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

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Associated Conditions
Indication TypeIndicationCombined Product DetailsApproval LevelAge GroupPatient CharacteristicsDose Form
Used in combination to treatMultiple myeloma (mm)Regimen in combination with: Dexamethasone (DB01234), Bortezomib (DB00188)••••••••••••••••••• ••••• ••• ••••• •••••••••••••
Used in combination to treatRefractory multiple myelomaRegimen in combination with: Dexamethasone (DB01234)••••••••••••••••••• ••••• • ••••• ••••••••• •••••••••• •••••••••• •• •• ••••• ••• •••••••••• ••••••••••• •• ••••• ••• •••••••••••••••• ••••••• ••• •• ••••••••• •••••••••• ••••••••••••••
Used in combination to treatRelapsed multiple myelomaRegimen in combination with: Dexamethasone (DB01234)••••••••••••••••••••••••••• •• •• ••••• ••• •••••••••• ••••••••••• •• ••••• ••• •••••••••••••••• ••••••• ••• •• ••••••••• •••••••••• ••••••••• •• ••••• • ••••• ••••••••• •••••••••••••••
Treatment ofRefractory diffuse large b-cell lymphoma nos••••••••••••••••••• ••••• ••• ••••• •••••••• •••••••••••••••
Treatment ofRelapsed diffuse large b-cell lymphoma nos••••••••••••••••••• ••••• ••• ••••• •••••••• •••••••••••••••
Contraindications & Blackbox Warnings
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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.

TargetActionsOrganism
AExportin-1
inhibitor
Humans
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
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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.
DrugInteraction
AbametapirThe serum concentration of Selinexor can be increased when it is combined with Abametapir.
AmbrisentanThe excretion of Ambrisentan can be decreased when combined with Selinexor.
AmbroxolThe risk or severity of methemoglobinemia can be increased when Selinexor is combined with Ambroxol.
AmiodaroneThe metabolism of Selinexor can be decreased when combined with Amiodarone.
AmprenavirThe 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

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Brand Name Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing EndRegionImage
NexpovioTablet, film coated20 mgOralStemline Therapeutics B.V.2023-03-15Not applicableEU flag
NexpovioTablet, film coated20 mgOralStemline Therapeutics B.V.2021-06-01Not applicableEU flag
NexpovioTablet, film coated20 mgOralStemline Therapeutics B.V.2021-06-01Not applicableEU flag
NexpovioTablet, film coated20 mgOralStemline Therapeutics B.V.2021-06-01Not applicableEU flag
NexpovioTablet, film coated20 mgOralStemline Therapeutics B.V.2021-06-01Not applicableEU flag

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
  1. 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]
  2. 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]
  3. 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]
  4. 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]
  5. 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]
  6. Xpovio FDA Announcement [Link]
  7. Cancer.ca: Multiple Myeloma [Link]
  8. BC Cancer Agency: Treatment of Multiple Myeloma [Link]
  9. Clinical Trials: BOSTON Trial [Link]
  10. ChemSpider: Selinexor [Link]
  11. FDA Approved Drug Products: XPOVIO (selinexor) oral tablets [Link]
  12. Health Canada Approved Drug Products: XPOVIO (selinexor) oral tablets [Link]
PubChem Compound
71481097
PubChem Substance
347828269
ChemSpider
32701989
BindingDB
50527778
RxNav
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);">
PhaseStatusPurposeConditionsCount
4RecruitingTreatmentDiffuse Large B-Cell Lymphoma, Not Otherwise Specified1
3Active Not RecruitingTreatmentEndometrial Cancer1
3Active Not RecruitingTreatmentMultiple Myeloma (MM)1
3Active Not RecruitingTreatmentRelapsed/Refractory Multiple Myeloma (RRMM)1
3CompletedTreatmentCancer / Coronavirus Disease 2019 (COVID‑19) / Viral Respiratory Tract Infection1

Pharmacoeconomics

Manufacturers
Not Available
Packagers
Not Available
Dosage Forms
FormRouteStrength
Tablet, film coatedOral20 MG
TabletOral20 mg
Tablet, film coatedOral20 mg/1
Tablet, film coatedOral40 mg/1
Tablet, film coatedOral50 mg/1
Tablet, film coatedOral60 mg/1
Prices
Not Available
Patents
Patent NumberPediatric ExtensionApprovedExpires (estimated)Region
US9079865No2015-07-142032-07-26US flag
US9714226No2017-07-252032-07-26US flag
US8999996No2015-04-072032-09-15US flag
US10519139No2019-12-312035-08-14US flag
US10544108No2020-01-282032-07-26US flag
US11034660No2021-06-152032-07-26US flag
US11753401No2015-08-142035-08-14US flag
US11746102No2015-08-142035-08-14US flag
US11787771No2012-07-262032-07-26US flag
US11807629No2015-08-142035-08-14US flag

Properties

State
Solid
Experimental Properties
PropertyValueSource
water solubility20mg/mLChemSpider: Selinexor
Predicted Properties
PropertyValueSource
Water Solubility0.00555 mg/mLALOGPS
logP2.85ALOGPS
logP3.07Chemaxon
logS-4.9ALOGPS
pKa (Strongest Acidic)12.18Chemaxon
pKa (Strongest Basic)1.34Chemaxon
Physiological Charge0Chemaxon
Hydrogen Acceptor Count6Chemaxon
Hydrogen Donor Count2Chemaxon
Polar Surface Area97.62 Å2Chemaxon
Rotatable Bond Count7Chemaxon
Refractivity120 m3·mol-1Chemaxon
Polarizability35.61 Å3Chemaxon
Number of Rings3Chemaxon
Bioavailability1Chemaxon
Rule of FiveYesChemaxon
Ghose FilterYesChemaxon
Veber's RuleNoChemaxon
MDDR-like RuleYesChemaxon
Predicted ADMET Features
Not Available

Spectra

Mass Spec (NIST)
Not Available
Spectra
SpectrumSpectrum TypeSplash Key
Predicted MS/MS Spectrum - 10V, Positive (Annotated)Predicted LC-MS/MSsplash10-0006-0002900000-8e23a1394d55353e6660
Predicted MS/MS Spectrum - 20V, Positive (Annotated)Predicted LC-MS/MSsplash10-00dr-0005900000-1069fe3aa637e33b7045
Predicted MS/MS Spectrum - 10V, Negative (Annotated)Predicted LC-MS/MSsplash10-004r-6902200000-a2b99db1794901725c80
Predicted MS/MS Spectrum - 40V, Positive (Annotated)Predicted LC-MS/MSsplash10-05mo-0269100000-c462a8d9ccd104ef3156
Predicted MS/MS Spectrum - 20V, Negative (Annotated)Predicted LC-MS/MSsplash10-053r-0019000000-22001ab8c6a27194f087
Predicted MS/MS Spectrum - 40V, Negative (Annotated)Predicted LC-MS/MSsplash10-000f-7193000000-736af70485761a88ead0
Predicted 1H NMR Spectrum1D NMRNot Applicable
Predicted 13C NMR Spectrum1D NMRNot Applicable
Chromatographic Properties
Collision Cross Sections (CCS)
AdductCCS Value (Å2)Source typeSource
[M-H]-187.09317
predicted
DeepCCS 1.0 (2019)
[M+H]+189.48874
predicted
DeepCCS 1.0 (2019)
[M+Na]+195.40126
predicted
DeepCCS 1.0 (2019)

Targets

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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