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- Prescribing Information
This site is intended for US healthcare professionals only.
XPOVIO + Vd within 4 different treatment journeys
If you see patients like these in your practice, consider whether introducing a different class could be their next step.
Primary endpoint: mPFS in the ITT population1
mPFS: 13.9 months with XPOVIO + Vd (n=195) vs 9.5 months with Vd alone (n=207); HR: 0.70 (95% CI: 0.53, 0.93), P=0.0075)
These patients are not actual patients. These patient characteristics do not represent all patient types for whom XPOVIO may be appropriate.
Early lines of therapy
Later lines of therapy
Charles is ready to tackle RRMM with a different treatment class
Charles, 76
I want a proven treatment from my local doctor.”
Patient background
- Likes his current doctor and wants to stay with them
- Prefers to avoid traveling far from home or seeing additional specialists
- Wants a treatment with an established safety profile
Treatment considerations
- Transplant ineligible
- Progressing following treatment with an anti-CD38 mAb
- Has not been treated with a PI
Treatment history
1L treatment
- DRd (daratumumab + lenalidomide + dexamethasone): 38 cycles
XPOVIO can meet Charles where he is
Introduces a different treatment class1
Oral, once-weekly tablets are readily accessible and can be taken at home1,2*
Hospitalization is not required for administration or monitoring1
*XPOVIO® (selinexor) is a prescription medicine approved in combination with subcutaneous bortezomib injection and oral dexamethasone.1
Efficacy observed in multiple subgroups3,4
Limitations of subgroup analyses:
- These subgroup analyses were exploratory in nature, not included in the study objectives, and do not control for type 1 error
- These subgroup analyses were not powered or adjusted for multiplicity to assess PFS/ORR across these subgroups
†These subgroup data are derived from an updated efficacy analysis from the XVd trial.
Early lines of therapy
Charles is ready to tackle RRMM with a different treatment class
Patient background
- Likes his current doctor and wants to stay with them
- Prefers to avoid traveling far from home or seeing additional specialists
- Wants a treatment with an established safety profile
“
I want a proven treatment from my local doctor.”
Treatment considerations
- Transplant ineligible
- Progressing following treatment with an anti-CD38 mAb
- Has not been treated with a PI
Treatment history
1L treatment
- DRd (daratumumab + lenalidomide + dexamethasone): 38 cycles
XPOVIO can meet Charles where he is
Introduces a different treatment class1
Oral, once-weekly tablets are readily accessible and can be taken at home1,2*
Hospitalization is not required for administration or monitoring1
XPOVIO® (selinexor) is a prescription medicine approved in combination with subcutaneous bortezomib injection and oral dexamethasone.1
Efficacy observed in multiple subgroups4
Limitations of subgroup analyses:
- These subgroup analyses were exploratory in nature, not included in the study objectives, and do not control for type 1 error
- These subgroup analyses were not powered or adjusted for multiplicity to assess PFS/ORR across these subgroups
†These subgroup data are derived from an updated efficacy analysis from the XVd trial.
Patricia is ready for a different treatment class that is accessible for her
Patient background
- Widow, lives independently and has no family living nearby
- Lacks ability to drive long distances or stay away from home
- Wants a treatment with an established safety profile
“
I want an established therapy that’s accessible for me.”
Treatment considerations
- High-risk cytogenetics
- Renal impairment: CLCR of 52 mL/min
- Progressed following treatment with an anti-CD38 mAb
Treatment history
1L treatment
- RVd (lenalidomide + bortezomib + dexamethasone): 12 cycles
- Maintenance lenalidomide: 16 cycles
2L treatment
- DPd (daratumumab + pomalidomide + dexamethasone): 12 cycles
XPOVIO can meet Patricia where she is
Introduces a different treatment class1
Oral, once-weekly tablets are readily accessible and can be taken at home1,2*
Hospitalization is not required for administration or monitoring1
XPOVIO® (selinexor) is a prescription medicine approved in combination with subcutaneous bortezomib injection and oral dexamethasone.1
Efficacy observed in multiple subgroups4
Limitations of subgroup analyses:
- These subgroup analyses were exploratory in nature, not included in the study objectives, and do not control for type 1 error
- These subgroup analyses were not powered or adjusted for multiplicity to assess PFS/ORR across these subgroups
‡Includes any of del(17p), t(14;16), t(4;14), 1q21.
Tanya is ready for a different treatment class while awaiting CAR-T
Patient background
- Pursuing CAR-T therapy now that her disease is progressing
- Willing to travel to a treatment center to receive CAR-T
“
I am pursuing CAR-T, but it’s going to take some time.”
