What is Selinexor?

Like other selective inhibitors of nuclear export (SINEs), selinexor works by binding to exportin 1 (also known as XPO1 or CRM1). XPO1 is an extranuclear protein that performs the nuclear transport of several proteins, including tumor suppressors, oncogenes, and proteins involved in controlling cell growth, from the nucleus to the cytoplasm; in several types of cancer, it is frequently overexpressed and its function misregulated.

By inhibiting the XPO1 protein, selinesol causes the accumulation of tumor suppressors in the nuclei of malignant cells and reduces the levels of oncogene products that drive cell proliferation. This ultimately leads to cell cycle arrest and death of cancer cells through apoptosis. In vitro, this effect does not appear to harm normal (non-malignant) cells. Inhibiting XPO1 affects many different cells in the body, which may explain the incidence of adverse effects of selinexol. For example, thrombocytopenia is a mechanistic and dose-dependent effect that occurs because selinexole causes the accumulation of the transcription factor STAT3 in the nuclei of hematopoietic stem cells, preventing their differentiation into mature megakaryocytes (platelet-producing cells), thereby slowing the production of new platelets.

The original drug Seleniso has been launched in China, but it has not yet entered the scope of medical insurance. Specifications The price of 20mg*12 tablets per box may be around 20,000 yuan. The US version of the original Seleniso drug sold overseas, with a specification of 20mg*8 tablets, may cost more than 100,000 yuan per box (the price may fluctuate due to exchange rates), which is very expensive. Currently, there are also generic Selinisol drugs produced and marketed overseas. The price of a box of 20mg*16 tablets produced by a Lao pharmaceutical factory may be around RMB 4,000 (the price may fluctuate due to the exchange rate). Its drug ingredients are basically the same as those of the original drugs sold domestically and abroad.