Selinexor (Xpovio®, Karyopharm Therapeutics) was recently FDA approved to treat relapsed/refractory diffuse large B-cell lymphoma (DLBCL). This approval extends to patients with DLBCL that resulted from follicular lymphoma and those who had previously received at least two prior lines of systemic therapy. John Leonard, MD, the Richard T. Silver Distinguished Professor of Hematology and Medical Oncology at Weill Cornell Medicine, discussed with i3 Health the importance of this approval and the future of treating this patient population.
What are the most challenging aspects of treating adult patients with relapsed/refractory DLBCL?
John Leonard, MD: While patients with relapsed/refractory DLBCL can be cured with additional therapy, a large percentage can die of their disease and its complications. Many patients receive additional and intensive chemotherapy and/or stem cell transplant approaches. In particular, many of these patients are older and have challenges tolerating treatment, and new/better options are needed.
Can you comment on the significance of the FDA approval of selinexor for DLBCL?
Dr. Leonard: Selinexor provides an additional outpatient, oral option for this group of patients that in some cases can provide meaningful therapeutic responses.
What are the next steps for this research?
Dr. Leonard: I would anticipate that there will be additional studies evaluating selinexor in combination with standard therapies to assess efficacy and toxicity.
How do you see the treatment landscape evolving in the coming years?
Dr. Leonard: I expect there will be a number of new therapies for recurrent DLBCL including CAR T cells, novel antibodies, and a number of other combination and investigational approaches that are currently in clinical trials.
Do you have any advice for community oncologists who treat this patient population?
Dr. Leonard: Community oncologists who treat patients with recurrent DLBCL should become familiar with the profile, dosing regimen, and supportive care associated with selinexor so that outcomes can be optimized when it is administered.
About Dr. Leonard
John Leonard, MD is the Richard T. Silver Distinguished Professor of Hematology and Medical Oncology at Weill Cornell Medical and an oncologist at New York-Presbyterian/Weill Cornell Medical Center. His research interests include novel immunotherapies and other translational strategies for lymphoma and other malignancies.
For More Information
Xpovio® (selinexor) prescribing information (2020). Karyopharm Therapeutics. Available at: https://www.xpovio.com/
Transcript edited for clarity. Any views expressed above are the speaker's own and do not necessarily reflect those of i3 Health.