Treatment considerations
- High-risk cytogenetics
- Renal impairment: CLCR of 40 mL/min
- Consistent rising M-spike over last 3 treatment cycles
Treatment history
1L treatment
- DRVd (daratumumab + lenalidomide + bortezomib + dexamethasone): 8 cycles
- ASCT
- Maintenance lenalidomide + daratumumab: 18 cycles
2L treatment
- KPd (carfilzomib + pomalidomide + dexamethasone): 7 cycles
Currently being evaluated for CAR-T
XPOVIO can meet Tanya where she is
Introduces a different treatment class1
Oral, once-weekly tablets are readily accessible and can be taken at home1,2*
The majority of patients receive treatment in <1 week of prescription2
XPOVIO® (selinexor) is a prescription medicine approved in combination with subcutaneous bortezomib injection and oral dexamethasone.1
Efficacy observed in multiple subgroups4
Limitations of subgroup analyses:
- These subgroup analyses were exploratory in nature, not included in the study objectives, and do not control for type 1 error
- These subgroup analyses were not powered or adjusted for multiplicity to assess PFS/ORR across these subgroups
‡Includes any of del(17p), t(14;16), t(4;14), 1q21.
David is determined to keep fighting with a different treatment class
Patient background
- A lifelong fighter who is determined to continue treatment
- Remains optimistic and hopeful
“
I’m fighting to be a part of every family moment.”
Treatment considerations
- High-risk cytogenetics
- Renal impairment: CLCR of 36 mL/min
- Slowly rising M-spike over 2 cycles
Treatment history
1L treatment
- RVd (lenalidomide + bortezomib + dexamethasone): 8 cycles
- ASCT
- Maintenance lenalidomide: 36 cycles
2L treatment
- DKd (daratumumab + carfilzomib + dexamethasone): 12 cycles
3L treatment
- EPd (elotuzumab + pomalidomide + dexamethasone): 8 cycles
4L treatment
- Ciltacabtagene autoleucel: DOR of 12 months
5L treatment
- Talquetamab: 4 cycles
XPOVIO can meet David where he is
Introduces a different treatment class1
Oral, once-weekly tablets are readily accessible and can be taken at home1,2*
The majority of patients receive treatment in <1 week of prescription2
XPOVIO® (selinexor) is a prescription medicine approved in combination with subcutaneous bortezomib injection and oral dexamethasone.1
Efficacy observed in multiple subgroups4
Limitations of subgroup analyses:
- These subgroup analyses were exploratory in nature, not included in the study objectives, and do not control for type 1 error
- These subgroup analyses were not powered or adjusted for multiplicity to assess PFS/ORR across these subgroups
‡Includes any of del(17p), t(14;16), t(4;14), 1q21.
XVd is an NCCN Category 1 Regimen5
Oral, once-weekly selinexor (XPOVIO) in combination with bortezomib and dexamethasone (XVd) is recommended by the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) as an NCCN Category 1§ therapeutic option in relapsed/refractory MM after 1 to 3 prior therapies.
§Category 1: Based upon high-level evidence (≥1 randomized phase 3 trials or high-quality, robust meta-analyses), there is uniform NCCN consensus (≥85% support of the Panel) that the intervention is appropriate
Help your patients receive
Dedicated support
KaryForward® is a patient support program for eligible XPOVIO patients and provides dedicated help with insurance information, financial assistance, and guidance from Nurse Case Managers.
- Assistance with benefits investigation¶
- Financial assistance¶
- XPOVIO Copay Program¶
- QuickStart and Bridge Programs¶
- Dose Exchange Program¶
- Nurse Case Manager support¶
Enroll your patients or learn more:
CALL 1-877-KARY4WD (1-877-527-9493) Monday through Friday, 8 AM to 8 PM ET or VISIT KaryForward.com/hcp
Learn More¶All programs and support are subject to eligibility requirements.
Abbreviations: 1/2/3/4/5L, first-/second-/third-/fourth-/fifth-line; AR, adverse reaction; ASCT, autologous stem cell transplant; BsAb, bispecific antibody; CAR-T, chimeric antigen receptor T-cell therapy; CI, confidence interval; CLCR, creatinine clearance; HR, hazard ratio; ITT, intent-to-treat; M-spike, monoclonal spike; mAb, monoclonal antibody; mPFS, median progression-free survival; ORR, overall response rate; PFS, progression-free survival; PI, proteasome inhibitor; Vd, bortezomib and dexamethasone; XVd, selinexor, bortezomib, and dexamethasone.
NCCN, National Comprehensive Cancer Network®.
