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Impact of prior treatment on selinexor, bortezomib, dexamethasone outcomes in patients with relapsed/refractory multiple myeloma: Extended follow-up subgroup analysis of the BOSTON trial Mateos, María-Victoria Engelhardt, Monika Leleu, Xavier CAVO, MICHELE Dimopoulos, Meletios Gironella, Mercedes Institut Català de la Salut [Mateos MV] Instituto de Investigación Biomédica de Salamanca (IBSAL), Hospital Universitario de Salamanca, Salamanca, Spain. [Engelhardt M] Interdisciplinary Cancer Center, University of Freiburg, Faculty of Freiburg, Freiburg, Germany. [Leleu X] University of Potiers and CHU, Poitiers, France. [Gironella Mesa M] Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Cavo M] IRCCS Azienda Ospedaliero-Universitaria di Bologna, Seràgnoli Institute of Haematology, Bologna University School of Medicine, Bologna, Italy. [Dimopoulos M] National and Kapodistrian University of Athens School of Medicine, Athens, Greece Vall d'Hebron Barcelona Hospital Campus Avaluació de resultats (Assistència sanitària) Quimioteràpia combinada Mieloma múltiple - Tractament ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Therapeutics::Therapeutics::Drug Therapy::Antineoplastic Protocols::Therapeutics::Drug Therapy::Antineoplastic Combined Chemotherapy Protocols DISEASES::Neoplasms::Neoplasms by Histologic Type::Neoplasms, Plasma Cell::Multiple Myeloma Other subheadings::Other subheadings::Other subheadings::/drug therapy ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Diagnosis::Prognosis::Treatment Outcome TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::terapéutica::terapéutica::farmacoterapia::protocolos antineoplásicos::terapéutica::farmacoterapia::protocolos de quimioterapia antineoplásica combinada ENFERMEDADES::neoplasias::neoplasias por tipo histológico::neoplasias de células plasmáticas::mieloma múltiple Otros calificadores::Otros calificadores::Otros calificadores::/farmacoterapia TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::diagnóstico::pronóstico::resultado del tratamiento Bortezomib; Multiple myeloma; Proteasome inhibitor Bortezomib; Mieloma múltiple; Inhibidor del proteasoma Bortezomib; Mieloma múltiple; Inhibidor del proteasoma Objectives To analyze the impact of prior therapies on outcomes with selinexor, bortezomib, and dexamethasone (SVd) versus bortezomib and dexamethasone (Vd) in 402 patients with relapsed/refractory multiple myeloma (RRMM) in the phase 3 BOSTON trial. Methods Post hoc analysis of progression-free survival (PFS), overall survival (OS), and safety for lenalidomide-refractory, proteasome inhibitor (PI)-naïve, bortezomib-naïve, and one prior line of therapy (1LOT) patient subgroups. Results At a median follow-up of over 28 months, clinically meaningful improvements in PFS were noted across all groups with SVd. The median SVd PFS was longer in all subgroups (lenalidomide-refractory: 10.2 vs. 7.1 months, PI-naïve: 29.5 vs. 9.7; bortezomib-naïve: 29.5 vs. 9.7; 1LOT: 21.0 vs. 10.7; p < .05). The lenalidomide-refractory subgroup had longer OS with SVd (26.7 vs. 18.6 months; HR 0.53; p = .015). In all subgroups, overall response and ≥very good partial response rates were higher with SVd. The manageable safety profile of SVd was similar to the overall patient population. Conclusions With over 2 years of follow-up, these clinically meaningful outcomes further support the use of SVd in patients who are lenalidomide-refractory, PI-naïve, bortezomib-naïve, or who received 1LOT (including a monoclonal antibody) and underscore the observed synergy between selinexor and bortezomib. The BOSTON trial was sponsored by Karyopharm Therapeutics. This subgroup analysis was supported by the Menarini Group. 2024-07-09T10:09:03Z 2024-07-09T10:09:03Z 2024-08 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Mateos MV, Engelhardt M, Leleu X, Mesa MG, Cavo M, Dimopoulos M, et al. Impact of prior treatment on selinexor, bortezomib, dexamethasone outcomes in patients with relapsed/refractory multiple myeloma: Extended follow-up subgroup analysis of the BOSTON trial. Eur J Haematol. 2024 Aug;113(2):242–52. 1600-0609 https://hdl.handle.net/11351/11683 10.1111/ejh.14223 38693052 001216638600001 http://hdl.handle.net/11351/11683 eng European Journal of Haematology;113(2) https://doi.org/10.1111/ejh.14223 Attribution-NonCommercial 4.0 International http://creativecommons.org/licenses/by-nc/4.0/ info:eu-repo/semantics/openAccess application/pdf Wiley Scientia