Selinexor monotherapy (JAKi-naïve myelofibrosis)

Current understanding

Selinexor, an oral XPO1 (exportin-1) inhibitor, is being evaluated as monotherapy in JAK inhibitor-naïve myelofibrosis patients with normal to moderately reduced platelet counts. An early-phase trial is assessing spleen volume reduction and safety in this specific subpopulation, extending selinexor’s investigation beyond the ruxolitinib-combination (SENTRY) context. Efficacy and safety data are pending.

Evidence log

• 2026-07-02 — A Study to Evaluate Single Agent Selinexor Versus Physician’s Choice in Participants With Previously Treated Myelofibrosis: cross-connection with selinexor-monotherapy-jaki-refractory-mf: Randomized Phase 2 in JAKi-pretreated MF pairs with the JAKi-naïve monotherapy study to characterize selinexor single-agent activity across the treatment continuum. (novelty: 3)
• 2026-06-08 — Selinexor in Myelofibrosis Refractory or Intolerant to JAK1/2 Inhibitors: cross-connection with selinexor-monotherapy-jaki-refractory-mf: Both evaluate single-agent selinexor in MF but in opposite clinical contexts — JAKi-naïve (with moderate thrombocytopenia) vs JAKi-refractory/intolerant — together delineating the monotherapy positioning of XPO1 inhibition across the MF treatment course. (novelty: 3)
• 2026-06-04 — Selinexor Monotherapy for Cytoreduction in BCR::ABL1-Negative Myeloproliferative Neoplasms: cross-connection with selinexor-monotherapy-cytoreduction-mpn: Parallel selinexor monotherapy programs: the cytoreduction trial spans PV/ET/PMF, while the MF-specific trial targets JAKi-naïve patients with moderate thrombocytopenia — together delineating the indication space for single-agent XPO1 inhibition in MPNs. (novelty: 4)
• 2026-02-12 — A Study of Selinexor Monotherapy in Subjects With JAK Inhibitor-naïve Myelofibrosis and Moderate Thrombocytopenia: cross-connection with selinexor-ruxolitinib-combination: Both evaluate selinexor in JAKi-naïve MF; the monotherapy trial tests single-agent XPO1 inhibition in a platelet-constrained population, whereas SENTRY pairs selinexor with ruxolitinib. (novelty: 3)

Open questions

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