Selinexor + Pacritinib combination

Current understanding

First-in-class combination pairing the XPO1 inhibitor selinexor with the JAK2/IRAK1 inhibitor pacritinib, under evaluation in a phase II trial for JAK inhibitor-naïve myelofibrosis patients with anemia and thrombocytopenia (trial-early). Rationale targets two distinct pathways simultaneously in a difficult-to-treat cytopenic subpopulation where ruxolitinib-based regimens are limited by platelet/hemoglobin thresholds.

Evidence log

• 2026-06-08 — Selinexor in Myelofibrosis Refractory or Intolerant to JAK1/2 Inhibitors: cross-connection with selinexor-monotherapy-jaki-refractory-mf: Both target post-ruxolitinib MF populations with XPO1 inhibition — one as monotherapy in JAKi-refractory/intolerant patients, the other as a pacritinib-paired strategy for cytopenic JAKi-naïve patients — together mapping selinexor’s role across difficult-to-treat MF subsets. (novelty: 3)
• 2026-02-12 — A Study of Selinexor Monotherapy in Subjects With JAK Inhibitor-naïve Myelofibrosis and Moderate Thrombocytopenia: cross-connection with selinexor-monotherapy-mf: Both target JAKi-naïve MF patients with cytopenia/thrombocytopenia constraints — one as selinexor monotherapy, the other combining selinexor with the platelet-sparing JAK inhibitor pacritinib. (novelty: 3)
• 2026-03-18 — Selinexor and Pacritinib in JAK Inhibitor-naïve MF Patients With Cytopenias: cross-connection with selinexor-ruxolitinib-combination: Both combinations pair the XPO1 inhibitor selinexor with a JAK inhibitor backbone; the pacritinib pairing extends the strategy specifically to cytopenic, JAKi-naïve MF where ruxolitinib dosing is constrained. (novelty: 4)

Open questions

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