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Selinexor is a first-in-class, oral small molecule that acts as a selective inhibitor of nuclear export (SINE) by targeting the nuclear export protein XPO1. By inhibiting XPO1, selinexor causes the accumulation of tumor suppressor proteins in the cell nucleus, reactivating their function and selectively inducing apoptosis in cancer cells while sparing normal cells. It is approved for use in combination with bortezomib and dexamethasone for adults with multiple myeloma who have received at least one prior therapy, and with dexamethasone alone for relapsed or refractory multiple myeloma after at least four prior therapies. Selinexor also has accelerated approval for relapsed or refractory diffuse large B-cell lymphoma (DLBCL), including DLBCL arising from follicular lymphoma, after at least two lines of systemic therapy. The drug is being explored for additional anti-inflammatory and antiviral applications due to its effects on key inflammatory pathways such as NF-kB and MAPK p38. It is developed and manufactured by Karyopharm Therapeutics.
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