---
title: "Selinexor plus bortezomib, lenalidomide, dexamethasone (XVRd) in newly diagnosed high‑risk multipl"
id: "pubmed-42544613"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42544613"
content_type: "clinical_feed_article"
specialty: "Oncology"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42544613/"
doi: "10.1080/07853890.2026.2703403"
published_at: "2026-08-03T12:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Selinexor plus bortezomib, lenalidomide, dexamethasone (XVRd) in newly diagnosed high‑risk multipl
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42544613
- **Specialty:** [Oncology](https://medichelpline.com/clinical-feed/oncology.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42544613/)
- **DOI:** [10.1080/07853890.2026.2703403](https://doi.org/10.1080%2F07853890.2026.2703403)
- **Published At:** 2026-08-03T12:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- This single‑arm, multi‑center, prospective observational study evaluated the **XVRd** regimen (selinexor combined with bortezomib, lenalidomide, dexamethasone) for newly diagnosed multiple myeloma (NDMM) patients with high‑risk features. - The trial enrolled 30 patients from August 2022 to November 2024, median age 62.1 years (range 47–73). - Eighty percent (24/30) had extramedullary plasmacytoma or plasma cell leukemia, representing a heavily high‑risk cohort. - Treatment included an induction phase with 21‑day cycles and oral **selinexor** 60 mg weekly, followed by maintenance with selinexor plus lenalidomide on 28‑day cycles. - Primary endpoints were overall response rate (**ORR**) and minimal residual disease (**MRD**) negativity after induction; secondary endpoints included progression‑free survival (**PFS**) and safety/tolerability. - The ORR was 93.3% (28/30): 5 stringent complete responses (sCR), 9 complete responses (CR), 4 very good partial responses (VGPR), and 10 partial responses (PR). - Five patients (16.7%) achieved **MRD** negativity after induction treatment. - Median **PFS** was 16.2 months (95% CI, 14.6–NA); 1‑year **PFS** rate was 89% (95% CI, 0.78–1); median overall survival (OS) was not reached at data cutoff. - Safety was described as manageable overall; most adverse events were grade 1–2 in the plain language summary. Specific adverse event details were not reported in the abstract. - Authors conclude that the **XVRd** regimen may offer promising efficacy with tolerable safety for NDMM patients with **extramedullary disease** and/or high‑risk cytogenetics. Trial registered at ChiCTR2200062860.
## Clinical Analysis & Structured Key Points
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Epub 2026 Aug 3. # Selinexor combined bortezomib, lenalidomide, and dexamethasone for newly diagnosed multiple myeloma with high-risk factors: a single-arm, multi-center, prospective observational clinical study [Junjing Yin](https://pubmed.ncbi.nlm.nih.gov/?term=Yin+J&cauthor_id=42544613)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42544613/#full-view-affiliation-1 "Department of Hematology, Qingdao Hospital, University of Health and Rehabilitation Science, Qingdao Municipal Hospital, Qingdao, China."), [Shuyuan Yu](https://pubmed.ncbi.nlm.nih.gov/?term=Yu+S&cauthor_id=42544613)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42544613/#full-view-affiliation-1 "Department of Hematology, Qingdao Hospital, University of Health and Rehabilitation Science, Qingdao Municipal Hospital, Qingdao, China."), [Hongying Wu](https://pubmed.ncbi.nlm.nih.gov/?term=Wu+H&cauthor_id=42544613)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42544613/#full-view-affiliation-1 "Department of Hematology, Qingdao Hospital, University of Health and Rehabilitation Science, Qingdao Municipal Hospital, Qingdao, China."), [Xia Zhou](https://pubmed.ncbi.nlm.nih.gov/?term=Zhou+X&cauthor_id=42544613)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42544613/#full-view-affiliation-1 "Department of Hematology, Qingdao Hospital, University of Health and Rehabilitation Science, Qingdao Municipal Hospital, Qingdao, China."), [Xuemei Li](https://pubmed.ncbi.nlm.nih.gov/?term=Li+X&cauthor_id=42544613)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42544613/#full-view-affiliation-1 "Department of Hematology, Qingdao Hospital, University of Health and Rehabilitation Science, Qingdao Municipal Hospital, Qingdao, China."), [Chenglu Yuan](https://pubmed.ncbi.nlm.nih.gov/?term=Yuan+C&cauthor_id=42544613)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42544613/#full-view-affiliation-2 "Department of Hematology, Qilu Hospital of Shandong University, Qingdao, China."), [Xiaoxia Chu](https://pubmed.ncbi.nlm.nih.gov/?term=Chu+X&cauthor_id=42544613)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42544613/#full-view-affiliation-3 "Department of Hematology, Yantai Yuhuangding Hospital, Yantai, China."), [Baohong Wang](https://pubmed.ncbi.nlm.nih.gov/?term=Wang+B&cauthor_id=42544613)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42544613/#full-view-affiliation-4 "Department of Hematology, Weifang People's Hospital, Weifang, China."), [Lumei Hao](https://pubmed.ncbi.nlm.nih.gov/?term=Hao+L&cauthor_id=42544613)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42544613/#full-view-affiliation-1 "Department of Hematology, Qingdao Hospital, University of Health and Rehabilitation Science, Qingdao Municipal Hospital, Qingdao, China."), [Liyan Wei](https://pubmed.ncbi.nlm.nih.gov/?term=Wei+L&cauthor_id=42544613)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42544613/#full-view-affiliation-1 "Department of Hematology, Qingdao Hospital, University of Health and Rehabilitation Science, Qingdao Municipal Hospital, Qingdao, China."), [Yuping Zhong](https://pubmed.ncbi.nlm.nih.gov/?term=Zhong+Y&cauthor_id=42544613)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42544613/#full-view-affiliation-1 "Department of Hematology, Qingdao Hospital, University of Health and Rehabilitation Science, Qingdao Municipal Hospital, Qingdao, China.") Affiliations Expand ### Affiliations * 1 Department of Hematology, Qingdao Hospital, University of Health and Rehabilitation Science, Qingdao Municipal Hospital, Qingdao, China. * 2 Department of Hematology, Qilu Hospital of Shandong University, Qingdao, China. * 3 Department of Hematology, Yantai Yuhuangding Hospital, Yantai, China. * 4 Department of Hematology, Weifang People's Hospital, Weifang, China. * PMID: **42544613** * DOI: [ 10.1080/07853890.2026.2703403 ](https://doi.org/10.1080/07853890.2026.2703403) Item in Clipboard Observational Study # Selinexor combined bortezomib, lenalidomide, and dexamethasone for newly diagnosed multiple myeloma with high-risk factors: a single-arm, multi-center, prospective observational clinical study Junjing Yin et al. Ann Med. 2026 Dec. Show details Display options Display options Format Abstract PubMed PMID Ann Med Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Ann+Med%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Ann+Med%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42544613/) . 2026 Dec;58(1):2703403. doi: 10.1080/07853890.2026.2703403. Epub 2026 Aug 3. ### Authors [Junjing Yin](https://pubmed.ncbi.nlm.nih.gov/?term=Yin+J&cauthor_id=42544613)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42544613/#short-view-affiliation-1 "Department of Hematology, Qingdao Hospital, University of Health and Rehabilitation Science, Qingdao Municipal Hospital, Qingdao, China."), [Shuyuan Yu](https://pubmed.ncbi.nlm.nih.gov/?term=Yu+S&cauthor_id=42544613)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42544613/#short-view-affiliation-1 "Department of Hematology, Qingdao Hospital, University of Health and Rehabilitation Science, Qingdao Municipal Hospital, Qingdao, China."), [Hongying Wu](https://pubmed.ncbi.nlm.nih.gov/?term=Wu+H&cauthor_id=42544613)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42544613/#short-view-affiliation-1 "Department of Hematology, Qingdao Hospital, University of Health and Rehabilitation Science, Qingdao Municipal Hospital, Qingdao, China."), [Xia Zhou](https://pubmed.ncbi.nlm.nih.gov/?term=Zhou+X&cauthor_id=42544613)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42544613/#short-view-affiliation-1 "Department of Hematology, Qingdao Hospital, University of Health and Rehabilitation Science, Qingdao