I don't think the approval was in any doubt (ODAC voted to approve unanimously). Uptake may be challenging in this (covid) environment - new MOA w unique toxicity requiring regular ophtho exams. This will compete with KPTI's selinexor and does seem a bit more active but not as convenient and different toxicity profile. I would imagine patients will cycle through both drugs if they live long enough. There is an ongoing study w velcade/dex similar to KPTI's Boston study - it will be interesting to compare outcomes there once this reads out as that is a much larger commercial opportunity (along w other combos that both companies have in the works)
Edit: GSK is also have to compete more directly w other BCMAs in due course. I would think the KPTI drug offering unique MOA would be used post relapse on a BCMA