Dr. Gasparetto on Therapies for Patients With Penta-Refractory Myeloma

Cristina Gasparetto, MD, an associate professor of medicine and director, Multiple Myeloma Program at Duke Cancer Institute, discusses therapies for patients with penta-refractory multiple myeloma.

There are several agents under investigation for patients with penta-refractory disease, including venetoclax (Venclexta) and selinexor. Oftentimes, patients are looking to enroll on clinical trials with different targeted therapies, as this patient population does not have many options left, says Gasparetto.

Selinexor is an XPO1 inhibitor; it can be a difficult drug to administer at first. However, the agent can lead to durable responses in a heavily pretreated patient population. For example, Gasparetto has had patients on selinexor for more than a couple of years who are doing very well. There are many dose modifications and reductions after the first few cycles, she adds. Selinexor is given orally, and in combination with dexamethasone, twice weekly. Many patients also receive this combination once weekly and are doing quite well, with good quality of life and sustained responses, she concludes.