Conversations Around Selinexor: Best Nursing Practices in Multiple Myeloma

For this episode of The Vitals, Oncology Nursing News® spoke with Daniel J. Verina, DNP, RN, MSN, ACNP-BC, of the Myeloma Team with Mount Sinai Medical Center, about optimal strategies for adverse event management for patients receiving selinexor (Xpovio). Verina recently presented on adverse event management for novel multiple myeloma therapies as part of the International Myeloma Society’s 6th Annual Nursing Symposium. 

“I think one of the challenges is when a patient keeps relapsing and [you have] to come back to them and [say] you relapsed again, we have to change your treatment. That is a challenge in all. In all honesty.” Time stamp [TS] 9:04

“Patients tend to become dehydrated: You really want to make sure they have good oral fluid intake, [and] you want to be able to monitor diarrhea.” TS 12:52

“Low sodium was another big side effect that we saw in our patient population… I tell patients to eat salty snacks, which will help with their lack of eating and help with their weight.” TS 15:24

“One of my educational points with patients is that you want to be able to weigh yourself every day, at the same time, with the caregiver with them, to make sure that they're maintaining their same weight.” TS 19:01

“We always have a nutritionist jump in right away with our patients that start on selinexor to try to find the best nutritional support whether it's high calories and small packages be able to give those to patients up front so they can maintain their weight.” TS 19:14

The Vitals Podcast:
                                                                   
·      Ask The Right Questions: Clinical Pearls of AE Management
·      Cardiac Complications in Blood Cancers

·      Verina Underscores Best Nursing Practices With Targeted Therapies in Multiple Myeloma
·      FDA Approves Selinexor Combination for Pretreated Patients with Myeloma
·      FDA Approves Selinexor for Relapsed/Refractory Myeloma
·      Myeloma Treatment Landscape Continues to Change

·      Nursing Considerations for Using Selinexor in Multiple Myeloma

·      Living With Multiple Myeloma: Nurses as the Lifeline

References
·      Verina DJ. Managing the toxicities associated with newer targeted therapies. Presented at: International Myeloma Society 6th Annual Nursing Symposium; August 25-27, 2022; Los Angeles, CA. NS-001.
·      Xpovio. Prescribing information. Karyopharm Therapeutics Inc; 2022. Accessed October 12, 2022. https://bit.ly/3CvLbO3
·      Parikh K, Cang S, Sekhri A, Liu D. Selective inhibitors of nuclear export (SINE)—a novel class of anti-cancer agents. J Hematol Oncol. 2014;7:78. doi:10.1186/s13045-014-0078-0
·      Gupta A, Saltarski JM, White MA, Scaglioni PP, Gerber DE. Therapeutic targeting of nuclear export inhibition in lung cancer. J Thorac Oncol. 2017;12(9):1446-1450. doi:10.1016/j.jtho.2017.06.013
·      Gavariatopoulou M, Chari A, Chen C, et al. Integrated safety profile of selinexor in multiple myeloma: experience from 437 patients enrolled in clinical trials. Leukemia. 2020;34(9):2430-2440. doi:10.1038/s41375-020-0756-6 
·      Common terminology criteria for adverse events, version 5.0. National Institutes of Health, National Cancer Institute. Published November 27, 2017. Accessed October 17, 2022. https://ctep.cancer.gov/protocoldevelopment/electronic_applications/docs/CTCAE_v5_Quick_Reference_8.5x11.pdf 
·      Mikhael J, Noonan KR, Faiman B, et al. Consensus recommendations for the clinical management of patients with multiple myeloma treated with selinexor. Clin Lymphoma Myeloma Leuk. 2020;20(6):351-357. doi:10.1016/j.clml.2019.12.026
·      Magen H, Geva M, Volchik Y, Avigdor A, Nagler A. Selinexor, bortezomib, and dexamethasone for heavily pretreated multiple myeloma: a case series. Clin Lymphoma Myeloma Leuk. 2020;20(12):e947-e955. doi:10.1016/j.clml.2020.07.016