How Do Selective Inhibitors of Nuclear Export Work?

Selective inhibitors of nuclear export (SINE) are a class of drugs used to treat multiple myeloma (a type of cancer of the bone marrow) and diffuse large B-cell lymphoma (a type of cancer that begins in the white blood cells) in patients who have previously been treated with at least one other medication.

SINE compounds are anti-cancer medications that work by blocking the action of a protein called chromosome region maintenance 1 or exportin. This blockage further leads to inhibition of transport of several proteins involved in cancer cell growth from the cell nucleus to the cytoplasm that eventually leads to cell cycle arrest and apoptosis (the death of cells which occurs as a normal and controlled part of an organism's growth or development).

SINE compounds are administered via oral route, typically once or twice a week with or without food.

Selective inhibitors of nuclear export are used to treat multiple myeloma in combination with bortezomib and dexamethasone. They are also used to treat diffuse large B-cell lymphoma.

Some of the common side effects include:

• Nausea
• Vomiting
• Constipation
• Diarrhea
• Headache
• Tiredness/weakness
• Loss of appetite
• Dysgeusia (a taste disorder that causes foul, rancid, metallic, or salty taste perception)

Other rare side effects include:

• Dizziness 
• Weight loss
• Fatigue 
• Anemia (low red blood cell count)
• Shortness of breath
• Chills, sore throat, fever, or cough
• Thrombocytopenia (low blood platelet count)
• Increased liver enzymes
• Increased creatinine 
• Hypocalcemia (low blood calcium level)
• Hyponatremia (low blood sodium level)
• Hypokalemia (low blood potassium level)
• Peripheral neuropathy (damage to one or more groups of nerves)
• Hyperglycemia (high blood glucose level)
• Epistaxis (bleeding from the nose)

Information contained herein is not intended to cover all possible side effects, precautions, warnings, drug interactions, allergic reactions, or adverse effects. Check with your doctor or pharmacist to make sure these drugs do not cause any harm when you take them along with other medicines. Never stop taking your medication and never change your dose or frequency without consulting your doctor.

Generic and brand names of selective inhibitors of nuclear export include:

• Selinexor
• Xpovio