Selinexor
Identification
- Brand Names
- Xpovio 100 Mg Once Weekly Carton
- Generic Name
- Selinexor
- DrugBank Accession Number
- DB11942
- Background
Selinexor is a first-in-class selective inhibitor of nuclear transport (SINE) compound. Selinexor, in combination with bortezomib and dexamethasone, is currently approved for the treatment of multiple myeloma, a type of cancer formed from antibody-producing plasma cells.6,7,11 This condition is typically treated with high dose bortezomib and dexamethasone chemotherapy followed by an autologous stem-cell transplant. Other chemotherapies for multiple myeloma include lenalidomide and dexamethasone, thalidomide, and may include melphalan if the patient is not eligible for transplant.8 Selinexor was also granted accelerated approval for the treatment of adult patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL) that have gone through at least 2 lines of systemic therapy.11
The FDA approved Selinexor in June 2019.11 The use of selinexor in combination with bortezomib and dexamethasone was approved by Health Canada in June 2022 for the treatment of multiple myeloma in adult patients who have received at least one prior therapy.
- Type
- Small Molecule
- Groups
- Approved, Investigational
- Structure
- Weight
- Average: 443.313
Monoisotopic: 443.09292698 - Chemical Formula
- C17H11F6N7O
- Synonyms
- Selinexor
- External IDs
- KPT 330
- KPT-330
Pharmacology
- Indication
Selinexor is indicated in combination with bortezomib and dexamethasone for the treatment of multiple myeloma in adult patients who have received at least one prior therapy. Selinexor is also indicated in combination with dexamethasone for the treatment of relapsed or refractory multiple myeloma in adult patients who have received at least four prior therapies and who are refractory to at least two proteasome inhibitors, two immunomodulatory agents, and an anti-CD38 monoclonal antibody.11
Selinexor is also indicated under an accelerated approval scheme for the treatment of relapsed or refractory diffuse large B-cell lymphoma (DLBCL), not otherwise specified, including that arising from follicular lymphoma, in adult patients who have received at least two prior lines of systemic therapy. Continued approval for this indication may be contingent on verification in confirmatory clinical trials.11
Reduce drug development failure ratesBuild, train, & validate machine-learning modelswith evidence-based and structured datasets.Build, train, & validate predictive machine-learning models with structured datasets.- Associated Conditions
Indication Type Indication Combined Product Details Approval Level Age Group Patient Characteristics Dose Form Used in combination to treat Multiple myeloma (mm) Regimen in combination with: Dexamethasone (DB01234), Bortezomib (DB00188) •••••••••••• ••••• •• ••••• ••• ••••• ••••••• •••••• Used in combination to treat Refractory multiple myeloma Regimen in combination with: Dexamethasone (DB01234) •••••••••••• ••••• •• ••••• • ••••• ••••••••• •••••••••• •••••••••• •• •• ••••• ••• •••••••••• ••••••••••• •• ••••• ••• •••••••••••••••• ••••••• ••• •• ••••••••• •••••••••• •••••••• •••••• Used in combination to treat Relapsed multiple myeloma Regimen in combination with: Dexamethasone (DB01234) •••••••••••• ••••• •••••••••• •• •• ••••• ••• •••••••••• ••••••••••• •• ••••• ••• •••••••••••••••• ••••••• ••• •• ••••••••• •••••••••• ••••••••• •• ••••• • ••••• ••••••••• ••••••••• •••••• Treatment of Refractory diffuse large b-cell lymphoma nos •••••••••••• ••••• •• ••••• ••• ••••• •••••••• ••••••••• •••••• Treatment of Relapsed diffuse large b-cell lymphoma nos •••••••••••• ••••• •• ••••• ••• ••••• •••••••• ••••••••• •••••• - Contraindications & Blackbox Warnings
- Prevent Adverse Drug Events TodayTap into our Clinical API for life-saving information on contraindications & blackbox warnings, population restrictions, harmful risks, & more.Avoid life-threatening adverse drug events with our Clinical API
- Pharmacodynamics
Selinexor causes cell cycle arrest and apoptosis in cancer cells.11
- Mechanism of action
Selinexor binds to and inhibits exportin-1 (XPO1).11 XPO1 is a nuclear exporter protein which contains a pocket to which nuclear proteins can bind. When complexed with these proteins and Ran, activated through guanosine triphosphate (GTP) binding, the XPO1-protein-Ran-GTP complex is able to exit the nucleus through a nuclear pore. Once outside, GTP is hydrolyzed and the complex dissociates.4 The inhibition of this process in cancer cells allows the targets of XPO1, many of which are tumor suppressors, to collect in the nucleus and result in increased transcription of tumor suppressor genes. Tumor suppressor proteins known to be affected by XPO1 inhibition include p53, p73, adenomatous polyposis coli, retinoblastoma, forkhead box protein O, breast cancer 1, nucleophosmin, and merlin. Regulators of cell cycle progression are also affected, namely p21, p27, galectin-3, and Tob. Inhibitor of NFκB also collects in the nucleus as a result leading to reduced activity of NFκB, a known contributor to cancer.4,5 XPO1 participates in the formation of a complex with eukaryotic initiation factor 4E and contributes to the transport of messenger RNA for several oncegenes including cell cycle promotors, cyclin D1, cyclin E, and CDK2/4/6, as well as antiapoptotic proteins, Mcl-1 and Bcl-xL.4 These wide ranging changes in protein expression and gene transcription culminate in cell cycle arrest and the promotion of apoptosis in cancer cells.
