# Selinexor

Source: https://onco.cc/drugs/selinexor/  
OnCo record `selinexor` (Treatment). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Selinexor is a first-in-class pill that traps tumour-suppressor proteins inside the nucleus; approved in myeloma, it failed its endometrial cancer test in 2026.

## Summary

Approved 2019 (penta-refractory myeloma with dexamethasone), 2020 (DLBCL; with bortezomib in myeloma, BOSTON). In endometrial cancer, SIENDO (2022) missed its primary endpoint but a TP53-wild-type subgroup showed a large PFS difference; the confirmatory XPORT-EC-042 missed its primary endpoint in July 2026. Nausea, fatigue, weight loss, and thrombocytopenia limit tolerability.

## Fields

- Kind: Treatment
- Status: approved
- Last checked: 2026-09-07
- Brand: Xpovio
- Code: KPT-330
- Modality: Small-molecule XPO1 (nuclear export) inhibitor
- Mechanism: Covalent inhibitor of exportin-1 (XPO1/CRM1), retaining p53, RB, FOXO, and other tumour suppressors in the nucleus and reducing oncoprotein translation.
- Approvals: US 2019: Relapsed/refractory multiple myeloma (≥4 lines) with dexamethasone; US 2020: Relapsed/refractory DLBCL; myeloma with bortezomib after ≥1 line; EU 2021: EU brand Nexpovio
- Dosing: Oral; 80 mg weekly with dexamethasone (myeloma); 60 mg weekly (endometrial trials)
- Toxicity (grade 3+): Nausea 10%; Thrombocytopenia 9%; Fatigue 9%

## Sources

- Wikipedia: https://en.wikipedia.org/wiki/Selinexor
- FDA label (DailyMed): https://dailymed.nlm.nih.gov/dailymed/search.cfm?query=Selinexor

## Connected records

- cancers: [Diffuse large B-cell lymphoma](https://onco.cc/cancers/dlbcl/), [Endometrial cancer](https://onco.cc/cancers/endometrial/), [Endometrial cancer with no specific molecular profile](https://onco.cc/cancers/endometrial-nsmp/), [Multiple myeloma](https://onco.cc/cancers/multiple-myeloma/), [Plasma cell leukaemia](https://onco.cc/cancers/plasma-cell-leukaemia/), [Primary myelofibrosis](https://onco.cc/cancers/primary-myelofibrosis/), [Relapsed or refractory multiple myeloma](https://onco.cc/cancers/myeloma-relapsed-refractory/)
- technologies: [Small-molecule kinase inhibitors](https://onco.cc/technologies/kinase-inhibitors/)
- targets: [Exportin-1 (XPO1)](https://onco.cc/targets/xpo1/), [TP53](https://onco.cc/targets/tp53/)
- companies: [Antengene](https://onco.cc/companies/antengene/), [Karyopharm Therapeutics](https://onco.cc/companies/karyopharm/)
- trials: [A Study of Rituximab-Gemcitabine-Dexamethasone-Platinum (R-GDP) With or Without Selinexor in Patients With Relapsed/Refractory Diffuse Large B-cell Ly](https://onco.cc/trials/nct04442022/), [A Study of Selinexor (Seli) + Low-dose Dexamethasone (LDD) in Penta-refractory Multiple Myeloma (MM), Seli and Bortezomib + LDD in Triple-class Refrac](https://onco.cc/trials/nct04414475/), [Selinexor (KPT-330) in Patients With Relapsed/Refractory Diffuse Large B-Cell Lymphoma (DLBCL)](https://onco.cc/trials/nct02227251/), [Selinexor & Talazoparib in Advanced Refractory Solid Tumors; Advanced/Metastatic Triple Negative Breast Cancer (START)](https://onco.cc/trials/nct05035745/), [Selinexor and Backbone Treatments of Multiple Myeloma Patients](https://onco.cc/trials/nct02343042/), [Study Assessing Activity of Intravenous (IV) Etentamig Monotherapy Versus Standard Available Therapies in Adult Participants With Relapsed or Refracto](https://onco.cc/trials/nct06158841/), [Study of Selinexor in Combination With Ruxolitinib in Myelofibrosis](https://onco.cc/trials/nct04562389/), [Study of Selinexor Plus DRd for Newly Diagnosed Multiple Myeloma](https://onco.cc/trials/nct04782687/), [Using Tumor Models to Determine Treatments](https://onco.cc/trials/nct06813079/), [XPORT-EC-042 / ENGOT-EN20 / GOG-3083](https://onco.cc/trials/xport-ec-042/)

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