Klinische Erfahrungen und Expertenempfehlungen zum Einsatz von Selinexor in der Therapie des Multiplen Myeloms

Zusammenfassung

Selinexor besitzt als Exportin-1-Inhibitor einen neuartigen Wirkmechanismus. In Kombination mit Bortezomib und Dexamethason (SVd) ist es zur Behandlung des rezidivierten/refraktären Multiplen Myeloms ab der 2. Linie zugelassen. Bei nicht transplantierbaren Patienten stellt SVd unter dem Gesichtspunkt des Substanzklassenwechsels eine relevante Kombination nach einer Erstlinientherapie mit Daratumumab, Lenalidomid und Dexamethason dar. Klinische Daten belegen, dass insbesondere Proteasom-Inhibitor-naive und Lenalidomid-refraktäre Patienten von SVd profitieren. Der Einsatz von Selinexor-Kombinationen in der klinischen Routine hat gezeigt, dass sie bei patientenindividuell adaptierter Dosierung und mit einer antiemetischen Prophylaxe nach modernem Standard sicher und wirksam einsetzbar sind.

Abstract

Selinexor has a unique mechanism of action as an exportin 1 inhibitor. In combination with bortezomib and dexamethasone (SVd), it is approved for the treatment of relapsed/refractory multiple myeloma from the 2nd line onwards. In non-transplantable patients, SVd represents an important combination after first-line therapy with daratumumab, lenalidomide and dexamethasone in terms of substance class switching. Clinical data show that proteasome inhibitor-naïve and lenalidomide-refractory patients in particular benefit from SVd. The use of Selinexor combinations in routine clinical practice has shown that it can be used safely and effectively when the dosage is adapted to the individual patient and with antiemetic prophylaxis according to modern standards.

Schlüsselwörter

Multiples Myelom - Selinexor - Therapiemanagement - Dosisanpassung - Therapiesequenz - Lenalidomid-Refraktärität - Substanzklassenwechsel - antiemetische Propylaxe - Bridging-Therapie

Keywords

multiple myeloma - selinexor - therapy management - dose adaptation - therapy sequence - lenalidomide refractoriness - substance class change - antiemetic prophylaxis - bridging therapy

Publication History

Article published online:
04 August 2025

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