Target Actions Organism AExportin-1 inhibitorHumans - Absorption
A single 80 mg dose of selinexor produces a mean Cmax of 680 ng/mL and a mean AUC of 5386 ng*h/mL.Label This relationship is dose proportion over the range of 3-85 mg/m2 which encompasses the range of 0.06-1.8 times the approved dosage. The official FDA labeling reports the Tmax as 4 hours but phase 1 studies have found a range of 2-4 hours.Label,1,2,3 Administering selinexor with food, either a high or low fat meal, results in an increase in the AUC of approximately 15-20% but this is not expected to be clinically significant.2
- Volume of distribution
The mean apparent volume of distribution is 125 L.Label A phase 1 study reported mean apparent volumes of distribution ranging from 1.9-2.9 L/kg in their investigation of food and formulation effects.2
- Protein binding
Selinexor is 95% bound to plasma proteins.Label
- Metabolism
Selinexor is known to be metabolized through CYP3A4, UDP‐glucuronosyltransferases, and glutathione S-transferases although the metabolite profile has yet to be characterized in published literature.Label The primary metabolites found in urine and plasma are glucuronide conjugates.3
- Route of elimination
Not Available
- Half-life
Selinexor has a mean half-life of elimination of 6-8 hours.Label,1,2,3
- Clearance
Selinexor has a mean apparent clearance of 17.9 L/h.Label
- Adverse Effects
- Improve decision support & research outcomesWith structured adverse effects data, including: blackbox warnings, adverse reactions, warning & precautions, & incidence rates. View sample adverse effects data in our new Data Library!Improve decision support & research outcomes with our structured adverse effects data.
- Toxicity
Not Available
- Pathways
- Not Available
- Pharmacogenomic Effects/ADRs Browse all" title="About SNP Mediated Effects/ADRs" id="snp-actions-info" class="drug-info-popup" href="javascript:void(0);">
- Not Available
Interactions
- Drug Interactions Learn More" title="About Drug Interactions" id="structured-interactions-info" class="drug-info-popup" href="javascript:void(0);">
- This information should not be interpreted without the help of a healthcare provider. If you believe you are experiencing an interaction, contact a healthcare provider immediately. The absence of an interaction does not necessarily mean no interactions exist.
Drug Interaction Integrate drug-drug
interactions in your softwareAbametapir The serum concentration of Selinexor can be increased when it is combined with Abametapir. Ambrisentan The excretion of Ambrisentan can be decreased when combined with Selinexor. Ambroxol The risk or severity of methemoglobinemia can be increased when Selinexor is combined with Ambroxol. Amiodarone The metabolism of Selinexor can be decreased when combined with Amiodarone. Amprenavir The metabolism of Selinexor can be decreased when combined with Amprenavir. - Food Interactions
- Take with or without food. Co-administration with food does not affect pharmacokinetics.
Products
- Drug product information from 10+ global regionsOur datasets provide approved product information including:dosage, form, labeller, route of administration, and marketing period.Access drug product information from over 10 global regions.
