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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.
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.
Covalent inhibitor of exportin-1 (XPO1/CRM1), retaining p53, RB, FOXO, and other tumour suppressors in the nucleus and reducing oncoprotein translation. Connects to TP53.
1.Binds XPO1 in the nuclear pore complex
Oral, self-administered, so it is a Part D drug: covered through a stand-alone Part D plan or Medicare Advantage drug benefit, usually on the specialty tier with 25 to 33% coinsurance until the annual cap ($2,000 in 2025, $2,100 in 2026).
Covered for FDA-labelled and NCCN-listed uses, but almost always behind prior authorisation confirming diagnosis, biomarker and line of therapy; dispensed through a specialty pharmacy.
Part D out-of-pocket capped at $2,000 (2025) / $2,100 (2026). Medicare patients cannot use manufacturer co-pay cards; charity funds (PAN, HealthWell, CancerCare) and the Extra Help subsidy are the routes.
Sources: Medicare.gov: Drug coverage (Part D) · Medicare.gov: Costs for Medicare drug coverage (annual out-of-pocket cap). Not medical or financial advice; verify with your plan.
Sources: NICE TA970. Funding decisions are indication-specific and change monthly; verify with NICE and your treating team.
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In combination with dexamethasone for adults with relapsed/refractory multiple myeloma after at least 4 prior therapies and refractory to at least 2 proteasome inhibitors, 2 immunomodulatory agents, and an anti-CD38 monoclonal antibody
Accelerated approval on a surrogate endpoint, with a confirmatory trial required.
Treatment of adult patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL), not otherwise specified, including DLBCL arising from follicular lymphoma (FL), after at least 2 lines of systemic therapy.
Accelerated approval on a surrogate endpoint, with a confirmatory trial required. source
In combination with dexamethasone for adults with relapsed/refractory multiple myeloma after at least 4 prior therapies and refractory to at least 2 proteasome inhibitors, 2 immunomodulatory agents, and an anti-CD38 monoclonal antibody
Confirmed: the accelerated approval of 2019 converted to traditional approval 1.5 years after it was granted.
Treatment of adult patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL), not otherwise specified, including DLBCL arising from follicular lymphoma (FL), after at least 2 lines of systemic therapy.
Withdrawn: the indication came off the label 5.9 years after its accelerated approval. source
XPORT-EC-042 misses primary endpoint; endometrial development deprioritised source
| Region | Year | Indication |
|---|---|---|
| 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 · Conditional marketing authorisation |
| Adverse event | Any grade | Grade 3+ |
|---|---|---|
| Nausea | 84% | 10% |
| Thrombocytopenia | 43% | 9% |
| Fatigue | 49% | 9% |
SIENDO selinexor arm. Events listed without rates were not read from a primary source; see the label. Blank cells mean the figure was not sourced, not that it is zero.
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Query for this drug: (TITLE:"Selinexor" OR ABSTRACT:"Selinexor" OR TITLE:"Xpovio" OR ABSTRACT:"Xpovio" OR TITLE:"KPT-330" OR ABSTRACT:"KPT-330") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Selinexor, not a curated reading list.
Shares Study Assessing Activity of Intravenous (IV) Etentamig Monotherapy Versus Standard Available Therapies in Adult Participants With Relapsed or Refracto, Plasma cell leukaemia, Relapsed or refractory multiple myeloma, Multiple myeloma.
Shares Selinexor and Backbone Treatments of Multiple Myeloma Patients, Study Assessing Activity of Intravenous (IV) Etentamig Monotherapy Versus Standard Available Therapies in Adult Participants With Relapsed or Refracto, Plasma cell leukaemia, Relapsed or refractory multiple myeloma.
Shares Plasma cell leukaemia, TP53, Multiple myeloma.
Shares Plasma cell leukaemia, Relapsed or refractory multiple myeloma, Multiple myeloma.
Shares Relapsed or refractory multiple myeloma, Multiple myeloma, Small-molecule kinase inhibitors.
Shares A Study of Selinexor (Seli) + Low-dose Dexamethasone (LDD) in Penta-refractory Multiple Myeloma (MM), Seli and Bortezomib + LDD in Triple-class Refrac, Selinexor and Backbone Treatments of Multiple Myeloma Patients, Study Assessing Activity of Intravenous (IV) Etentamig Monotherapy Versus Standard Available Therapies in Adult Participants With Relapsed or Refracto, Plasma cell leukaemia.
Shares Plasma cell leukaemia, Relapsed or refractory multiple myeloma.
Shares Endometrial cancer with no specific molecular profile, Endometrial cancer, Small-molecule kinase inhibitors.