Indications
Selinex is used together with dexamethasone to treat adults with relapsed or refractory multiple myeloma (RRMM). It is meant for people who have already received at least four prior therapies, and whose disease is refractory to at least two proteasome inhibitors, at least two immunomodulatory agents, and an anti-CD38 monoclonal antibody. This use is approved under accelerated approval, which was based on response rate. Continued approval may depend on a confirmatory trial verifying and describing the clinical benefit.
⚠️ Always consult a registered physician before taking any medicine.
Pharmacology
In nonclinical studies, Selinexor blocks exportin 1 (XPO1), and this reversibly stops the nuclear export of tumor suppressor proteins (TSPs), growth regulators and the mRNAs of oncogenic proteins. When XPO1 is inhibited, TSPs build up in the nucleus. Several oncoproteins, such as c-myc and cyclin D1, are reduced, and the cancer cells go into cell cycle arrest and apoptosis. Selinexor also showed pro-apoptotic activity in vitro in multiplemyeloma cell lines and in patient tumor samples, and in murine xenograft models.
Pregnancy & Breastfeeding
Pregnancy: This is based on findings in animal studies and on how the medicine works. Selinexor can cause harm to the fetus when a pregnant woman takes it. There are no data in pregnant women to show what risk the drug carries. In animal reproduction studies, giving the medicine to pregnant rats during organogenesis caused structural abnormalities and changes in growth, at exposures below those seen clinically at the recommended dose. Pregnant women should be told about the risks to the fetus. The estimated background risk of major birth defects and miscarriage for the indicated population is unknown. All pregnancies have a background risk of birth defect, loss or other adverse outcomes. In the U.S. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2% to 4% and 15% to 20%, respectively. Lactation: There is no information on whether Selinexor or its metabolites are present in human milk, or on their effects on the breastfed child or on milk production. Because a breastfed child could have serious adverse reactions, women should be advised not to breastfeed during treatment with Selinexor and for 1 week after the last dose.
⚠️ Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
Dosage Reference
⚠️ Reference ranges from official sources only. Consult your doctor for personalized dosing.