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What is Selinexor?

Selinexor is the first in a new family of drugs known as a selective inhibitor of nuclear export compounds. This is used for the treatment of multiple myeloma. 

Multiplemyeloma is cancer that forms in a type of white bloodcell called a plasma cell. Plasma cells help you fight infections by makingantibodies that recognize and attack germs. This condition causes cancer toaccumulate in the bone marrow. It is where they crowd out healthy blood cells.Rather than produce helpful antibodies, the cancer cells produce abnormalproteins that can cause complications. The treatment for this condition is notalways needed for people who are not experiencing any signs or symptoms. Thesigns and symptoms of multiple myeloma can vary and early in the disease, theremay be none, when signs and symptoms do occur, they can be:

  • Nausea
  • Bone pain especially in your spine or chest
  • Loss of appetite
  • Constipation
  • Fatigue
  • Mental fogginess or confusion
  • Frequent infections
  • Weakness or numbness in your legs
  • Weight loss 
  • Excessive thirst 

Doctorsknow that myeloma begins with one abnormal plasma cell in your bone marrow.Bone marrow is the soft, blood-producing tissue that fills in the center ofmost of your bones. The abnormal cell multiplies rapidly. Because cancer cellsdon’t mature and then die as normal cells do, they accumulate, eventuallyoverwhelming the production of healthy cells. In the bone marrow, myeloma cellscrowd out healthy white blood cells and red blood cells. In which it leads tofatigue and an inability to fight infections.

Themyeloma cells continue trying to produce antibodies, as healthy plasma cellsdo. But, the myeloma cells produce abnormal antibodies that the body can’t use.Instead, the abnormal antibodies build up in the body and cause problems suchas damage to the kidneys. Cancer cells can also cause damage to the bones thatincreases the risk of broken bones. 

Complicationsof multiple myeloma include:

  1. Frequentinfections

Myelomacells inhibit your body’s ability to fight infections.

  • Bone problems

Multiplemyeloma can also affect your bones which may lead to bone pain, broken bones,and thinning bones.

  • Reduced kidney function

Multiplemyeloma may cause problems with kidney function including kidney failure.Higher calcium levels in the blood related to eroding bones can interfere withthe ability of your kidney to filter your blood’s waste. The proteins producedby the myeloma cells can cause similar problems.

  • Low red blood cell count (anemia)

Asmyeloma cells crowd out normal blood cells, multiple myeloma can also causeanemia and other blood problems.

How doesit work?

Selinexorblocks the action of a protein called XPO1 within the nucleus of myeloma cells.XPO1 is a protein responsible for moving other proteins between different partsof the cell. 

Cells aremade up of two compartments called the cytoplasm and the nucleus. These areseparated by a plasma membrane. Some proteins involved in the life cycle of thecell, for example, so-called tumor suppressor proteins, are active only whenlocated within the nucleus. Other proteins must be moved from the nucleus intothe cytoplasm to become active. The compartment in which different proteins arelocated can, therefore, affect the growth and survival of the cell. XPO1 is atransport protein responsible for moving proteins out of the nucleus of a cellinto the cytoplasm. One of the characteristics of myeloma cells that make themdifferent from healthy cells is their high level of XPO1, which is essentialfor myeloma cell survival. Myeloma cells use XPO1 to move tumor suppressorproteins from the nucleus into the cytoplasm. This deactivates them and allowsthe myeloma cells to multiply uninhibited. 

How touse Selinexor?

Selinexoris in a tablet form to be taken by mouth. It can be given on its own as amonotherapy. But, it has shown to be most effective when used in combinationwith other myeloma treatments such as dexamethasone. The usual maximum dose ofSelinexor is 80mg twice a week or sometimes 100mg once a week. The dosage isbased on your medical condition, age, and response to the treatment. 

Swallowthe tablets whole with water. Do not break, chew, crush, or split the tablets.Drink plenty of fluids during treatment with this medication unless otherwisedirected by your doctor. Your doctor may direct you to take this medicationonce a week if you have certain side effects. Follow your doctor’s instructionscarefully. If you vomit after taking your dose of the medication, do not takean extra dose. Take the next dose of your medication at a regular time. Do notincrease your dose or use this drug more often or for longer than prescribed.Your condition will not improve any faster, and your risk of serious sideeffects will increase. Let your doctor know right away if your condition doesnot improve or if it gets worse. 


Commonside effects:

  • Fatigue
  • Low blood platelets 
  • Anemia
  • Nausea
  • Weight loss
  • Decreased appetite
  • Vomiting
  • Diarrhea
  • Constipation
  • Low white blood cell counts
  • Low blood sodium
  • Shortness of breath
  • Upper respiratory tract infection 

If youhave the following signs of an allergic reaction, call your doctor or call formedical assistance right away:

  • Hives
  • Difficulty or trouble breathing
  • Swelling of your tongue, lips, throat, or face 


  • Before taking this medication, tell your doctor if you are allergic to it or if you have any other allergies. This may contain inactive ingredients that may cause allergic reactions or other complications. 
  • Inform as well your doctor about the medical history that you had. 
  • This drug can make you more likely to get infections or may worsen any current infections. Avoid contact with people who have infections that may spread to others. Consult your doctor if you have been exposed to an infection or for more details.
  • Do not have any vaccinations or immunizations without the consent of your doctor. Avoid contact with people who recently received live vaccines. 
  • To lower the chance of getting cut, bruised, or injured, use caution with sharp objects like razors and nail cutters, and avoid activities such as contact sports.
  • This can make you dizzy. Avoid doing things that may require your full alertness.