How it is administered

Selinexor is taken by mouth (orally) as a tablet. The tablets are available in strengths of 10 mg, 20 mg, 40 mg, 50 mg, and 60 mg. You should swallow the tablet whole with water, without breaking, chewing, crushing, or dividing it. Selinexor is usually taken once or twice a week, depending on your specific treatment plan and whether it is combined with other medications like dexamethasone or bortezomib. Always follow your healthcare provider’s instructions for dosing and timing.

How it works

Selinexor is a nuclear export inhibitor. It works by blocking a protein called exportin 1 (XPO1), which is responsible for transporting 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 better control cell growth and trigger cell death (apoptosis) in cancer cells.

In multiple myeloma, selinexor helps reduce the levels of proteins that promote cancer cell survival and growth, leading to cell cycle arrest and cancer cell death. This mechanism is especially important in patients whose disease has become resistant to other treatments. Selinexor has shown effectiveness in laboratory studies and animal models, particularly when used in combination with other drugs like dexamethasone and bortezomib.

Who Should take it

Selinexor is used to treat adults with multiple myeloma who have received at least one prior therapy, in combination with bortezomib and dexamethasone. It is also approved for use with dexamethasone alone in adults with relapsed or refractory multiple myeloma who have received at least four prior therapies and whose disease is resistant to at least two proteasome inhibitors, two immunomodulatory agents, and an anti-CD38 monoclonal antibody.

Selinexor may also be used in adults with relapsed or refractory diffuse large B-cell lymphoma (DLBCL) after at least two lines of systemic therapy. Your doctor will determine if selinexor is appropriate for you based on your previous treatments and the type of blood cancer you have.

Who should not take it

There are no absolute contraindications listed for selinexor. However, it should not be used in patients who are allergic to selinexor or any of its ingredients.

Caution is advised in patients who are pregnant or may become pregnant, as selinexor can cause harm to an unborn baby. Women of childbearing potential and men with partners of childbearing potential should use effective contraception during treatment and for at least one week after the last dose. Always discuss your full medical history and current medications with your doctor before starting selinexor.

Commonly used with

For multiple myeloma, selinexor is commonly used in combination with:

• Bortezomib (a proteasome inhibitor)
• Dexamethasone (a corticosteroid)

These combinations have been shown to improve treatment outcomes in patients who have previously received other therapies.

Commonly tested with

Selinexor has been tested in clinical trials with other medications commonly used in multiple myeloma, such as bortezomib and dexamethasone. It has also been studied in combination with other anti-cancer agents in various types of blood cancers.

Your doctor will decide the best combination based on your specific situation and previous treatments.