Dr. Hill on the Safety Profile of Selinexor in Relapsed/Refractory DLBCL

Brian T. Hill, MD, PhD, director of the Lymphoid Malignancies Program and staff physician, Taussig Cancer Institute, and assistant professor, Hematology and Oncology, Cleveland Clinic, discusses the safety profile of selinexor (Xpovio) in relapsed/refractory diffuse large B-cell lymphoma (DLBCL).

On June 22, 2020, the FDA approved selinexor for the treatment of patients with relapsed/refractory DLBCL, not otherwise specified, including DLBCL arising from follicular lymphoma, after at least 2 prior lines of systemic therapy.

The approval is based on findings from the phase 2b SADAL trial, in which patients were administered oral selinexor twice weekly at a dose of 60 mg. Early on the study also included 100 mg but was discontinued in 2017, explains Hill.

Regarding safety, common adverse effects that were observed with the 100 mg dose were nausea, anorexia, diarrhea, fatigue, constipation, vomiting, and pyrexia, says Hill. The approval is for the 60 mg dose.

Supportive care measures such as antiemetics and appetite stimulants may alleviate some of these toxicities and allow patients to remain on treatment for extended periods of time, concludes Hill.