selinexor + dexamethasone + daratumumab

A combination therapy consisting of **selinexor**, **dexamethasone**, and **daratumumab** evaluated for use in **relapsed or refractory multiple myeloma (RRMM)** and in particular for patients refractory to prior daratumumab-based regimens. Selinexor is an oral selective inhibitor of nuclear export (SINE) that blocks exportin 1 (XPO1)-mediated nuclear export of tumor suppressor proteins, the glucocorticoid receptor, and oncoprotein mRNAs, leading to accumulation of tumor suppressors in the nucleus and reduction of oncogenic signals. Dexamethasone is a synthetic glucocorticoid that enhances the anti-myeloma effect, partly via glucocorticoid receptors. Daratumumab is a monoclonal antibody that targets CD38 on plasma cells, inducing apoptosis and immune-mediated mechanisms. The combination has demonstrated efficacy and manageable safety in heavily pretreated, daratumumab-refractory multiple myeloma, with evidence of possible synergy between selinexor and daratumumab[1][2][7].