 43.3] in AAs vs. 23.4% [17.2, 30.5] in other races), as were clinical benefit rates (37.1% [21.5, 55.1] vs. 35.9% [28.7, 43.7]), median duration of response (5.6 months [2.1, NR] vs. 5.3 [3.6, NR]), median treatment duration (9 weeks [IQR 3-22 weeks] vs. 8 weeks [4-16 weeks]), and mean dose intensity (117.9 mg/weeks [STD 35.1] vs. 117.1 [34.7]). Rates of adverse events (AEs) ≥ grade 3 (94.3% vs. 95.8%) and AE-related dose reductions (45.7% vs. 54.5%), discontinuations (22.9% vs. 30.5%), and deaths (5.7% vs. 10.8%) were also similar. After adjusting for gender, age, and prior therapy, the HR for MM relapse in AAs was 0.45 (95% CI 0.22, 0.92; P= 0.028).
The study found AAs pts were younger with more women had similar response rates but significantly longer PFS when treated with selinexor compared to other racial groups, suggesting potential differences in biology or drug response.
Source: https://ascopubs.org/doi/abs/10.1200/JCO.2023.41.16_suppl.e20016
Clinical Trial: https://clinicaltrials.gov/study/NCT02336815
Craig Cole, Anne Maria Opalikhin, Matthew McCartney, Caroline Heideman, Swetha Pentapati, and Ling Wang. DOI: 10.1200/JCO.2023.41.16_suppl.e20016 Journal of Clinical Oncology 41, no. 16_suppl (June 01, 2023) e20016-e20016.
