Introduction: The efficacy of selinexor, the first commercially available exportin inhibitor, has been evaluated in patients with diffuse large B-cell lymphoma (DLBCL) who have received at least 2 lines of therapy. Its role in treatment of DLBCL requires a review of current evidence.
Areas covered: This review describes the pharmacology of selinexor and the clinical trials of the medication for the treatment of patients with DLBCL. To clarify the role of selinexor in the treatment of DLBCL, a PubMed search was performed for articles on currently available treatments for relapsed/refractory (R/R) DLBCL.
Expert opinion: Selinexor, which is administered orally, benefits from an advantageous pharmacokinetic profile with toxicity limited to hematological and digestive side effects. It has little or no interaction with other medications and no dose adjustment is required for patients with renal or hepatic impairment. Selinexor has been assessed for treatment of R/R DLBCL in one phase I and one phase II trial. Those studies found a 28% overall response rate, including 12% complete remission, with a median duration of response of 9.3 months. If selinexor's effectiveness as monotherapy is limited, it remains an option when there are no other therapeutic possibilities and can then give long-lasting responses.
Keywords: DLBCL; Selinexor; diffuse large B cell lymphoma; exportin inhibitor; non Hodgkin lymphoma; relapse refractory DLBCL.