@article{3077561,
    title = "Integrated safety profile of selinexor in multiple myeloma: experience from 437 patients enrolled in clinical trials",
    author = "Gavriatopoulou, M. and Chari, A. and Chen, C. and Bahlis, N. and Vogl, D.T. and Jakubowiak, A. and Dingli, D. and Cornell, R.F. and Hofmeister, C.C. and Siegel, D. and Berdeja, J.G. and Reece, D. and White, D. and Lentzsch, S. and Gasparetto, C. and Huff, C.A. and Jagannath, S. and Baz, R. and Nooka, A.K. and Richter, J. and Abonour, R. and Parker, T.L. and Yee, A.J. and Moreau, P. and Lonial, S. and Tuchman, S. and Weisel, K.C. and Mohty, M. and Choquet, S. and Unger, T.J. and Li, K. and Chai, Y. and Li, L. and Shah, J. and Shacham, S. and Kauffman, M.G. and Dimopoulos, M.A.",
    journal = "Leukemia Research",
    year = "2020",
    volume = "34",
    number = "9",
    pages = "2430-2440",
    publisher = "Springer Nature BV",
    issn = "0145-2126",
    doi = "10.1038/s41375-020-0756-6",
    keywords = "aprepitant;  bismuth salicylate;  cannabinoid;  dronabinol;  eltrombopag;  fosaprepitant;  granulocyte colony stimulating factor;  loperamide;  lorazepam;  megestrol;  methylphenidate;  neurokinin 1 receptor antagonist;  olanzapine;  pegfilgrastim;  rolapitant;  romiplostim;  selinexor;  serotonin 3 antagonist;  sodium chloride;  antineoplastic agent;  hydrazine derivative;  selinexor;  triazole derivative, adult;  aged;  Article;  clinical trial (topic);  decreased appetite;  diarrhea;  drug dose reduction;  drug safety;  fatigue;  female;  human;  human cell;  hyponatremia;  major clinical study;  male;  multiple myeloma;  nausea;  nausea and vomiting;  neutropenia;  neutrophil count;  patient care;  patient monitoring;  platelet count;  priority journal;  retrospective study;  thrombocyte transfusion;  thrombocytopenia;  thrombocytopoiesis;  vomiting;  appetite;  clinical trial (topic);  diarrhea;  drug effect;  fatigue;  hyponatremia;  middle aged;  multiple myeloma;  nausea;  thrombocytopenia, Aged;  Antineoplastic Agents;  Appetite;  Clinical Trials as Topic;  Diarrhea;  Fatigue;  Female;  Humans;  Hydrazines;  Hyponatremia;  Male;  Middle Aged;  Multiple Myeloma;  Nausea;  Thrombocytopenia;  Triazoles",
    abstract = "Selinexor is an oral, small molecule inhibitor of the nuclear export protein exportin 1 with demonstrated activity in hematologic and solid malignancies. Side effects associated with selinexor include nausea, vomiting, fatigue, diarrhea, decreased appetite, weight loss, thrombocytopenia, neutropenia, and hyponatremia. We reviewed 437 patients with multiple myeloma treated with selinexor and assessed the kinetics of adverse events and impact of supportive care measures. Selinexor reduced both platelets and neutrophils over the first cycle of treatment and reached a nadir between 28 and 42 days. Platelet transfusions and thrombopoietin receptor agonists were effective at treating thrombocytopenia, and granulocyte colony stimulating factors were effective at resolving neutropenia. The onset of gastrointestinal side effects (nausea, vomiting, and diarrhea) was most common during the first 1–2 weeks of treatment. Nausea could be mitigated with 5-HT3 antagonists and either neurokinin 1 receptor antagonists, olanzapine, or cannbainoids. Loperamide and bismuth subsalicylate ameliorated diarrhea. The primary constitutional side effects of fatigue and decreased appetite could be managed with methylphenidate, megestrol, cannabinoids or olanzapine, respectively. Hyponatremia was highly responsive to sodium replacement. Selinexor has well-established adverse effects that mainly occur within the first 8 weeks of treatment, are reversible, and respond to supportive care. © 2020, The Author(s)."
}