Selinexor is an oral selective nuclear output inhibitor primarily used for the treatment of relapsed/refractory multiple myeloma and diffuse large B-cell lymphoma. The standard dose is 80mg taken twice a week, and the whole tablet needs to be swallowed with meals. The treatment scope covers specific hematological malignancies.

1. Standard usage and dosage

(1) Multiple myeloma: Take 80mg orally on the first and third day of each week, in combination with 20mg dexamethasone.

(2) Diffuse large B-cell lymphoma: 60mg orally on the 1st and 3rd day of each week during monotherapy.

(3) Medication requirements: The entire tablet should be taken with meals and should not be broken, crushed, or chewed.

2. Principle of dose adjustment

(1) First dose reduction: When grade 3 non hematological toxicity occurs, reduce to 60mg per week (divided into two doses).

(2) Secondary reduction: When toxicity occurs again, reduce to 40mg per week (divided into two doses).

(3) Permanent discontinuation of medication: unable to tolerate 40mg/week or experiencing grade 4 hematological toxicity.

3. Scope of treatment

(1) FDA approved indications: Adult relapsed/refractory multiple myeloma (combination therapy) and diffuse large B-cell lymphoma (monotherapy).

(2) Clinical trial stage: Other hematological malignancies such as Fahrenheit macroglobulinemia.

(3) Medication restrictions: Not applicable to newly diagnosed patients or non malignant tumor diseases.

4. Special precautions

(1) Omission treatment: If it is ≥ 48 hours before the next administration, it can be taken again, otherwise it will be skipped.

(2) Vomiting treatment: Vomiting after taking medication does not require supplementation, and medication should continue according to the original plan.

(3) Treatment cycle: Continue medication until disease progression or intolerable toxicity occurs.