
NEW INDICATION: XPOVIO is the first and only FDA-approved XPO1 inhibitor that helps restore the body’s own tumor suppressor pathways to fight multiple myeloma as early as first relapse.1
In the BOSTON trial, XVd (XPOVIO + bortezomib and dexamethasone [Vd]) improved clinical outcomes compared with Vd (P=0.0075)1
46%
30%
progression or death
XPOVIO is now available for your patients with multiple myeloma who have received ≥1 prior therapy as a combined regimen with bortezomib and dexamethasone (XVd)1
SELINEXOR (XPOVIO) is recommended by the NCCN Clinical Practice Guidelines in Oncology (NCCN GUIDELINES®) as a Category 1* therapeutic option in previously treated MULTIPLE MYELOMA2
*Category 1=Based upon high-level evidence; there is uniform National Comprehensive Cancer Network® (NCCN®) consensus that the intervention is appropriate. Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®): Multiple Myeloma V.4.2021. ©National Comprehensive Cancer Network,Inc. 2020. All rights reserved. Accessed December 20, 2020. To view the most recent and complete version of the guideline, go online to NCCN.org.2
PFS=progression-free survival.
BOSTON trial: Phase 3, global, randomized, open-label study of patients with multiple myeloma who have received 1-3 prior therapies that compared XPOVIO + Vd (XVd) with Vd1

MM=multiple myeloma
Primary endpoint1:
- Progression-free survival (PFS)
Select secondary endpoints1:
- Overall response rate (ORR)
- Very good partial response (≥VGPR) rate
- Grade ≥2 peripheral neuropathy (PN)
XVd demonstrated an early and sustained progression-free survival benefit compared with Vd1

46% increased median PFS compared with Vd1
30% reduction in risk of progression or death1
Hazard ratio: 0.70 (95% CI 0.53-0.93) P=0.0075XVd met its primary endpoint (PFS) and select secondary endpoints (improved ORR, improved ≥VGPR, and lower Grade 2 + peripheral neuropathy[PN]) when compared with Vd1
Depth of response observed with once-weekly XVd was significant versus twice-weekly Vd1

Improvement in ORR was observed across a variety of patient subgroups1
Responses observed with oral, once-weekly XVd were rapid and durable compared with twice-weekly Vd1

(range: 1 to 120 weeks), and the median dose was 80 mg (range: 30 to 137 mg) per week.1
In the BOSTON trial, oral once-weekly XVd offered a high-efficacy regimen compared with the twice-weekly dosing schedule with Vd1
XVd required less bortezomib, less dexamethasone, and
fewer treatment administration visits compared with Vd in the first 24 weeks1,3
~40%
less bortezomib
25%
less dexamethasone
37%
fewer clinical visits over the first 6 months
XPOVIO® (selinexor) is the first and only FDA-approved oral XPO1 inhibitor that gets to the cell’s nucleus, which leads to cell-cycle arrest and apoptosis in cancer cells1

For illustrative purposes only
Learn more about how XPOVIO works on the nuclear export of
tumor suppressor proteins.

For illustrative purposes only
Recommended once-weekly dosage and schedule for XPOVIO® (selinexor) in adults with multiple myeloma (MM)1

The recommended dosage of XPOVIO is 100 mg taken orally once weekly on Day 1 of each week until disease progression or unacceptable toxicity in combination with1:
- Bortezomib 1.3 mg/m2 administered subcutaneously once weekly on Day 1 of each week for 4 weeks followed by 1 week off
- Dexamethasone 20 mg taken orally twice weekly on Days 1 and 2 each week
For additional information regarding the dosing and administration of bortezomib or dexamethasone, refer to the prescribing information for each.
Administer anti-nausea agents prior to and during treatment
The NCCN Guidelines® recommend starting with a 5-HT3 RA before selinexor (XPOVIO) and continuing daily. Low-dose olanzapine and/or an NK1 RA may be added to the 5-HT3 for nausea prevention. If nausea and vomiting still persist, add a medication from another class for breakthrough treatment. Referenced with permission from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Antiemesis V.1.2021. ©National Comprehensive Cancer Network, Inc. 2020. All rights reserved.12
XVd offers a safety profile that is generally manageable and/or reversible with appropriate prophylactic measures and supportive care1,3
Patients receiving XVd experienced lower levels of Grade ≥2 peripheral neuropathy (PN)1
21%
Grade ≥2 PN1
XVd
34%
Grade ≥2 PN1
Vd
In the BOSTON study, XVd was not associated with major organ, cardiac, pulmonary, renal, or liver toxicities13
BOSTON study: Safety1
Adverse Reactions (≥10%) in patients with MM who received XVd with a difference between arms of ≥5% compared to Vd1

- Serious adverse reactions occurred in 52% of patients who received the XVd regimen. 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 vomiting1
- Fatal adverse reactions occurred in 6% of patients within 30 days of last treatment, including pneumonia (n=3) and sepsis (n=3)1
BOSTON study: Laboratory abnormalities1
Select laboratory abnormalities (≥15%) that worsened from baseline in patients with MM who received XVd1

Support and resources
Discover the benefits of KaryForward®, a patient support program by Karyopharm Therapeutics® Inc. dedicated to providing assistance and resources to patients and their caregivers for XPOVIO® (selinexor) treatment.
Dedicated Nurse Case Managers can provide additional information about XPOVIO treatment such as:
- Prescription instructions
- Psychosocial support and additional nonclinical education
- Highlight what to expect when taking Karyopharm medications and the importance of talking to healthcare providers about the treatment journey
- Determine if additional third-party support is available, such as transportation assistance