- Brand Name Prescription Products
Name Dosage Strength Route Labeller Marketing Start Marketing End Region Image Nexpovio Tablet, film coated 20 mg Oral Stemline Therapeutics B.V. 2023-03-15 Not applicable EU Nexpovio Tablet, film coated 20 mg Oral Stemline Therapeutics B.V. 2021-06-01 Not applicable EU Nexpovio Tablet, film coated 20 mg Oral Stemline Therapeutics B.V. 2021-06-01 Not applicable EU Nexpovio Tablet, film coated 20 mg Oral Stemline Therapeutics B.V. 2021-06-01 Not applicable EU Nexpovio Tablet, film coated 20 mg Oral Stemline Therapeutics B.V. 2021-06-01 Not applicable EU
Categories
- ATC Codes
- L01XX66 — Selinexor
- Drug Categories
- Chemical TaxonomyProvided by Classyfire
- Description
- This compound belongs to the class of organic compounds known as phenyl-1,2,4-triazoles. These are organic compounds containing a 1,2,4-triazole substituted by a phenyl group.
- Kingdom
- Organic compounds
- Super Class
- Organoheterocyclic compounds
- Class
- Azoles
- Sub Class
- Triazoles
- Direct Parent
- Phenyl-1,2,4-triazoles
- Alternative Parents
- Trifluoromethylbenzenes / Pyrazines / Imidolactams / Vinylogous amides / Heteroaromatic compounds / Acrylic acids and derivatives / Carboxylic acid hydrazides / Azacyclic compounds / Organonitrogen compounds / Organofluorides show 4 more
- Substituents
- Acrylic acid or derivatives / Alkyl fluoride / Alkyl halide / Aromatic heteromonocyclic compound / Azacycle / Benzenoid / Carbonyl group / Carboxylic acid derivative / Carboxylic acid hydrazide / Heteroaromatic compound show 14 more
- Molecular Framework
- Aromatic heteromonocyclic compounds
- External Descriptors
- Not Available
- Affected organisms
- Not Available
Chemical Identifiers
- UNII
- 31TZ62FO8F
- CAS number
- 1393477-72-9
- InChI Key
- DEVSOMFAQLZNKR-RJRFIUFISA-N
- InChI
- InChI=1S/C17H11F6N7O/c18-16(19,20)11-5-10(6-12(7-11)17(21,22)23)15-26-9-30(29-15)4-1-14(31)28-27-13-8-24-2-3-25-13/h1-9H,(H,25,27)(H,28,31)/b4-1-
- IUPAC Name
- (2Z)-3-{3-[3,5-bis(trifluoromethyl)phenyl]-1H-1,2,4-triazol-1-yl}-N'-(pyrazin-2-yl)prop-2-enehydrazide
- SMILES
- FC(F)(F)C1=CC(=CC(=C1)C1=NN(\C=C/C(=O)NNC2=NC=CN=C2)C=N1)C(F)(F)F
References
- General References
- Alexander TB, Lacayo NJ, Choi JK, Ribeiro RC, Pui CH, Rubnitz JE: Phase I Study of Selinexor, a Selective Inhibitor of Nuclear Export, in Combination With Fludarabine and Cytarabine, in Pediatric Relapsed or Refractory Acute Leukemia. J Clin Oncol. 2016 Dec;34(34):4094-4101. doi: 10.1200/JCO.2016.67.5066. Epub 2016 Oct 31. [Article]
- Gounder MM, Zer A, Tap WD, Salah S, Dickson MA, Gupta AA, Keohan ML, Loong HH, D'Angelo SP, Baker S, Condy M, Nyquist-Schultz K, Tanner L, Erinjeri JP, Jasmine FH, Friedlander S, Carlson R, Unger TJ, Saint-Martin JR, Rashal T, Ellis J, Kauffman M, Shacham S, Schwartz GK, Abdul Razak AR: Phase IB Study of Selinexor, a First-in-Class Inhibitor of Nuclear Export, in Patients With Advanced Refractory Bone or Soft Tissue Sarcoma. J Clin Oncol. 2016 Sep 10;34(26):3166-74. doi: 10.1200/JCO.2016.67.6346. Epub 2016 Jul 25. [Article]
- Abdul Razak AR, Mau-Soerensen M, Gabrail NY, Gerecitano JF, Shields AF, Unger TJ, Saint-Martin JR, Carlson R, Landesman Y, McCauley D, Rashal T, Lassen U, Kim R, Stayner LA, Mirza MR, Kauffman M, Shacham S, Mahipal A: First-in-Class, First-in-Human Phase I Study of Selinexor, a Selective Inhibitor of Nuclear Export, in Patients With Advanced Solid Tumors. J Clin Oncol. 2016 Dec;34(34):4142-4150. doi: 10.1200/JCO.2015.65.3949. Epub 2016 Oct 31. [Article]
