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Multiple MyelomaNovember 2020Summary reviewed June 2026

What the BOSTON Trial Found — Selinexor for Multiple Myeloma

Researchers tested whether adding selinexor to a standard treatment could help people with multiple myeloma who had tried one to three other treatments. Patients who got selinexor with bortezomib and dexamethasone went nearly 14 months before their cancer worsened, compared to about 9.5 months with bortezomib and dexamethasone alone.

What the trial was testing

The BOSTON enrolled 402 patients with multiple myeloma. The study was sponsored by Karyopharm Therapeutics Inc and tracked outcomes across the full group of patients who matched the trial's eligibility profile.

It was a large trial designed to confirm whether the treatment works well enough for wider use. Trials at this stage are designed to produce evidence regulators and physicians can act on — not just observations to follow up later.

What the results showed

The combination kept cancer from getting worse for 13.93 months versus 9.46 months with standard treatment.

Lancet (London, England) · 2020 · NCT03110562

These findings — that nearly 4.5 months longer than standard treatment before the cancer got worse — were published in the Lancet (London, England) and represent the headline result of the study.

Researchers tracked outcomes across 402 patients enrolled in the trial. The result was consistent enough across the group that the team felt confident reporting it.

What this means for patients

For patients with multiple myeloma, this result changes the calculus on what to ask their care team about. Whether it changes day-to-day care depends on factors like disease subtype, prior treatments, and where the patient is in their care journey.

What you can do now

Selinexor combined with bortezomib and dexamethasone is FDA-approved for multiple myeloma that has come back after other treatments. The once-weekly dosing schedule is more convenient than twice-weekly bortezomib alone and caused less nerve damage. Talk to your oncologist about whether this combination is right for your situation.

Eligibility for the treatments mentioned above depends on specific test results and clinical history. Bring this summary, the trial name, and your most recent labs or pathology report to your next visit.

Open multiple myeloma trials

RecruitingInterventional study

A Prospective Multicenter Study of the Effects of Plant-based Diets on Gut Microbiome and Derived Metabolites in Patients Affected by Smoldering Multiple Myeloma

Our overarching hypothesis is that plant-based diets will induce beneficial modifications of the gut microbiota favoring short fatty acid (SCFA)-producing commensals and a more advantageous CD8/Th17 ratio in sMM patients, thus preventing evolution to MM. Goal of this national, prospective, multicenter study is to demonstrate that plant-based diets substantially modify the gut microbiome inducing increased production of SCFAs in patients affected by sMM. The study will involve up to 62 patients affected by sMM. 56 Enrolled and eligible patients will be encouraged to consume a balanced diet rich in fiber for the entire duration of the trial (i.e., 12 weeks). Patients will choose among a list of different diet plans or individual food according to the personal tastes and preference. Free outpatient medical visit will be performed at enrollment and at week 12, and nutritional counseling will be given at the time of enrollment, one month later and on demand. As in line with routine diagnosis and follow-up of for patients affected by sMM, the investigators will collect bone marrow aspirates and peripheral blood at the time of screening, for plasma, serum, and peripheral blood mononuclear cells (PBMCs), while stool samples will be collected immediately before diet initiation. The investigators will also collect stool samples 4 and 12 weeks after diet initiation, and peripheral blood at 12 weeks after study initiation (as per routine clinical follow-up of this patient population). Dietary measurements will be conducted along the entire duration of the nutritional regimen by questionnaires. Biological paired comparison will be conducted between data obtained from samples collected at time 0 and samples collected 4 and 12 weeks later.

Milan, Milano, Italy +4 more
RecruitingObservational study

A Study of Real-Life Current Standards of Care in Participants With Relapsed and/or Refractory Multiple Myeloma

The purpose of this study is to assess in real-life clinical practice, over a 24-month period, the effectiveness and safety and patient-reported outcomes (PROs) associated with standard of care (SOC) antimyeloma treatments in participants with previously treated relapsed and/or refractory multiple myeloma.

Leoben, Austria +24 more