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Generic Name: selinexor

Trade Name: Xpovio™

How is Xpovio used? Xpovio in combination with dexamethasone is approved to treat adults with relapsed or refractory multiple myeloma who have received at least four prior therapies and are refractory to at least two proteasome inhibitors and at least two immunomodulatory agents and an anti-CD38 monoclonal antibody.

What is the mechanism of action? Xpovio is a nuclear export inhibitor. Xpovio works by binding with and inhibiting the nuclear export protein XPO1 which is through to increase tumor suppressor proteins and lead to cancer cell death while largely sparing normal cells.

How is Xpovio given (administered)? Xpovio is taken orally with dexamethasone on days 1 and 3 of each week. Xpovio should be swallowed whole with water. If a dose is missed or if you vomit after Xpovio, talk to your doctor.

How are patients monitored? Patients will usually have scheduled meetings with their healthcare provider while they are being treated with Xpovio. Typically, blood will be drawn to check levels of blood cells and platelets and to monitor functions of some organ systems, such as the kidney or liver. Patients will also be monitored for gastrointestinal toxicities, infections, neurological toxicity and sodium levels. Patients may also undergo physical examinations, scans or other measures to assess side effects and response to therapy.

What are the most common side effects of treatment with Xpovio?

  • Decrease in platelets (thrombocytopenia)
  • Fatigue
  • Nausea
  • Decrease in red blood cells (anemia)
  • Decreased appetite
  • Decreased weight
  • Diarrhea
  • Vomiting
  • Low levels of sodium (hyponatremia)
  • Decrease in white blood cells (neutropenia)
  • Decrease in leukocytes (leukopenia)
  • Constipation
  • Shortness of breath
  • Upper respiratory tract infection

This is not a complete list of side effects. Some patients may experience other side effects that are not listed here. Patients may wish to discuss with their physician the other less common side effects of this drug, some of which may be serious.

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Some side effects may require medical attention. Other side effects do not require medical attention and may go away during treatment. Patients should check with their physician about any side effects that continue or are bothersome.

What can patients do to help alleviate or prevent discomfort and side effects?

  • Pay careful attention to your healthcare provider’s instructions and inform your doctor of any side effects.
  • Take Xpovio exactly as prescribed.
  • Maintain adequate rest, nutrition and hydration.

Are there any special precautions patients should be aware of before starting treatment?

  • Patients should inform their physician about all medical conditions including bleeding problems or recent or active infections.
  • Patients should inform their physician of any other medication or supplement they are taking (whether prescription or over-the-counter).
  • Patients should inform their physician if they are pregnant, breastfeeding, or planning a family in the near future. Xpovio can harm an unborn baby.

When should patients notify their physician?

Tell your doctor if you experience any side effects that bother you or don’t go away. Also tell your doctor if you experience any of the following: persistent nausea, vomiting, diarrhea or signs of infections.

What is a package insert?

A package insert is required by the FDA and contains a summary of the essential scientific information needed for the safe and effective use of the drug for healthcare providers and consumers. A package insert typically includes information regarding specific indications, administration schedules, dosing, side effects, contraindications, results from some clinical trials, chemical structure, pharmacokinetics and metabolism of the specific drug. By carefully reviewing the package insert, you will get the most complete and current information about how to safely use this drug. If you do not have the package insert for the drug you are using, your pharmacist or physician may be able to provide you with a copy.

Last updated on 8/25/2019.