- Gandhi UH, Senapedis W, Baloglu E, Unger TJ, Chari A, Vogl D, Cornell RF: Clinical Implications of Targeting XPO1-mediated Nuclear Export in Multiple Myeloma. Clin Lymphoma Myeloma Leuk. 2018 May;18(5):335-345. doi: 10.1016/j.clml.2018.03.003. Epub 2018 Mar 14. [Article]
- Xia Y, Shen S, Verma IM: NF-kappaB, an active player in human cancers. Cancer Immunol Res. 2014 Sep;2(9):823-30. doi: 10.1158/2326-6066.CIR-14-0112. [Article]
- Xpovio FDA Announcement [Link]
- Cancer.ca: Multiple Myeloma [Link]
- BC Cancer Agency: Treatment of Multiple Myeloma [Link]
- Clinical Trials: BOSTON Trial [Link]
- ChemSpider: Selinexor [Link]
- FDA Approved Drug Products: XPOVIO (selinexor) oral tablets [Link]
- Health Canada Approved Drug Products: XPOVIO (selinexor) oral tablets [Link]
- External Links
- PubChem Compound
- 71481097
- PubChem Substance
- 347828269
- ChemSpider
- 32701989
- BindingDB
- 50527778
- 2178390
- ChEMBL
- CHEMBL3545185
- ZINC
- ZINC000096170454
- Wikipedia
- Selinexor
- FDA label
- Download (588 KB)
Clinical Trials
- Clinical Trials Learn More" title="About Clinical Trials" id="clinical-trials-info" class="drug-info-popup" href="javascript:void(0);">
Phase Status Purpose Conditions Count 4 Recruiting Treatment Diffuse Large B-Cell Lymphoma, Not Otherwise Specified 1 3 Active Not Recruiting Treatment Endometrial Cancer 1 3 Active Not Recruiting Treatment Multiple Myeloma (MM) 1 3 Active Not Recruiting Treatment Relapsed/Refractory Multiple Myeloma (RRMM) 1 3 Completed Treatment Cancer / Coronavirus Disease 2019 (COVID‑19) / Viral Respiratory Tract Infection 1
Pharmacoeconomics
- Manufacturers
- Not Available
- Packagers
- Not Available
- Dosage Forms
Form Route Strength Tablet, film coated Oral 20 MG Tablet Oral 20 mg Tablet, film coated Oral 20 mg/1 Tablet, film coated Oral 40 mg/1 Tablet, film coated Oral 50 mg/1 Tablet, film coated Oral 60 mg/1 - Prices
- Not Available
- Patents
Patent Number Pediatric Extension Approved Expires (estimated) Region US9079865 No 2015-07-14 2032-07-26 US US9714226 No 2017-07-25 2032-07-26 US US8999996 No 2015-04-07 2032-09-15 US US10519139 No 2019-12-31 2035-08-14 US US10544108 No 2020-01-28 2032-07-26 US US11034660 No 2021-06-15 2032-07-26 US US11753401 No 2015-08-14 2035-08-14 US US11746102 No 2015-08-14 2035-08-14 US US11787771 No 2012-07-26 2032-07-26 US US11807629 No 2015-08-14 2035-08-14 US
Properties
- State
- Solid
- Experimental Properties
Property Value Source water solubility 20mg/mL ChemSpider: Selinexor - Predicted Properties
Property Value Source Water Solubility 0.00555 mg/mL ALOGPS logP 2.85 ALOGPS logP 3.07 Chemaxon logS -4.9 ALOGPS pKa (Strongest Acidic) 12.18 Chemaxon pKa (Strongest Basic) 1.34 Chemaxon Physiological Charge 0 Chemaxon Hydrogen Acceptor Count 6 Chemaxon Hydrogen Donor Count 2 Chemaxon Polar Surface Area 97.62 Å2 Chemaxon Rotatable Bond Count 7 Chemaxon Refractivity 120 m3·mol-1 Chemaxon Polarizability 35.61 Å3 Chemaxon Number of Rings 3 Chemaxon Bioavailability 1 Chemaxon Rule of Five Yes Chemaxon Ghose Filter Yes Chemaxon Veber's Rule No Chemaxon MDDR-like Rule Yes Chemaxon - Predicted ADMET Features
- Not Available
Spectra
- Mass Spec (NIST)
- Not Available
- Spectra
