How effective is Selinexor in the treatment of multiple myeloma?

Selinexor is an oral selective nuclear export inhibitor (SINE) that exerts anti-cancer effects by inhibiting the XPO1 protein. It has been approved for the treatment of multiple myeloma (MM), especially in relapsed or refractory cases. It has shown certain efficacy. Its emergence provides new treatment options for patients after failure of traditional treatments (such as proteasome inhibitors, immunomodulators, and monoclonal antibodies).

Clinical studies have shown that selinesol combined with dexamethasone has clear anti-tumor activity in patients who have failed multiple front-line therapies, including bortezomib, lenalidomide and anti-CD38 antibodies. In the STORM trial, this combination treatment achieved an overall response rate (ORR) of approximately 26% in patients with highly refractory multiple myeloma, and some patients achieved disease stabilization or even remission, indicating that it still has therapeutic potential in advanced patients.

In addition, selinesol is also used in combination with other drugs to enhance its efficacy. For example, in the BOSTON study, selinisole was combined with bortezomib and dexamethasone (SVd regimen) to treat relapsed or refractory In patients with refractory multiple myeloma, the results showed that this regimen significantly prolonged progression-free survival (PFS) and improved the overall response rate, which has obvious advantages over traditional bortezomib plus dexamethasone treatment.

However, the use of selinesol is also associated with certain side effects, including nausea, fatigue, decreased appetite, thrombocytopenia, and hyponatremia. These side effects require particular attention in elderly or frail patients. Therefore, the patient's physical condition needs to be closely monitored during use, and dose adjustment or supportive treatment should be performed if necessary. Overall, selinesol provides a new and effective option for late-line treatment of multiple myeloma, especially for relapsed or refractory patients with limited treatment options.

Reference materials:https://www.selincro.com/

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