Table 4.
Dose Adjustments of Selinexor for Toxicity.4
| Parameter or Toxicity | Threshold | Interrupt Therapy? | Threshold for Restart | Dose Reduction |
|---|---|---|---|---|
| Absolute neutrophil count | 500 – 1000 cells/mm3 | No | N/A | 1 level |
| < 500 cells/mm3 or neutropenic fever | Yes | ≥ 1000 cells/mm3 | 1 level | |
| Hemoglobin | < 8 g/dL | No | N/A | 1 level |
| Life-threatening requiring urgent intervention | Yes | ≥ 8 g/dL | 1 level | |
| Platelets | 25,000 – 75,000 cells/mm3, no bleeding | No | N/A | 1 level |
| 25,000 – 75,000 cells/mm3, bleeding | Yes | Bleeding resolved | 1 level | |
| < 25,000 cells/mm3 | Yes | ≥ 50,000 cells/mm3 | 1 level | |
| Diarrhea | Initial grade 2 | No | N/A | None |
| Recurrent grade 2 | No | N/A | 1 level | |
| Grade ≥ 3 | Yes | Grade ≤ 2 | 1 level | |
| Fatigue | Grade 2 > 7 days | Yes | Grade ≤ 1 | 1 level |
| Grade ≥ 3 | ||||
| Nausea or vomiting | Grade 1 or 2 | No | N/A | None |
| Grade ≥ 3 | Yes | Grade ≤ 2 | 1 level | |
| Sodium | ≤ 130 mmol/L | Yes | ≥ 130 mmol/L | 1 level |
| Weight loss | ≥ 10% or associated with anorexia or malnutrition | Yes | > 90% of baseline weight | 1 level |
| Other | Grade ≥ 3 | Yes | Grade ≤ 2 | 1 level |