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    Adverse reactions (ARs) with XPOVIO® (selinexor) 80 mg + dexamethasone 20 mg administered twice weekly1

    ARs 
    (≥10%)
    Any 
    Grade
    (N=202) (%)
    Grade ≥3
    (N=202) (%)
    Thrombocy­topeniaa 74 61
    Fatigueb 73 22
    Nausea 72 9
    Anemiac 59 40
    Decreased appetite 53 4.5
    Weight decreased 47 0.5
    Diarrhea 44 6
    Vomiting 41 3.5
    Hyponatre­mia 39 22
    Neutropeniad 34 21
    Leukopenia 28 11
    Constipation 25 1.5
    Dyspneae 24 3.5f
    Upper respiratory tract infectiong 21 3
    Coughh 16 0
    Mental status changesi 16 7
    Pyrexia 16 0.5
    Hyperglyce­mia 15 7
    Dizziness 15 0
    Insomnia 15 2
    Lymphope­nia 15 10
    Dehydration 14 3.5
    Hypercreatini­nemiaj 14 2
    Pneumoniak 13 9f
    Epistaxis 12 0.5
    Hypokalemia 12 3.5
    Dysgeusia 11 0
    Vision blurred 10 0.5
    Headache 10 0
    ARs (≥10%)
    (cont’d)
    Any Grade
    (N=202) (%)
    Grade ≥3
    (N=202) (%)
    Mental status changesi 16 7
    Pyrexia 16 0.5
    Hyperglycemia 15 7
    Dizziness 15 0
    Insomnia 15 2
    Lymphopenia 15 10
    Dehydration 14 3.5
    Hypercreatininemiaj 14 2
    Pneumoniak 13 9f
    Epistaxis 12 0.5
    Hypokalemia 12 3.5
    Dysgeusia 11 0
    Vision blurred 10 0.5
    Headache 10 0

    aThrombocytopenia includes thrombocytopenia and platelet count decreased.

    bFatigue includes fatigue and asthenia.

    cAnemia includes anemia and hematocrit decreased.

    dNeutropenia includes neutropenia and neutrophil count decreased.

    eDyspnea includes dyspnea, dyspnea exertional, and dyspnea at rest.

    fIncludes fatal event.

    gUpper respiratory tract infection includes upper respiratory tract infection, respiratory tract infection, pharyngitis, nasopharyngitis, bronchitis, bronchiolitis, respiratory syncytial virus infection, parainfluenza virus infection, rhinitis, rhinovirus infection, and adenovirus infection.

    hCough includes cough, productive cough, and upper-airway cough syndrome.

    iMental status changes includes mental status changes, confusional state, and delirium.

    jHypercreatininemia includes hypercreatininemia and hypercreatinemia.

    kPneumonia includes pneumonia, atypical pneumonia, lung infection, lower respiratory tract infection, pneumocystis jirovecii pneumonia, pneumonia aspiration, pneumonia influenzal, and pneumonia viral.

    See the dose modification guidelines for the management of ARs

    Learn More
    • The treatment discontinuation rate due to ARs was 27%
    • Reduction or interruption of XPOVIO dose occurred in 53% and 65.3% of patients, respectively
    • The most frequent ARs requiring permanent discontinuation in ≥4% of patients included fatigue, nausea, and thrombocytopenia
    • The rate of fatal ARs was 8.9%

    Recommended monitoring for safety

    • Monitor at baseline and during treatment as clinically indicated:
      • Complete blood count (CBC) with differential
      • Standard blood chemistry
      • Body weight
    • Monitor more frequently during the first 3 months of treatment

    Recommended concomitant treatments

    • Advise patients to maintain adequate fluid and caloric intake throughout treatment
    • Consider intravenous hydration for patients at risk of dehydration
    • Provide prophylactic concomitant treatment with a 5-HT3 antagonist and/or other anti-nausea agents prior to and during treatment with XPOVIO

    Reference: 1. XPOVIO (selinexor) [package insert]. Newton, MA: Karyopharm Therapeutics Inc.; June 2020.

    INDICATIONS

    • XPOVIO® (selinexor) in combination with dexamethasone is indicated for the treatment of adult patients with relapsed or refractory multiple myeloma who have received at least 4 prior therapies and whose disease is refractory to at least 2 proteasome inhibitors, at least 2 immunomodulatory agents, and an anti-CD38 monoclonal antibody.
    • XPOVIO is indicated for the treatment of adult patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL), not otherwise specified, including DLBCL arising from follicular lymphoma, after at least 2 lines of systemic therapy.

    IMPORTANT SAFETY INFORMATION

    Thrombocytopenia: XPOVIO can cause life-threatening thrombocytopenia, potentially leading to hemorrhage. Thrombocytopenia was reported in patients with multiple myeloma (MM) and developed or worsened in patients with DLBCL.

    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. Institute platelet transfusion and/or other treatments as clinically indicated. Monitor patients for signs and symptoms of bleeding and evaluate promptly. Interrupt, reduce dose, or permanently discontinue based on severity of adverse reaction.