Drug updated on 9/4/2024
| Dosage Form | Tablet (oral: 20 mg 40 mg, 50 mg, 60 mg) |
| Drug Class | Nuclear export inhibitors |
| Ongoing and Completed Studies | ClinicalTrials.gov |
Indication
- Indicated in combination with bortezomib and dexamethasone for the treatment of adult patients with multiple myeloma who have received at least one prior therapy.
- Indicated in combination with dexamethasone for the treatment of adult patients with relapsed or refractory multiple myeloma (RRMM) who have received at least four prior therapies and whose disease is refractory to at least two proteasome inhibitors, at least two immunomodulatory agents, and an anti-CD38 monoclonal antibody.
- Indicated for the treatment of adult patients with relapsed or refractory diffuse large B‐cell lymphoma (DLBCL), not otherwise specified, including DLBC arising from follicular lymphoma, after at least 2 lines of systemic therapy.
Latest News
Summary
- Xpovio (selinexor) is indicated in combination with bortezomib and dexamethasone for the treatment of adult patients with multiple myeloma who have received at least one prior therapy. It is also indicated in combination with dexamethasone for the treatment of adult patients with relapsed or refractory multiple myeloma (RRMM) who have received at least four prior therapies and whose disease is refractory to at least two proteasome inhibitors, at least two immunomodulatory agents, and an anti-CD38 monoclonal antibody. Additionally, it is indicated for the treatment of adult patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL), not otherwise specified, including DLBCL arising from follicular lymphoma, after at least two lines of systemic therapy.
- This summary is based on the review of six systematic review(s)/meta-analysis(es). [1-6]
- R/R Large B Cell Lymphoma (LBCL): CAR T cell therapies (lisocabtagene maraleucel, axicabtagene ciloleucel, tisagenlecleucel) improved general and lymphoma-specific health-related quality of life (HRQOL). Novel therapies, including selinexor, had utility values of 0.83 for progression-free survival and 0.39 to 0.71 for disease progression.
- Multiple Myeloma (MM) with +1q Abnormality: Selinexor (BOSTON trial) improved progression-free survival (PFS) in patients with +1q abnormality. However, overall survival (OS) and PFS outcomes were generally worse for patients with +1q abnormality across all treatments.
- Relapsed/Refractory Multiple Myeloma (RRMM): Selinexor-based treatments achieved higher objective response rates (ORR) when combined with protease inhibitors (PIs) or immunomodulatory drugs (IMiDs) compared to selinexor and dexamethasone alone, with earlier use (before fifth-line therapy) resulting in a higher ORR (65.9% vs. 23.4%) and longer PFS (12.5 months vs. 2.9 months).
- There were no specific safety outcomes reported for the use of selinexor in R/R LBCL, MM with +1q abnormality, and DLBCL subgroups.
- Selinexor combination therapies in RRMM were found to have a tolerable safety profile, with no excessive toxicity reported when combined with dexamethasone, bortezomib, or carfilzomib.
Product Monograph / Prescribing Information
| Document Title | Year | Source |
|---|---|---|
| Xpovio (selinexor) Prescribing Information. | 2022 | Karyopharm Therapeutics Inc., Newton, MA |
Systematic Reviews / Meta-Analyses
Clinical Practice Guidelines
| Document Title | Year | Source |
|---|---|---|
| Multiple myeloma: EHA-ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. | 2021 | Annals of Oncology |