Selinexor for the treatment of multiple myeloma. (3rd March 2020)

• Record Type: Journal Article
• Authors: Podar, Klaus; Shah, Jatin; Chari, Ajai; Richardson, Paul G; Jagannath, Sundar
• Is Part Of: Expert opinion on pharmacotherapy. Volume 21:Number 4(2020)
• Page Start: 399
• Page End: 408
• Publication Date: 2020-03-03
• Subjects: Multiple myeloma -- exportin-1 -- selective inhibitor of nuclear export (sine) compounds -- penta-refractoriness; Chemotherapy -- Periodicals; 615.5805
• DOI: 10.1080/14656566.2019.1707184
• Languages: English
• ISSNs: 1465-6566

Abstract

ABSTRACT: Introduction : Despite unprecedented advances in the treatment of multiple myeloma (MM), almost all patients develop a disease that is resistant to the five most commonly used and active anti-MM agents. The prognosis for this patient population is particularly poor resulting in an unmet need for additional therapeutic options. Exportin-1 (XPO-1) is a major nuclear export protein of macromolecular cargo frequently overexpressed in MM. Selinexor is a first-in-class, oral Selective-Inhibitor-of-Nuclear-Export (SINE) compound that impedes XPO-1. Based on results of the STORM-trial, selinexor in combination with dexamethasone was granted accelerated FDA approval for patients with penta-refractory MM in July 2019. Areas covered : This article summarizes our up-to-date knowledge on the pathophysiologic role of XPO-1 in MM. Furthermore, it reviews the most recent clinical data on selinexor in combination with dexamethasone and other anti-MM agents; and discusses its safety profile, management strategies; and potential future developments. Expert opinion : Selinexor represents a next-generation-novel agent with an innovative mechanism of action that marks a significant advance in the treatment of heavily pretreated MM patients. Ongoing studies investigate its therapeutic potential also in earlier lines of therapy. Additional data is needed to confirm that selinexor and other SINE compounds are a valuable addition to our current therapeutic armamentarium.