Selinexor in combination with low-dose dexamethasone are in development for the treatment of patients with penta-refractory multiple myeloma who have received at least five prior therapies. MM is a rare, incurable cancer of the plasma cells in the bone marrow where large amounts of abnormal plasma cells are produced and interfere with the production of red and white blood cells and platelets. Symptoms of MM vary but some may include bone pain, fractures, body weakness, malaise, bleeding, and anaemia. The cause of MM is unknown.
Selinexor is the first treatment option that targets XPO1, a protein that is responsible for exporting tumour suppressor proteins from the cell nucleus. It belongs to a new family of therapies called selective inhibition of nuclear export (SINE) compounds that blocks XPO1 leading to controlled death of myeloma cells. Currently there is no standard of care for the fifth line treatment of MM. Selinexor and low-dose dexamethasone are being developed as an oral treatment. If licensed, this combination could be an effective treatment option for a patient group with clear unmet need.
Apalutamide is an oral tablet that works by blocking the androgen receptor to prevent the effects of the hormone testosterone in the prostate and, thereby, reducing the growth of the cancer cells. If licensed, apalutamide in addition to ADT will increase the treatment options available for patients with metastatic. Apalutamide is also currently being considered for use in hormone-resistant prostate cancer which has not yet spread.