Effect of age and frailty on the efficacy and tolerability of once?weekly selinexor, bortezomib, and dexamethasone in previously treated multiple myeloma

Elderly and frail patients with multiple myeloma (MM) are more vulnerable to the toxicity of combination therapies, often resulting in treatment modifications suboptimal outcomes. The phase 3 BOSTON study showed that once-weekly selinexor bortezomib low-dose dexamethasone (XVd) improved PFS ORR compared standard twice-weekly moderate-dose (Vd) previously treated MM. This is a retrospective subgroup analysis multicenter, prospective, randomized trial. Post hoc analyses were performed compare XVd versus Vd safety efficacy according age frailty status (<65 ?65 years, nonfrail frail). Patients years had higher (OR 1.77, p = .024), ?VGPR (OR, 1.68, .027), (HR 0.55, .002), OS 0.63, .030), Vd. In patients, was associated trend towards better 0.69, .08) 0.62, .062). Significant improvements also observed <65 (ORR TTNT) (PFS, ORR, ?VGPR, TTNT). lower incidence grade ? 2 peripheral neuropathy year-old (22% vs. 37%; .0060) (15% 44%; .0002). Grade ?3 TEAEs not older younger nor patients. safe effective