Optimal timing and drug combination of selinexor in multiple myeloma: a systematic review and meta-analysis

Figures & data

Figure 1. PRISMA flow diagram illustrating the selection of studies in the meta-analysis.

Table 1. Characteristics of included studies.

First Author, Year, Strategy	ID	Name	Study Phase	Regimen	No. Pts	Age (Year)	Prior Lines
RCT
Grosicki 2020 [4]	NCT03110562	BOSTON	3	XVd	195	66 (59–72)	2 (1–3)
Multi-arm clinical trial
Gasparetto 2021 [15]	NCT02343042	STOMP Arm 6	1/2	XKd	27	71 (50–76)	4 (1–8)
White 2021 [16]	NCT02343042	STOMP Arm 1	1/2	XPd	65	64 (37–85)	3 (1–10)
Gasparetto 2020 [17]	NCT02343042	STOMP Arm 5	1/2	XDd	34	68 (44–83)	3 (2–10)
White 2020 [18]	NCT02343042	STOMP Arm 3	1/2	XRd	24	67 (49–84)	2 (1–8)
Bahlis 2018 [19]	NCT02343042	STOMP Arm 2	1/2	XVd	42	64 (43–75)	3 (1–11)
Single-arm clinical trial
Fu 2021 [12]	NCT03944057	MARCH	2	Xd	60	61 (43–82)	5 (1–16)
Rodríguez-Otero 2021 [25]	NCT03589222	SELIBORDARA	2	XDVd	57	65.5 (NR)	2 (1-NR)
Salcedo 2020 [20]	NCT02831686	NA	1	XId	18	66 (44–78)	5 (1–11)
Chari 2019 [13]	NCT02336815	STORM Part 2	2	Xd	123	65 (40–86)	7 (3–18)
Jakubowiak 2019 [21]	NCT02199665	SINE	1	XKd	21	64 (55–74)	4 (2–10)
Broijl 2018 [22]	EudraCT201400244440	SELVEDEX	1/2	XVd	11	NR	3 (1–7)
Vogl 2018 [14]	NCT02336815	STORM Part 1	2	Xd	79	63 (34–78)	7 (3–17)
Baz 2017 [23]	NCT02186834	NA	1/2	XAd	27	60 (49–76)	6 (2–10)
Chen 2015 [11]	NCT01607892	NA	2	X	40	66 (NR)	6 (1–16)
Case series
Magen 2020 [24]	NA	NA	NA	XVd	13	67 (45–86)	7 (4–10)

No. Pts number of patients; XVd selinexor, bortezomib and dexamethasone; XKd selinexor, carfilzomib and dexamethasone; XPd selinexor, pomalidomide and dexamethasone; XDd selinexor, daratumumab and dexamethasone; XRd selinexor, lenalidomide and dexamethasone; Xd selinexor and dexamethasone; XDVd selinexor, daratumumab, bortezomib and dexamethasone; XId selinexor, ixazomib and dexamethasone; XAd selinexor, adriamycin and dexamethasone; NA not applicable; NR not reported.

Figure 2. Meta-analysis of the ORR by subgroups according to different treatment lines and selinexor-based drug combinations in RRMM patients. (A) Objective response rate (ORR) of selinexor-based regimens used in the fifth-line or prior treatment (treatment line = 2-5) vs selinexor-based regimens used after fifth-line treatment (treatment line > 5) in relapsed/refractory multiple myeloma (RRMM); (B) ORR of Xd + PIs, Xd + IMiDs and Xd.

Figure 3. Survival curves of selinexor-based regimens in RRMM patients. (A) Pooled progression-free survival (PFS) curves of selinexor-based regimens used prior to fifth-line treatment (median treatment line < 5) vs selinexor-based regimens used as fifth-line or later treatment (median treatment line ≥ 5) in relapsed/refractory multiple myeloma (RRMM); (B) pooled overall survival (OS) curves of selinexor-based regimens used in the fifth-line treatment (median treatment line = 5) vs selinexor-based regimens used after fifth-line treatment (median prior line > 5) in RRMM.

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Data availability statement

The original contributions presented in the study are included in the article/supplementary material. Further inquiries can be directed to the corresponding author.