Martina C. Murphy, MD

Discussant of the ENGOT-EN5/GOG-305/SIENDO trial, Martina C. Murphy, MD, Associate Professor of the Department of Medicine, Division of Hematology, University of Florida, shared insights on the topic of maintenance therapy, its effects on quality of life, and toxicity management.

Dr. Murphy highlighted the importance of tailoring maintenance therapy for the patient’s perspective, as what clinicians might consider “tolerable” or “acceptable” may vastly differ from a patient’s view. She also emphasized that the goals of maintenance therapy are fundamentally different from those of systemic treatment.

“Maintenance therapy is designed to be given over a prolonged period, so we need to design strategies that minimally disrupt patients’ lives and consider the logistics that impact quality of life in a positive way,” Dr. Murphy explained. “You must also weigh the potential benefits [of maintenance therapy] against available alternative later-line therapies.”

In addition, Dr. Murphy touched on the adverse effects of some maintenance therapies, particularly the necessity of defining toxicity in the context of long-term treatment regimens. For example, although temporary nausea might be manageable, she said, daily nausea could quickly become intolerable over time.

Clinical Considerations With Selinexor

With respect to the SIENDO trial, Dr. Murphy underscored the promising potential of selinexor in this patient population. “Selinexor, as a maintenance strategy in advanced endometrial cancer, makes a lot of sense, given this population’s historically short response to systemic therapy and limited treatment options,” she said. “As an oral therapy with a weekly dosing protocol, selinexor doesn’t require frequent trips to the doctor, making it an extremely convenient option.”

“We know a fair amount about selinexor again from other studies and other patient populations. We also know the side effects are generally reversible or manageable with dose alterations and supportive care medications,” she added.

However, Dr. Murphy also noted a lack of patient-reported outcomes. “I look forward to learning more about the patient-reported outcomes. Although we know about toxicity management of selinexor in other patient populations, it will also be important to learn more about toxicity management in this specific patient population to help inform patient care in the clinic as well as patient and family education and counseling.” 

DISCLOSURE: Dr. Murphy reported no conflicts of interest.