A Novel Conditioning Regimen Combining Selinexor with Melphalan Could Improve Survival of Patients with Multiple Myeloma

作者：Liangliang Ma, Jingping Zhang, Xiaoqing Chen, Shanglun Yang, Youmei Fei, Qiuhao Hu, Jian Li, Caigang Xu, Ting Niu, Yongqian Jia · 发表于：Blood · 年份：2024 · DOI：10.1182/blood-2024-206877 · 被引用次数：1 · 研究领域：Multiple Myeloma Research and Treatments、Dendrimers and Hyperbranched Polymers、RNA Interference and Gene Delivery

Background: High-dose melphalan followed by autologous hematopoietic stem cell transplantation (ASCT) is regarded as the standard consolidation option for patients with multiple myeloma (MM). The previous attempted strategies aimed at refining the conditioning regimen for high-dose melphalan have encountered less superiority. Selinexor, a selective inhibitor of nuclear export protein (XPO-1), has demonstrated a synergistic anti-tumor effect with melphalan in preclinical studies. Thus, we present a cohort study to evaluating the efficacy and the safety of a new conditioning regimen that combines selinexor with high-dose melphalan. Methods: Referring to the RP2D dose recommended by Dr. Nishihori et al. (Blood (2019) 134 (Supplement_1): 3314.), our initial dose of selinexor was administered at 60 mg on days -4 and -1, and melphalan at 100 mg/m² on days -3 and -2. However, the first case experienced severe vomiting resulting in Mallory-Weiss syndrome. All the remaining cases received a modified regimen with selinexor 60 mg on days -11 and -4 and melphalan 100 mg/m² on days -3 and -2 (with melphalan reduced to 70 mg/m² on days -3 and -2 for patients with Serum Creatinine Clearance (CrCl) < 60 mL/min).This study has obtained approval from the ethics committee of the hospital, and the informed consent was obtained from patients. The further study is ongoing according to the clinical trial (ChiCTR2400086849). Results: From January 2022 to May 2024, a total of 25 patients with ...