Selinexor for the treatment of multiple myeloma

Klaus Podar, Jatin Shah, Ajai Chari, Paul G Richardson, Sundar Jagannath

Research output: Journal article (peer-reviewed)Review article

43 Citations (Scopus)


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.

Original languageEnglish
Pages (from-to)399-408
Number of pages10
JournalExpert Opinion on Pharmacotherapy
Issue number4
Publication statusPublished - 03 Mar 2020


  • Active Transport, Cell Nucleus/drug effects
  • Antineoplastic Combined Chemotherapy Protocols/administration & dosage
  • Cell Line, Tumor
  • Cell Nucleus/drug effects
  • Clinical Trials as Topic
  • Dexamethasone/therapeutic use
  • Drug Evaluation, Preclinical
  • Humans
  • Hydrazines/administration & dosage
  • Karyopherins/antagonists & inhibitors
  • Multiple Myeloma/drug therapy
  • Prognosis
  • Receptors, Cytoplasmic and Nuclear/antagonists & inhibitors
  • Triazoles/administration & dosage
  • Multiple myeloma
  • selective inhibitor of nuclear export (sine) compounds
  • penta-refractoriness
  • exportin-1

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Pharmacology


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