**3. The phase II STORM trial with selinexor plus low-dose dexamethasone in patients with multiple myeloma pretreated with bortezomib, carfilzomib, lenalidomide, pomalidomide, daratumumab, and an alkylating agent**

Selinexor demonstrated small single-agent activity with an overall response rate achieved in 4% (2/57 heavily pre-treated patients with RRMM (about six prior therapies)) [27]. The response was considerably increased from 4 to 50% (6/12) when selinexor was combined with dexamethasone in a phase I trial in patients with advanced hematological malignancies (NCT 01607892) [27]. The phase II STORM trial (NCT02336815) with selinexor and dexamethasone combination in heavily pre-treated patients with RRMM had relatively quick responses. The primary

#### *Multiple Myeloma*

endpoint was overall response. Patients were given twice weekly oral doses of selinexor (80 mg) and dexamethasone (20 mg) in 28-day cycles [28, 29]. An overall response was recorded in 21% patients (16/78) or 26% (32/122) and median duration of response was 5 months. Patients required a lot of supportive care to mange many side effects. The most common adverse event was thrombocytopenia.
