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What is Xpovio (selinexor)?

Xpovio® (selinexor) is a “nuclear export inhibitor,” the first medication in this drug class to treat myeloma. Nuclear export inhibitors prevent cancer cells from expelling “tumor suppressor proteins” that help protect the cell from cancer. 

How is Xpovio used and who is a candidate

to receive it?

Xpovio is used in myeloma in both early relapse and late relapse settings. 

In 2019, supported by the results of the phase IIb STORM clinical trial, the U.S. Food and Drug Administration (FDA) approved Xpovio in combination with the steroid dexamethasone (Xd) for the treatment of adult patients with relapsed or refractory disease.

In 2020, supported by the results of the BOSTON phase III clinical trial, the FDA approved Xpovio in combination with Velcade® (bortezomib) and dexamethasone (XVd) for myeloma patients who have received at least one prior therapy.

How is Xpovio taken?

Xpovio is an oral medication in tablet form. Each tablet should be swallowed whole with water. Do not break, chew, crush, or divide the tablets.

Your doctor will monitor your complete blood count (CBC), standard blood chemistry panel, and body weight before you start Xpovio and as needed during treatment.

Prior to and during treatment with Xpovio, you will receive treatment to prevent nausea and vomiting. Be sure to take your anti-nausea medication as a preventive prior to treatment with Xpovio, even if you’re not experiencing nausea. 

It is very important to maintain good intake of food and fluids throughout your treatment with Xpovio.

Possible side effects of Xpovio

Side effects of Xpovio can be prevented or managed well with dose reductions, dose interruptions, or other supportive care. Common side effects include nausea, thrombocytopenia (low level of platelets), fatigue, anemia (low level of red blood cells), decreased appetite, diarrhea, vomiting, hyponatremia (low level of sodium in the blood), neutropenia (low level of neutrophils, a type of white blood cell), lymphopenia (low level of lymphocytes, a type of white blood cell), peripheral neuropathy, hypophosphatemia (low level of phosphorus in the blood), decreased weight, cataract, constipation, dyspnea (shortness of breath), and upper respiratory tract infection.

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