dexamethasone + selinexor + melflufen

dexamethasone + selinexor + melflufen is an investigational triplet regimen for relapsed or refractory multiple myeloma that combines the synthetic glucocorticoid dexamethasone with selinexor, a first-in-class selective inhibitor of nuclear export that blocks exportin 1 (XPO1), and melflufen (melphalan flufenamide), a first-in-class peptide–drug conjugate that delivers an alkylating melphalan payload to myeloma cells via aminopeptidase-mediated cleavage.[6][7] Selinexor is approved in combination with dexamethasone and in other backbone regimens for heavily pretreated multiple myeloma, while melflufen plus dexamethasone has demonstrated clinical benefit and is approved in Europe for relapsed/refractory multiple myeloma; the dexamethasone + selinexor + melflufen combination is mechanistically rational but remains an experimental, non-standard regimen explored conceptually and preclinically within the broader development of selinexor- and melflufen-based triplets.[2][6][7]