Leukemias, lymphomas, and other hematologic cancers:
Indications for XPOVIO:
In combination with dexamethasone for the treatment of adults with relapsed or refractory multiple myeloma (MM) in adults who have received at least 4 prior therapies and whose disease is refractory to at least 2 proteasome inhibitors, at least 2 immunomodulatory agents, and an anti-CD38 monoclonal antibody. Relapsed or refractory diffuse large B-cell lymphoma (DLBCL), not otherwise specified, including DLBCL arising from follicular lymphoma, after at least 2 lines of systemic therapy.
Premedicate with 5-HT3 antagonists and/or other anti-nausea agents prior to and during treatment. Swallow whole. Continue until disease progression or unacceptable toxicity. MM: 80mg on Days 1 and 3 of each week. Give oral dexamethasone 20mg with each Xpovio dose on scheduled days. DLBCL: 60mg on Days 1 and 3 of each week. Dose modification for adverse reactions: see full labeling.
Monitor CBC with differential (eg, platelets, WBC), blood chemistries (eg, sodium), body weight, nutritional and volume status at baseline, during treatment (more frequently for first 3 months), and as clinically indicated. Monitor for signs/symptoms of bleeding, infection; evaluate promptly. Consider supportive measures for signs of infection (eg, antimicrobials, G-CSFs). Interrupt, reduce dose, or permanently discontinue based on severity of adverse reaction. Correct sodium levels for concurrent hyperglycemia and high serum paraprotein levels. Maintain adequate hydration and caloric intake. Embryo-fetal toxicity. Pregnancy: exclude status prior to initiation. Advise females of reproductive potential and males (w. female partners) to use effective contraception during and for 1 week after the last dose. Nursing mothers: not recommended (during and for 1 week after the last dose).
Nuclear export inhibitor.
Avoid concomitant medications that can exacerbate dizziness or mental status changes.
Thrombocytopenia, fatigue, nausea, anemia, decreased appetite, decreased weight, diarrhea, vomiting, hyponatremia, neutropenia, leukopenia, constipation, dyspnea, upper respiratory tract infection, pyrexia, lymphopenia; infections (eg, pneumonia, sepsis), neurological toxicity.
Tabs—8, 12, 16, 20, 24, 32