When you use selinexor for relapsed/refractory myeloma, with what total weekly dose do you practically start?

Topics: Hematologic Malignancies • Medical Oncology • Myeloma • NCI-CCC Tumor Board Question • University of Washington • NCI-CCC Myeloma Tumor Board Question

If tolerated through Cycle #1, how aggressively do you try to titrate the selinexor dose up toward 100mg weekly or 80mg twice-weekly?

And does your answer change based on the regimen, e.g. seli-Kd (with carfizomib) vs seli-Pd (with pomalidomide) vs seli-Vd (with once-weekly bortezomib as in BOSTON)?

Answer from: Medical Oncologist at Academic Institution

The answer is it depends. For most older or more frail adults, I would start at 60 mg weekly. For more robust, 80 mg weekly. More important, is whether I am combining with another anti myeloma agent other than steroids. In that case, I typically stick with 60 mg weekly. This helps not only wit...

Comments

Medical Oncologist at University of Washington, Fred Hutchinson Cancer Research Center
Could not agree more - 60-80mg once weekly as a st...

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