The Efficacy And Safety Of Selinexor In The Treatment Of Relapsed/refractory Multiple Myeloma:meta Analysis

Objective:Selinexor,an oral inhibitor of nuclear export protein,has received extensive attention due to its unique mechanism of action.In this paper,by retrieving the clinical trials of Selinexor in the treatment of relapsed/refractory multiple myeloma in the database and extracting relevant data,the efficacy and safety of Selinexor in multiple myeloma were further analyzed,and the reference for clinical research and medication was provided.Methods:By searching various English databases(such as Pubmed,Embase,The Cochrane Library,Web of sciense),searching for clinical trials of Selinexor in the treatment of multiple myeloma,extracting relevant data,and using Rev Man 5.3 software to merge and analyze the extracted data for further evaluation efficacy and safety of Selinexor.Results:According to the inclusion and exclusion criteria,10 studies were finally included,with a total of 649 patients.The results of the meta-analysis showed that in terms of efficacy,the combined ORR,CBR,s CR,CR,VGPR,PR,MR,and PD of the Selinexor combination regimen in the treatment of RRMM were 49%,59%,5%,5%,16%,and27%,respectively.%,11%,13%,the ORR of patients with <7 previous treatments was higher than that of patients with ≥7 previous treatments(57% vs 24%),ORR of triple regimen(XVd 84%,XKd 60%,XPd 69%)The ORR of the XId group was higher than that of the dual regimen(Xd 24%),but the combined results were not statistically significant.After an RCT analysis,it was found that the ORR of the experimental group(XVd 76.4%)was better than that of the control group(Vd 62.3%)and the PD was lower than that of the control group(1% vs 5%),and the combination of Selinexor could prolong the PFS of patients.,the triple regimens(13.96 months,9 months,3.7 months,and 15 months)were longer than the double regimens(2.3 months,3.7 months),and the experimental group was longer than the control group(13.93 months vs 9.46 months).),subgroup analyses,meta-regression analyses,and sensitivity analyses ultimately identified the number of prior treatments,treatment regimens,and sample size as sources of heterogeneity.In terms of safety,the adverse reactions of any grade of the Selinexor combination regimen are more common in hematological adverse reactions,mainly anemia and thrombocytopenia,while fatigue and nausea are more common in non-hematological adverse reactions,which are more common in grades ≥ 3 Among the adverse reactions,hematological adverse reactions are more common,and the incidence of non-hematological adverse reactions is low.After an RCT analysis,it was found that the incidence of adverse reactions in the experimental group was higher than that in the control group,but the incidence of peripheral neuropathy was low.(5% vs9%).Conclusion:In terms of efficacy,the Selinexor combination regimen can relieve the condition of RRMM patients to a certain extent and prolong the PFS of patients.Subgroup analysis showed that the number of previous treatments and different treatment regimens will affect the efficacy of Selinexor;in terms of safety,The adverse reactions of the Selinexor combination regimen are mostly tolerable,and thrombocytopenia,anemia,fatigue,and nausea are more common,and the incidence of peripheral neuropathy can also be reduced.