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Selinexor in multiple myeloma.

Enrica Antonia Martino1, Ernesto Vigna1, Antonella Bruzzese1

  • 1Hematology Unit, Azienda Ospedaliera Annunziata, Cosenza, Italy.

Expert Opinion on Pharmacotherapy
|March 19, 2024
PubMed
Summary

Selinexor, an XPO1 inhibitor, shows promise for relapsed/refractory multiple myeloma (RRMM). Clinical trials demonstrate its efficacy in combination therapies, improving response rates and progression-free survival for patients with challenging disease.

Keywords:
MMSelinexorXPO1therapy

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Area of Science:

  • Oncology
  • Hematology
  • Pharmacology

Background:

  • Relapsed/refractory multiple myeloma (RRMM) presents significant treatment challenges.
  • Selinexor, a selective inhibitor of exportin 1 (XPO1), is an emerging therapeutic option.

Purpose of the Study:

  • To review the clinical efficacy and safety of selinexor in patients with multiple myeloma (MM).
  • To explore selinexor's role in various combination regimens and patient populations.

Main Methods:

  • Review of clinical trials, including STORM and BOSTON.
  • Analysis of real-world evidence and ongoing investigations.

Main Results:

  • Selinexor demonstrated notable overall response rates (ORR) and prolonged median progression-free survival (mPFS) in combination regimens (XKd, XRd, XPd).
  • Efficacy was observed in triple-class refractory and high-risk MM patients, including those with extramedullary disease.

Conclusions:

  • Selinexor is a versatile and pivotal component in multidrug strategies for RRMM.
  • Careful management of resistance mechanisms and adverse events is crucial for optimal outcomes.