[Successfully second line treatment with selinexor-bortezomib-dexamethasone of a patient affected by multiple myeloma, refractory to first line therapy with daratumab-lenalidomide-dexamethasone].

Refractoriness to first-line therapy with daratumumab and lenalidomide represents the paradigm of patients with functional high-risk multiple myeloma. In Italy, the currently available second-line therapies have been approved based on phase 3 clinical trials with patients' populations that are not fully representative of this condition (only some patients were lenalidomide refractory and only in a few studies there were a small number of patients refractory to an anti-CD38 monoclonal antibody). For this reason, real-life studies and individual clinical experiences represent an important resource for the second-line therapeutic choice for such patients. In the reported clinical case, a patient with multiple myeloma refractory to first-line therapy with daratumumab-lenalidomide-dexamethasone was successfully treated with selinexor-bortezomib-dexamethasone, achieving a good and durable disease remission.