References: 1. XPOVIO (selinexor) [prescribing information]. Newton, MA: Karyopharm Therapeutics, Inc. 2. Data on file. Karyopharm Therapeutics, Inc. 2021 [1]. 3. Data on file. Karyopharm Therapeutics, Inc. 2021 [2]. 4. Data on file. Karyopharm Therapeutics, Inc. 2021 [3]. 5. Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Multiple Myeloma V.2.2025. © National Comprehensive Cancer Network, Inc. 2025. All rights reserved. Accessed June 3, 2025. To view the most recent and complete version of the guideline, go online to NCCN.org.
INDICATION
XPOVIO® (selinexor) is a prescription medicine approved in combination with bortezomib and dexamethasone (XVd) to treat adult patients with multiple myeloma who have received at least one prior therapy.
IMPORTANT SAFETY INFORMATION
Thrombocytopenia: XPOVIO can cause life-threatening thrombocytopenia, potentially leading to hemorrhage. Thrombocytopenia was reported in patients with multiple myeloma.
Thrombocytopenia is the leading cause of dosage modifications. Monitor platelet counts at baseline and throughout treatment. Monitor more frequently during the first 3 months of treatment. Monitor patients for signs and symptoms of bleeding. Interrupt, reduce dose, or permanently discontinue based on severity of adverse reaction.
Neutropenia: XPOVIO can cause life-threatening neutropenia, potentially increasing the risk of infection.
Monitor more frequently during the first 3 months of treatment. Consider supportive measures, including antimicrobials and growth factors (e.g., G-CSF). Interrupt, reduce dose, or permanently discontinue based on severity of adverse reaction.
Gastrointestinal Toxicity: XPOVIO can cause severe gastrointestinal toxicities in patients.
Nausea/Vomiting/Diarrhea: Provide prophylactic antiemetics or treatment as needed.
Anorexia/Weight Loss: Monitor weight, nutritional status, and volume status at baseline and throughout treatment and provide nutritional support, fluids, and electrolyte repletion as clinically indicated.
Hyponatremia: XPOVIO can cause severe or life-threatening hyponatremia.
Monitor sodium level at baseline and throughout treatment.
Serious Infection: XPOVIO can cause serious and fatal infections. Atypical infections reported after taking XPOVIO include, but are not limited to, fungal pneumonia and herpesvirus infection.
Neurological Toxicity: XPOVIO can cause life-threatening neurological toxicities.
Coadministration of XPOVIO with other products that cause dizziness or mental status changes may increase the risk of neurological toxicity.
Advise patients to refrain from driving and engaging in hazardous occupations or activities, until the neurological toxicity fully resolves. Institute fall precautions as appropriate.
Embryo-Fetal Toxicity: XPOVIO can cause fetal harm when administered to a pregnant woman.
Advise pregnant women of the potential risk to a fetus. Advise females of reproductive potential and males with a female partner of reproductive potential to use effective contraception during treatment with XPOVIO and for 1 week after the last dose.
Cataracts: New onset or exacerbation of cataract has occurred during treatment with XPOVIO. The incidence of new onset or worsening cataract requiring clinical intervention was reported.
ADVERSE REACTIONS
The most common adverse reactions (ARs) (≥20%) in patients with multiple myeloma who received XVd were fatigue, nausea, decreased appetite, diarrhea, peripheral neuropathy, upper respiratory tract infection, decreased weight, cataract, and vomiting.
Grade 3-4 laboratory abnormalities (≥10%) were thrombocytopenia, lymphopenia, hypophosphatemia, anemia, hyponatremia and neutropenia.
Fatal ARs occurred in 6% of patients within 30 days of last treatment. Serious ARs occurred in 52% of patients. Treatment discontinuation rate due to ARs was 19%. The most frequent ARs requiring permanent discontinuation in >2% of patients included fatigue, nausea, thrombocytopenia, decreased appetite, peripheral neuropathy and vomiting. Adverse reactions led to XPOVIO dose interruption in 83% of patients and dose reduction in 64% of patients.
USE IN SPECIFIC POPULATIONS
No overall difference in effectiveness of XPOVIO was observed in patients >65 years old when compared with younger patients. Patients ≥65 years old had a higher incidence of discontinuation due to an adverse reaction (AR) and a higher incidence of serious ARs than younger patients.
The effect of end-stage renal disease (CLCR <15 mL/min) or hemodialysis on XPOVIO pharmacokinetics is unknown.
Please see full Prescribing Information.
To report SUSPECTED ADVERSE REACTIONS, contact Karyopharm Therapeutics Inc. at 1-888-209-9326 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.
© 2025 Karyopharm Therapeutics Inc.
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