Municipal Hospital, Qingdao, China."), [Xuemei Li](https://pubmed.ncbi.nlm.nih.gov/?term=Li+X&cauthor_id=42544613)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42544613/#short-view-affiliation-1 "Department of Hematology, Qingdao Hospital, University of Health and Rehabilitation Science, Qingdao Municipal Hospital, Qingdao, China."), [Chenglu Yuan](https://pubmed.ncbi.nlm.nih.gov/?term=Yuan+C&cauthor_id=42544613)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42544613/#short-view-affiliation-2 "Department of Hematology, Qilu Hospital of Shandong University, Qingdao, China."), [Xiaoxia Chu](https://pubmed.ncbi.nlm.nih.gov/?term=Chu+X&cauthor_id=42544613)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42544613/#short-view-affiliation-3 "Department of Hematology, Yantai Yuhuangding Hospital, Yantai, China."), [Baohong Wang](https://pubmed.ncbi.nlm.nih.gov/?term=Wang+B&cauthor_id=42544613)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42544613/#short-view-affiliation-4 "Department of Hematology, Weifang People's Hospital, Weifang, China."), [Lumei Hao](https://pubmed.ncbi.nlm.nih.gov/?term=Hao+L&cauthor_id=42544613)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42544613/#short-view-affiliation-1 "Department of Hematology, Qingdao Hospital, University of Health and Rehabilitation Science, Qingdao Municipal Hospital, Qingdao, China."), [Liyan Wei](https://pubmed.ncbi.nlm.nih.gov/?term=Wei+L&cauthor_id=42544613)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42544613/#short-view-affiliation-1 "Department of Hematology, Qingdao Hospital, University of Health and Rehabilitation Science, Qingdao Municipal Hospital, Qingdao, China."), [Yuping Zhong](https://pubmed.ncbi.nlm.nih.gov/?term=Zhong+Y&cauthor_id=42544613)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42544613/#short-view-affiliation-1 "Department of Hematology, Qingdao Hospital, University of Health and Rehabilitation Science, Qingdao Municipal Hospital, Qingdao, China.") ### Affiliations * 1 Department of Hematology, Qingdao Hospital, University of Health and Rehabilitation Science, Qingdao Municipal Hospital, Qingdao, China. * 2 Department of Hematology, Qilu Hospital of Shandong University, Qingdao, China. * 3 Department of Hematology, Yantai Yuhuangding Hospital, Yantai, China. * 4 Department of Hematology, Weifang People's Hospital, Weifang, China. * PMID: **42544613** * DOI: [ 10.1080/07853890.2026.2703403 ](https://doi.org/10.1080/07853890.2026.2703403) Item in Clipboard Cite Display options Display options Format Abstract PubMed PMID ## Abstract **Objective:** This study aimed to evaluate the efficacy and safety of selinexor combined with bortezomib, lenalidomide, and dexamethasone (the XVRd regimen) for newly diagnosed multiple myeloma (NDMM) patients with high-risk features. **Methods:** This single-arm, open-label, prospective observational study recruited patients between August 2022 and November 2024. The study consisted of an induction phase (21-day cycles) and a maintenance phase (28-day cycles). During induction, all enrolled patients aged ≥18 years received the XVRd regimen containing oral selinexor 60 mg weekly. After induction, patients transitioned to maintenance therapy with selinexor plus lenalidomide. The primary endpoints were the overall response rate (ORR) and minimal residual disease (MRD) negative rate. Secondary endpoints included progression-free survival (PFS), treatment safety, and tolerability. **Results:** A total of 30 patients were enrolled, with a median age of 62.1 years (range, 47-73 years). Twenty-four patients (80%) presented with extramedullary plasmacytoma or plasma cell leukemia (PCL). The ORR across the entire cohort was 93.3% (28/30), including 5 patients with stringent complete response (sCR), 9 with complete response (CR), 4 with very good partial response (VGPR), and 10 with partial response (PR). Five patients (16.7%) achieved MRD negativity after induction treatment. Survival analysis demonstrated a median PFS of 16.2 months (95% CI, 14.6-NA), a 1-year PFS rate of 89% (95% CI, 0.78-1), and unreached median overall survival (OS). The overall safety profile was