Selinexor Associated With Increased OS in R/R DLBCL

A subgroup of patients with relapsed or refractory (R/R) diffuse large B-cell lymphoma (DLBCL) from the SADAL study were evaluated for survival outcomes to best understand patients who could most benefit from selinexor therapy (J Hematol Oncol. Jul;14(1):111).

“Patients with R/R DLBCL who have received 2 or more lines of therapy have limited treatment options and an expected overall survival (OS) of less than 6 months. The SADAL study evaluated single-agent oral selinexor in patients with R/R DLBCL and demonstrated an overall response rate (ORR) of 29.1 percent with a median duration of response (DOR) of 9.3 months,” explained Marie Maerevoet, MD, Institute Jules Bordet, Belgium, and co-researchers.

The investigators analyzed subpopulations from the study out of a total of 244 participants. Baseline characteristics were described as the following: patients had a median age of 67 years and 44.8 percent were 70 years old or older.

The median OS was 9 months (95% CI, 6.2-13.7) at a median follow-up time of 14.8 months. Notably, the median OS was not reached in patients with a complete (CR) or partial response (PR), whereas patients who did not respond had a median OS of 4.9 months (P < 0.0001).

“Patients less than 70 years old had an OS of 11.1 months compared with 7.8 months in patients ≥ 70 years old. Among patients with or without prior autologous stem cell transplant (ASCT), the median OS was 10.9 and 7.8 months, respectively,” continued Dr Maerevoet and co-authors.

As for patients who were disease refractory to the most recent DLBCL treatment regimen, the median OS was 7 months compared to 11.1 months for those who had non-refractory disease. Further, the researchers confirmed that in a patient population in which survival is expected to be less than 6 months, treatment with single-agent oral selinexor was associated with a median survival of 9 months.

“Increased OS observed in patients responding to selinexor was consistent across subgroups regardless of age, prior ASCT therapy, or refractory status. Randomized studies of Selinexor in combination with a variety of other anti-DLBCL agent are planned,” concluded Dr Maerevoet, et al.—Alexa Stoia