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Integrated safety profile of selinexor in multiple myeloma: experience from 437 patients enrolled in clinical trials.

Publication ,  Journal Article
Gavriatopoulou, M; Chari, A; Chen, C; Bahlis, N; Vogl, DT; Jakubowiak, A; Dingli, D; Cornell, RF; Hofmeister, CC; Siegel, D; Berdeja, JG ...
Published in: Leukemia
September 2020

Selinexor is an oral, small molecule inhibitor of the nuclear export protein exportin 1 with demonstrated activity in hematologic and solid malignancies. Side effects associated with selinexor include nausea, vomiting, fatigue, diarrhea, decreased appetite, weight loss, thrombocytopenia, neutropenia, and hyponatremia. We reviewed 437 patients with multiple myeloma treated with selinexor and assessed the kinetics of adverse events and impact of supportive care measures. Selinexor reduced both platelets and neutrophils over the first cycle of treatment and reached a nadir between 28 and 42 days. Platelet transfusions and thrombopoietin receptor agonists were effective at treating thrombocytopenia, and granulocyte colony stimulating factors were effective at resolving neutropenia. The onset of gastrointestinal side effects (nausea, vomiting, and diarrhea) was most common during the first 1-2 weeks of treatment. Nausea could be mitigated with 5-HT3 antagonists and either neurokinin 1 receptor antagonists, olanzapine, or cannbainoids. Loperamide and bismuth subsalicylate ameliorated diarrhea. The primary constitutional side effects of fatigue and decreased appetite could be managed with methylphenidate, megestrol, cannabinoids or olanzapine, respectively. Hyponatremia was highly responsive to sodium replacement. Selinexor has well-established adverse effects that mainly occur within the first 8 weeks of treatment, are reversible, and respond to supportive care.

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Published In

Leukemia

DOI

EISSN

1476-5551

Publication Date

September 2020

Volume

34

Issue

9

Start / End Page

2430 / 2440

Location

England

Related Subject Headings

  • Triazoles
  • Thrombocytopenia
  • Nausea
  • Multiple Myeloma
  • Middle Aged
  • Male
  • Immunology
  • Hyponatremia
  • Hydrazines
  • Humans
 

Citation

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Gavriatopoulou, M., Chari, A., Chen, C., Bahlis, N., Vogl, D. T., Jakubowiak, A., … Dimopoulos, M. A. (2020). Integrated safety profile of selinexor in multiple myeloma: experience from 437 patients enrolled in clinical trials. Leukemia, 34(9), 2430–2440. https://doi.org/10.1038/s41375-020-0756-6
Gavriatopoulou, Maria, Ajai Chari, Christine Chen, Nizar Bahlis, Dan T. Vogl, Andrzej Jakubowiak, David Dingli, et al. “Integrated safety profile of selinexor in multiple myeloma: experience from 437 patients enrolled in clinical trials.Leukemia 34, no. 9 (September 2020): 2430–40. https://doi.org/10.1038/s41375-020-0756-6.
Gavriatopoulou M, Chari A, Chen C, Bahlis N, Vogl DT, Jakubowiak A, et al. Integrated safety profile of selinexor in multiple myeloma: experience from 437 patients enrolled in clinical trials. Leukemia. 2020 Sep;34(9):2430–40.
Gavriatopoulou, Maria, et al. “Integrated safety profile of selinexor in multiple myeloma: experience from 437 patients enrolled in clinical trials.Leukemia, vol. 34, no. 9, Sept. 2020, pp. 2430–40. Pubmed, doi:10.1038/s41375-020-0756-6.
Gavriatopoulou M, Chari A, Chen C, Bahlis N, Vogl DT, Jakubowiak A, Dingli D, Cornell RF, Hofmeister CC, Siegel D, Berdeja JG, Reece D, White D, Lentzsch S, Gasparetto C, Huff CA, Jagannath S, Baz R, Nooka AK, Richter J, Abonour R, Parker TL, Yee AJ, Moreau P, Lonial S, Tuchman S, Weisel KC, Mohty M, Choquet S, Unger TJ, Li K, Chai Y, Li L, Shah J, Shacham S, Kauffman MG, Dimopoulos MA. Integrated safety profile of selinexor in multiple myeloma: experience from 437 patients enrolled in clinical trials. Leukemia. 2020 Sep;34(9):2430–2440.

Published In

Leukemia

DOI

EISSN

1476-5551

Publication Date

September 2020

Volume

34

Issue

9

Start / End Page

2430 / 2440

Location

England

Related Subject Headings

  • Triazoles
  • Thrombocytopenia
  • Nausea
  • Multiple Myeloma
  • Middle Aged
  • Male
  • Immunology
  • Hyponatremia
  • Hydrazines
  • Humans