New agent approved for multiple myeloma
Selinexor (Xpovio) has been TGA approved for the management of multiple myeloma in adults
The selective inhibitor of nuclear export (SINE) that specifically blocks exportin can be used in combination with bortezomib and dexamethasone in patients who have received at least one prior therapy.
It is also indicated, in combination with dexamethasone (Sd), for the treatment of patients with relapsed or refractory multiple myeloma who have received at least three prior therapies and whose disease is refractory to at least one proteasome inhibitor, at least one immunomodulatory medicinal product, and an anti CD38 monoclonal antibody.
“The combination of selinexor and dexamethasone or bortezomib demonstrated synergistic cytostatic and cytotoxic effects in multiple myeloma in vitro and in vivo models, including those resistant to proteasome inhibitors,” the TGA said.
Selinexor will be included in the Black Triangle Scheme for the next five years.
CLL patients have poor melanoma outcomes
People with chronic lymphocytic leukaemia (CLL) who develop melanoma have significantly poorer outcomes compared to people without a history of blood cancer, a first study of its kind shows.
The retrospective case-controlled trial from the Peter MacCallum Cancer Centre involving 56 patients with CLL and melanoma found CLL was associated with significantly worse melanoma-specific mortality (hazard ratio [HR]: 2.46, P = 0.007) and recurrence (HR: 3.44, P < 0.001) compared to patients with melanoma alone.
Furthermore, adverse events requiring cessation of immunotherapy occurred in 43% of patients with CLL compared to 7% of patients without CLL.
“With new and effective treatments, patients with CLL are living longer and the impact of second malignancies on their survival is becoming increasingly important. We found that the patients with CLL who developed melanoma had poorer MSS, RFS and potentially poorer immunotherapy intolerance,” the authors led by Professor Michael Henderson said.
“Patients with CLL with newly diagnosed melanoma should be counselled about this recurrence risk and possible immunotherapy complications. Future studies should investigate the most appropriate management in this vulnerable population,” they concluded.
The authors noted that the study was limited by its small, low event number and long observational period.
Read more in the British Journal of Haematology
Doctors win, nurses lose under tax changes
High income medical specialists such as surgeons will get a $9,000 windfall from the government’s planned stage 3 tax cuts, whereas other healthcare workers such as nurses will be worse off, a new analysis suggests.
The stage 3 tax cuts, worth $15.7 billion per year will come into effect in July 2024, and will increase the income at which the top tax bracket begins from $180,001 to $200,000.
According to the Australia Institute think tank, this will mean that medical practitioners such as surgeons and anaesthetists with average incomes over $200,000 will get the maximum tax cut worth $9,075 per year.
In contrast, healthcare occupations that currently qualify for the Low- and Middle-Income Tax Offset (LMITO), worth $7 billion per year, will be net losers when it is discontinued at the of end this year, the institute says.
It cites the example of a midwife with a salary of $78,784 who will gain $845 from the stage 3 tax cuts but lose $1,080 when the LMITO is removed.
Workers on incomes below $50,000 such as aged care staff, secretaries and receptionists will be worst off, receiving no tax cuts and losing up to $832 from the LMITO, the institute predicts.