How it is administered

Selinexor is taken by mouth as a tablet. It is available in strengths of 10 mg, 20 mg, 40 mg, 50 mg, and 60 mg. For diffuse large B-cell lymphoma (DLBCL), the recommended dose is 60 mg taken orally on Days 1 and 3 of each week. Tablets should be swallowed whole with water and should not be broken, chewed, crushed, or divided.

How it works

Selinexor is a nuclear export inhibitor. It works by blocking a protein called exportin 1 (XPO1), which is responsible for moving certain proteins, including tumor suppressor proteins, out of the cell nucleus. By inhibiting XPO1, selinexor causes these tumor suppressor proteins to accumulate in the nucleus, where they can help control cell growth and trigger cancer cell death (apoptosis). This leads to cell cycle arrest and the death of cancer cells. Selinexor has shown anti-tumor activity in laboratory studies and animal models of multiple myeloma and diffuse large B-cell lymphoma.

Who Should take it

Selinexor is indicated for adults with relapsed or refractory diffuse large B-cell lymphoma (DLBCL), including DLBCL arising from follicular lymphoma, who have received at least two prior lines of systemic therapy. It is also used in combination with other medications for certain patients with multiple myeloma.

Your doctor may recommend selinexor if your DLBCL has not responded to other treatments or has come back after previous therapies. It is typically used when other standard treatments are no longer effective.

Who should not take it

There are no absolute contraindications listed for selinexor. However, it should be used with caution in certain situations:

• Women who are pregnant should not take selinexor, as it can cause harm to an unborn baby.
• Women should not breastfeed during treatment and for at least 1 week after the last dose.
• Patients with severe side effects or intolerances to selinexor may need to stop the medication.

Always discuss your full medical history with your healthcare provider before starting selinexor.

Commonly used with

For DLBCL, selinexor is typically used alone. For multiple myeloma, it is often combined with dexamethasone, and sometimes with bortezomib. Your doctor will determine the best combination based on your specific type of blood cancer and previous treatments.

Commonly tested with

Selinexor has been tested in combination with dexamethasone and bortezomib for multiple myeloma. For DLBCL, it has mainly been studied as a single agent in patients who have already tried other therapies.