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- Prescribing Information
This site is intended for US healthcare professionals only.
Results from the XVd trial
XPOVIO + Vd demonstrated an early and sustained PFS benefit vs Vd1 *
mPFS in the XVd trial1
46% increased median PFS compared with Vd1*
30% reduction in risk of progression or death1†
HR, 0.70 (95% Cl, 0.53-0.93; P=0.0075)
- XPOVIO + Vd met its primary endpoint (PFS) and select secondary endpoints (improved ORR, improved VGPR rate or above, and lower rate of grade ≥2 peripheral neuropathy) when compared with Vd1
*Efficacy results are from topline data analysis unless otherwise noted.
†Median follow-up of 15.1 months.
Efficacy observed in multiple subgroups, including patients with prior daratumumab exposure and no prior PI exposure2,3
mPFS in selected subgroups in the XVd trial2,3
Limitations of subgroup analyses:
- These subgroup analyses were exploratory in nature, not included in the study objectives, and do not control for type 1 error
- These subgroup analyses were not powered or adjusted for multiplicity to assess ORR across these subgroups
*XVd arm: 95% Cl, 2.86, NE. Vd arm: 95% Cl, 0.69, NE.
†XVd arm: 95% Cl, 7.95, NE. Vd arm: 95% Cl, 5.75-11.89. Includes any of del(17p)/p53, t(14;16), t(4;14), tq21.
‡XVd arm: 95% Cl, 7.95, NE. Vd arm: 95% Cl, 5.09-14.13.
§XVd arm: 95% Cl, 12.91, NE. Vd arm: 95% Cl, 7.26-12.55.
‖XVd arm: 95% Cl, 27.50, NE. Vd arm: 95% Cl, 8.44-23.69. These subgroup data are derived from an updated efficacy analysis from the XVd trial.
View patient profiles
See why XPOVIO + Vd could be right for patients like Michelle, who has been triple-class exposed and recently relapsed.
3 out of 4 patients experienced a response to XPOVIO + Vd1
ORR was consistent across select subgroups
Including those with high-risk cytogenetics, renal insufficiency, age ≥65 years, and prior anti-CD38 mAb treatment2-4
Limitations of subgroup analyses:
- These subgroup analyses were exploratory in nature, not included in the study objectives, and do not control for type 1 error
- These subgroup analyses were not powered or adjusted for multiplicity to assess ORR across these subgroups
*Includes any of del(17p)/p53, t(14;16), t(4;14), tq21.
†These subgroup data are derived from an updated efficacy analysis from the XVd trial.
View patient profiles
See why XPOVIO + Vd could be right for patients like Joseph, who have high-risk cytogenetics and progressed after an anti-CD38 mAb.
Response to XPOVIO + Vd was durable—the median DOR among responding patients was more than 20 months1
Median DOR in the XVd trial1,5
once-weekly XPOVIO + Vd
(95% Cl, 12.55, NE)
twice-weekly Vd
(95% Cl, 9.26-15.77)
Among patients who received XPOVIO + Vd, the median duration of XPOVIO treatment was 29 weeks (range, 1-120 weeks), and the median dose was 80 mg (range, 30-137 mg) per week.1
Click here to see data from the Xd phase 2 trial.
Abbreviations: AR, adverse reaction; CR, complete response; HR, hazard ratio; mAb, monoclonal antibody; mPFS, median progression-free survival; NE, not evaluable; ORR, overall response rate; PFS, progression-free survival; PR, partial response; RRMM, relapsed or refractory multiple myeloma; sCR, stringent complete response; Vd, bortezomib and dexamethasone; VGPR, very good partial response; XVd, selinexor, bortezomib, and dexamethasone.
References: 1. XPOVIO (selinexor) [prescribing information]. Newton, MA. Karyopharm Therapeutics, Inc. 2. Data on file [1]. Karyopharm Therapeutics Inc. 2023. 3. Data on file [2]. Karyopharm Therapeutics Inc. 2023. 4. Data on file [3]. Karyopharm Therapeutics Inc. 2023. 5. Data on file [4]. Karyopharm Therapeutics Inc. 2023.
