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The 'comeback' of Selinexor: From toxic to tolerable

Hamza Hashmi1, Kimberly Green1

  • 1Division of Hematology Oncology, Medical University of South Carolina, Charleston, SC.

Current Problems in Cancer
|September 4, 2021
PubMed

Insights

Selinexor, an XPO1 inhibitor, shows promise for relapsed refractory multiple myeloma. Lower doses and combination therapies improve its safety profile, making it a viable option for heavily pretreated patients.

Area of Science:

  • Oncology
  • Pharmacology

Background:

  • Selinexor is an approved XPO1 inhibitor for relapsed refractory multiple myeloma.
  • Twice-weekly dosing of selinexor is linked to significant toxicities, limiting its clinical application.

Purpose of the Study:

  • To evaluate novel combinations and dosing strategies for selinexor in relapsed refractory multiple myeloma.
  • To assess the safety and efficacy of modified selinexor regimens.

Main Methods:

  • Investigated newer combinations of selinexor with other chemotherapeutic agents.
  • Evaluated less frequent and lower doses of selinexor.
  • Incorporated aggressive supportive care protocols.

Main Results:

  • Novel combinations demonstrated tolerable safety profiles.
  • Drug efficacy was preserved with modified dosing and combination strategies.
  • Selinexor in these new regimens is a reasonable option for heavily pretreated patients.

Conclusions:

  • Modified dosing and combination regimens enhance the tolerability of selinexor.
  • Selinexor remains an effective treatment option for relapsed refractory multiple myeloma, even in heavily pretreated populations.
Keywords:
Clinical commentaryRelapsed refractorySelinexormultiple myeloma

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