manageable. **Conclusion:** The XVRd regimen may yield promising efficacy with a tolerable safety profile in NDMM patients with extramedullary disease (EMD) and/or high-risk cytogenetic abnormalities. **Clinical trial registration:** Chinese Clinical Trial Registry, registration number: ChiCTR2200062860. **Keywords:** Multiple myeloma; extramedullary disease; high risk myeloma; newly diagnosed; selinexor. ## Plain language summary The XVRd regimen (Selinexor plus VRd) yields promising efficacy in patients with newly diagnosed high-risk multiple myeloma.The XVRd regimen achieves a high overall response rate of 93.3%.The median progression-free survival (PFS) reached 16.2 months, with a 1-year PFS rate of 89%.The safety profile of XVRd was manageable, and most adverse events were grade 1–2. [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## Similar articles * [ Carfilzomib or bortezomib in combination with lenalidomide and dexamethasone for patients with newly diagnosed multiple myeloma without intention for immediate autologous stem-cell transplantation (ENDURANCE): a multicentre, open-label, phase 3, randomised, controlled trial. ](https://pubmed.ncbi.nlm.nih.gov/32866432/) Kumar SK, Jacobus SJ, Cohen AD, Weiss M, Callander N, Singh AK, Parker TL, Menter A, Yang X, Parsons B, Kumar P, Kapoor P, Rosenberg A, Zonder JA, Faber E Jr, Lonial S, Anderson KC, Richardson PG, Orlowski RZ, Wagner LI, Rajkumar SV.Kumar SK, et al.Lancet Oncol. 2020 Oct;21(10):1317-1330. doi: 10.1016/S1470-2045(20)30452-6. Epub 2020 Aug 28.Lancet Oncol. 2020.PMID: 32866432Free PMC article.Clinical Trial. * [ Quadruplet daratumumab in combination with bortezomib, lenalidomide, and dexamethasone as front-line regimen improved clinical outcomes in high-risk myeloma patients in China: a multi-centered prospective real-world study. ](https://pubmed.ncbi.nlm.nih.gov/41808058/) Cheng L, Liang D, Jia J, Zhang R, Yang Y, Liu P, Sun H, Qin X, Ma Y, Wu Y, Wang H, Zhuang J.Cheng L, et al.BMC Cancer. 2026 Mar 10;26(1):497. doi: 10.1186/s12885-026-15815-8.BMC Cancer. 2026.PMID: 41808058Free PMC article. * [ Autologous haematopoietic stem-cell transplantation versus bortezomib-melphalan-prednisone, with or without bortezomib-lenalidomide-dexamethasone consolidation therapy, and lenalidomide maintenance for newly diagnosed multiple myeloma (EMN02/HO95): a multicentre, randomised, open-label, phase 3 study. ](https://pubmed.ncbi.nlm.nih.gov/32359506/) Cavo M, Gay F, Beksac M, Pantani L, Petrucci MT, Dimopoulos MA, Dozza L, van der Holt B, Zweegman S, Oliva S, van der Velden VHJ, Zamagni E, Palumbo GA, Patriarca F, Montefusco V, Galli M, Maisnar V, Gamberi B, Hansson M, Belotti A, Pour L, Ypma P, Grasso M, Croockewit A, Ballanti S, Offidani M, Vincelli ID, Zambello R, Liberati AM, Andersen NF, Broijl A, Troia R, Pascarella A, Benevolo G, Levin MD, Bos G, Ludwig H, Aquino S, Morelli AM, Wu KL, Boersma R, Hajek R, Durian M, von dem Borne PA, Caravita di Toritto T, Zander T, Driessen C, Specchia G, Waage A, Gimsing P, Mellqvist UH, van Marwijk Kooy M, Minnema M, Mandigers C, Cafro AM, Palmas A, Carvalho S, Spencer A, Boccadoro M, Sonneveld P.Cavo M, et al.Lancet Haematol. 2020 Jun;7(6):e456-e468. doi: 10.1016/S2352-3026(20)30099-5. Epub 2020 Apr 30.Lancet Haematol. 2020.PMID: 32359506Clinical Trial. * [ Selinexor for the treatment of patients with relapsed or refractory multiple myeloma. ](https://pubmed.ncbi.nlm.nih.gov/38454813/) Babar A, Babar M, Zubair H, Shahid A, Rafique S, Bano M, Waleed MS, Khan M, Inayat A, Safi D.Babar A, et al.J Oncol Pharm Pract. 2024 Apr;30(3):535-546. doi: 10.1177/10781552241235902. Epub 2024 Mar 8.J Oncol Pharm Pract. 2024.PMID: 38454813Review. * [ Comparative efficacy of carfilzomib, lenalidomide, and dexamethasone (KRd) versus bortezomib, lenalidomide, and dexamethasone (VRd) in newly-diagnosed multiple myeloma: A systematic review and meta-analysis. ](https://pubmed.ncbi.nlm.nih.gov/38606993/) Costa BA, Costa TA, Pak K, Patel A, Felix N, Mouhieddine TH, Richter J.Costa BA, et al.Am J Hematol. 2024 Jul;99(7):1411-1414. doi: 10.1002/ajh.27314. Epub 2024 Apr 12.Am J Hem
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