INDICATION
XPOVIO® (selinexor) is a prescription medicine approved in combination with bortezomib and dexamethasone (XVd) to treat adult patients with multiple myeloma who have received at least one prior therapy.
IMPORTANT SAFETY INFORMATION
Thrombocytopenia: XPOVIO can cause life-threatening thrombocytopenia, potentially leading to hemorrhage. Thrombocytopenia was reported in patients with multiple myeloma.
Thrombocytopenia is the leading cause of dosage modifications. Monitor platelet counts at baseline and throughout treatment. Monitor more frequently during the first 3 months of treatment. Monitor patients for signs and symptoms of bleeding. Interrupt, reduce dose, or permanently discontinue based on severity of adverse reaction.
Neutropenia: XPOVIO can cause life-threatening neutropenia, potentially increasing the risk of infection.
Monitor more frequently during the first 3 months of treatment. Consider supportive measures, including antimicrobials and growth factors (e.g., G-CSF). Interrupt, reduce dose, or permanently discontinue based on severity of adverse reaction.
Gastrointestinal Toxicity: XPOVIO can cause severe gastrointestinal toxicities in patients.
Nausea/Vomiting/Diarrhea: Provide prophylactic antiemetics or treatment as needed.
Anorexia/Weight Loss: Monitor weight, nutritional status, and volume status at baseline and throughout treatment and provide nutritional support, fluids, and electrolyte repletion as clinically indicated.
Hyponatremia: XPOVIO can cause severe or life-threatening hyponatremia.
Monitor sodium level at baseline and throughout treatment.
Serious Infection: XPOVIO can cause serious and fatal infections. Atypical infections reported after taking XPOVIO include, but are not limited to, fungal pneumonia and herpesvirus infection.
Neurological Toxicity: XPOVIO can cause life-threatening neurological toxicities.
Coadministration of XPOVIO with other products that cause dizziness or mental status changes may increase the risk of neurological toxicity.
Advise patients to refrain from driving and engaging in hazardous occupations or activities, until the neurological toxicity fully resolves. Institute fall precautions as appropriate.
Embryo-Fetal Toxicity: XPOVIO can cause fetal harm when administered to a pregnant woman.
Advise pregnant women of the potential risk to a fetus. Advise females of reproductive potential and males with a female partner of reproductive potential to use effective contraception during treatment with XPOVIO and for 1 week after the last dose.
Cataracts: New onset or exacerbation of cataract has occurred during treatment with XPOVIO. The incidence of new onset or worsening cataract requiring clinical intervention was reported.
ADVERSE REACTIONS
The most common adverse reactions (ARs) (≥20%) in patients with multiple myeloma who received XVd were fatigue, nausea, decreased appetite, diarrhea, peripheral neuropathy, upper respiratory tract infection, decreased weight, cataract, and vomiting.
Grade 3-4 laboratory abnormalities (≥10%) were thrombocytopenia, lymphopenia, hypophosphatemia, anemia, hyponatremia and neutropenia.
Fatal ARs occurred in 6% of patients within 30 days of last treatment. Serious ARs occurred in 52% of patients. Treatment discontinuation rate due to ARs was 19%. The most frequent ARs requiring permanent discontinuation in >2% of patients included fatigue, nausea, thrombocytopenia, decreased appetite, peripheral neuropathy and vomiting. Adverse reactions led to XPOVIO dose interruption in 83% of patients and dose reduction in 64% of patients.
USE IN SPECIFIC POPULATIONS
No overall difference in effectiveness of XPOVIO was observed in patients >65 years old when compared with younger patients. Patients ≥65 years old had a higher incidence of discontinuation due to an adverse reaction (AR) and a higher incidence of serious ARs than younger patients.
The effect of end-stage renal disease (CLCR <15 mL/min) or hemodialysis on XPOVIO pharmacokinetics is unknown.
Please see full Prescribing Information.
To report SUSPECTED ADVERSE REACTIONS, contact Karyopharm Therapeutics Inc. at 1-888-209-9326 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.
© 2023 Karyopharm Therapeutics Inc.
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