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Updated: Mar 7, 2026

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Selinexor plus ruxolitinib in JAK inhibitor-naïve patients with myelofibrosis: a multicenter, open-label, phase 1

Haris Ali1, Sanjay Ram Mohan2, Ashwin Kishtagari2

  • 1Division of Leukemia, Department of Hematology and Hematopoietic Cell Transplantation, City of Hope Comprehensive Cancer Center, Duarte, CA.

Blood Advances
|March 5, 2026
PubMed

Insights

Selinexor combined with ruxolitinib shows promise for myelofibrosis patients. The 60 mg dose demonstrated superior efficacy in reducing spleen size and symptoms with manageable safety.

Area of Science:

  • Hematology
  • Oncology
  • Clinical Pharmacology

Background:

  • Myelofibrosis is a serious bone marrow disorder.
  • JAK inhibitors are standard therapy, but many patients need additional treatment options.

Purpose of the Study:

  • To evaluate the safety and efficacy of selinexor plus ruxolitinib in JAK inhibitor-naïve myelofibrosis patients.
  • To determine the recommended Phase 3 dose of selinexor in combination therapy.

Main Methods:

  • Phase 1 clinical trial (SENTRY/XPORT-MF-034) involving 24 patients.
  • Patients received selinexor (40 mg or 60 mg weekly) plus ruxolitinib.
  • Assessed safety, tolerability, maximum tolerated dose, and efficacy endpoints like spleen volume reduction (SVR35) and symptom score reduction (TSS50).

Main Results:

  • No dose-limiting toxicities were observed; common adverse events were manageable.
  • Selinexor 60 mg weekly plus ruxolitinib was identified as the recommended Phase 3 dose.
  • Higher rates of SVR35 (79%) and TSS50 (58%) were observed with 60 mg selinexor compared to 40 mg (38% and 25%) at Week 24.

Conclusions:

  • Selinexor combined with ruxolitinib is a safe and effective treatment option for myelofibrosis.
  • The 60 mg weekly dose of selinexor demonstrated superior efficacy in improving spleen and symptom burden.

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