Highlighting Selinexor in the RRMM Setting After CAR T Therapy

Physician Summary: Impact of Recurrent Infections on Treatment Choice and Selinexor Dosing

Impact of Recurrent Infections on Treatment Choice:

• High risk for infections: Bispecific antibodies can increase infection risk due to their immune-modulating effects, making them a less ideal choice for patients with a history of recurrent infections.
• Low risk for infections: Selinexor is associated with lower infection risk compared with bispecifics and may be a preferred option in patients with compromised immune systems or a history of infections.

Selinexor Dosing Considerations:

• Once-weekly dosing: In clinical practice, selinexor is typically prescribed as a once-weekly dose for patients with relapsed/refractory myeloma, which offers convenience and better patient adherence.
• Dose reduction: There is some concern that dose reduction in selinexor therapy could decrease its efficacy. However, studies have shown that dose reductions may still maintain clinical benefit, especially when managing side effects such as fatigue or nausea (Selinexor Dose Reduction Clinical Outcomes).

Key Takeaway: For patients with recurrent infections, selinexor offers a safer option due to its lower infection risk. Dose reductions can be considered if needed to improve tolerability, with maintained efficacy in many cases