How it Works
XPOVIO is a new class of myeloma treatment called an XPO1 inhibitor. Healthy cells have a protein called XPO1 that carries key material in and out of the nucleus of a cell.
These materials can fight myeloma, but only when they are inside the nucleus. Myeloma cells have too much XPO1, which moves cancer-fighting material out of the nucleus, leaving myeloma cells with the ability to replicate. XPOVIO targets and blocks XPO1, stopping cancer-fighting material from leaving the cell nucleus. Thus, allowing the death of myeloma cells.
How it’s Administered
XPOVIO is given orally once a week along with bortezomib (shot or infusion).
The standard dose is 100 mg, but healthcare professionals can modify the dose based on the side effect profile.
Dexamethasone is given orally on day 2. Anti-nausea drugs can be given effectively with XPOVIO, so please ask your doctor about these complementary drugs.
Who Should Take XPOVIO
XPOVIO is currently approved for:
- Relapsed myeloma patients who have had at least one prior line of therapy to be used with bortezomib and dexamethasone
- Relapsed or refractory myeloma patients who have received at least four prior lines of therapy and have not responded to at least two proteasome inhibitors, at least two immunomodulatory drugs, and an anti-CD38 monoclonal antibody
Who Shouldn’t Take XPOVIO
- Patients who do not fit the criteria above cannot take XPOVIO
- XPOVIO should also not be taken by patients who are severely underweight or who struggle with anorexia
The most common side effects of taking XPOVIO include:
- Tiredness or weakness
- Low red blood cell count (anemia)
- Low white blood cell counts
- Nausea, vomiting, and/or diarrhea
- Loss of appetite and weight loss
- Infections (lung, sepsis)
- Shortness of breath
- Changes in body salt and mineral levels in your blood
- Changes in kidney and liver function blood tests
- dizziness, fainting, decreased alertness, and changes in your mental status, thinking, hallucinations
- New or worsening cataract, cloudiness, or loss of lens transparency in the eye
Commonly Used With
Currently Being Tested With XPOVIO
- Immunomodulators (IMiDs): Thalidomide, Lenalidomide, Pomalidomide
- Corticosteroids: Dexamethasone, Prednisone, Methylprednisolone
- Monoclonal antibodies: Daratumumab, Elotuzumab
- Proteasome inhibitors: Bortezomib, Ixazomib, Carfilzomib
- Antineoplastic agents: Cyclophosphamide, Liposomal Doxorubicin, Melphalan
- Peptide-drug Conjugate (PDC)