Spectrum Spectrum Type Splash Key Predicted MS/MS Spectrum - 10V, Positive (Annotated) Predicted LC-MS/MS splash10-0006-0002900000-8e23a1394d55353e6660 Predicted MS/MS Spectrum - 20V, Positive (Annotated) Predicted LC-MS/MS splash10-00dr-0005900000-1069fe3aa637e33b7045 Predicted MS/MS Spectrum - 10V, Negative (Annotated) Predicted LC-MS/MS splash10-004r-6902200000-a2b99db1794901725c80 Predicted MS/MS Spectrum - 40V, Positive (Annotated) Predicted LC-MS/MS splash10-05mo-0269100000-c462a8d9ccd104ef3156 Predicted MS/MS Spectrum - 20V, Negative (Annotated) Predicted LC-MS/MS splash10-053r-0019000000-22001ab8c6a27194f087 Predicted MS/MS Spectrum - 40V, Negative (Annotated) Predicted LC-MS/MS splash10-000f-7193000000-736af70485761a88ead0 Predicted 1H NMR Spectrum 1D NMR Not Applicable Predicted 13C NMR Spectrum 1D NMR Not Applicable - Chromatographic Properties
Collision Cross Sections (CCS)
Adduct CCS Value (Å2) Source type Source [M-H]- 187.09317 predictedDeepCCS 1.0 (2019) [M+H]+ 189.48874 predictedDeepCCS 1.0 (2019) [M+Na]+ 195.40126 predictedDeepCCS 1.0 (2019)
Targets
- Kind
- Protein
- Organism
- Humans
- Pharmacological action
- Yes
- Actions
- Inhibitor
- General Function
- Mediates the nuclear export of cellular proteins (cargos) bearing a leucine-rich nuclear export signal (NES) and of RNAs. In the nucleus, in association with RANBP3, binds cooperatively to the NES on its target protein and to the GTPase RAN in its active GTP-bound form (Ran-GTP). Docking of this complex to the nuclear pore complex (NPC) is mediated through binding to nucleoporins. Upon transit of a nuclear export complex into the cytoplasm, disassembling of the complex and hydrolysis of Ran-GTP to Ran-GDP (induced by RANBP1 and RANGAP1, respectively) cause release of the cargo from the export receptor. The directionality of nuclear export is thought to be conferred by an asymmetric distribution of the GTP- and GDP-bound forms of Ran between the cytoplasm and nucleus. Involved in U3 snoRNA transport from Cajal bodies to nucleoli. Binds to late precursor U3 snoRNA bearing a TMG cap.
- Specific Function
- Nuclear export signal receptor activity
- Gene Name
- XPO1
- Uniprot ID
- O14980
- Uniprot Name
- Exportin-1
- Molecular Weight
- 123384.98 Da
Enzymes
- Kind
- Protein
- Organism
- Humans
- Pharmacological action
- Unknown
- Actions
- Substrate
- General Function
- Vitamin d3 25-hydroxylase activity
- Specific Function
- Cytochromes P450 are a group of heme-thiolate monooxygenases. In liver microsomes, this enzyme is involved in an NADPH-dependent electron transport pathway. It performs a variety of oxidation react...
- Gene Name
- CYP3A4
- Uniprot ID
- P08684
- Uniprot Name
- Cytochrome P450 3A4
- Molecular Weight
- 57342.67 Da
Transporters
- Kind
- Protein
- Organism
- Humans
- Pharmacological action
- Unknown
- Actions
- Inhibitor
- General Function
- Sodium-independent organic anion transmembrane transporter activity
- Specific Function
- Mediates the Na(+)-independent uptake of organic anions such as 17-beta-glucuronosyl estradiol, taurocholate, triiodothyronine (T3), leukotriene C4, dehydroepiandrosterone sulfate (DHEAS), methotre...
- Gene Name
- SLCO1B3
- Uniprot ID
- Q9NPD5
- Uniprot Name
- Solute carrier organic anion transporter family member 1B3
- Molecular Weight
- 77402.175 Da
Drug created at October 20, 2016 21:03 / Updated at December 01, 2022 11:27