Joseph Mikhael, MD, shares what he believes are the unmet needs and remaining challenges in multiple myeloma care.

Dr. Mikhael is a Professor in the Applied Cancer Research and Drug Discovery Division at the Translational Research Institute, an affiliate of the City of Hope Cancer Center in Duarte, California. He is also the Chief Medical Officer of the International Myeloma Foundation.

Dr. Mikhael reflects on how the BOSTON and STOMP studies impacted the myeloma treatment paradigm.

“We've had the results of BOSTON and STOMP for several years, and we've been really introducing them into practice,” he said. “I think this is a particularly important point, because very often important studies like BOSTON and STOMP are completed. But then as we translate them into the clinic, we want to give the best opportunity to our patients to have response and to maintain that response.”

He went on to describe a massive shift in treatment since the two studies.

"One of the massive shifts we've seen with selinexor, moving from a higherdose, twiceweekly therapy to a lowerdose, onceweekly therapy, is that the drug is very effective at 60 milligrams once weekly. The significance of these studies is that we've learned that we can partner selinexor with literally all other myeloma therapies,” Dr. Mikhael said.

“It now really serves as a fourth class, in addition to proteasome inhibitors and modulatory drugs and monoclonal antibodies. It's an option to be combined to obtain the best response by virtue of multiple mechanisms of action while maintaining a tolerable regimen whose toxicities we're becoming much better at managing with the onceweekly dosing with the proper use of antiemetics and supportive care.”