Safety and Efficacy of the Combination of Selinexor, Lenalidomide and Dexamethasone (SRd) in Patients with Relapsed/Refractory Multiple Myeloma (RRMM)

The nuclear export protein Exportin 1 (XPO1) is overexpressed in a wide variety of cancers including multiple myeloma. Selinexor (SEL) is a novel, first-in-class selective inhibitor of nuclear export (SINE), which blocks XPO1, forcing the nuclear retention and activation of tumor suppressor proteins. SEL in combination with dexamethasone (DEX) has demonstrated an overall response rate (ORR) of 26.2% in patients (pts) with triple class refractory MM. Lenalidomide (LEN) in combination with DEX is approved for the treatment of RRMM with an overall response rate (ORR) of 60-76%. The combination of SEL and LEN showed at least additive activity in preclinical models of MM. We therefore hypothesized that the all oral combination of SEL/LEN/DEX may result in improved response rates.