Truxima (rituximab) vs Xpovio (selinexor)

Truxima (rituximab) vs Xpovio (selinexor)

Truxima (rituximab) and Xpovio (selinexor) are used to treat different types of cancer and they work in different ways. Truxima is a monoclonal antibody that targets the CD20 protein on the surface of B cells and is commonly used in the treatment of non-Hodgkin lymphoma and chronic lymphocytic leukemia. In contrast, Xpovio is a selective inhibitor of nuclear export (SINE) that blocks the export of tumor suppressor proteins from the nucleus of cancer cells and is used for multiple myeloma and certain types of diffuse large B-cell lymphoma. The choice between these medications would depend on the specific type of cancer diagnosed, its stage, previous treatments, and the patient's overall health profile. It is crucial for a patient to consult with their oncologist to determine the most appropriate treatment option based on their individual medical condition.

Difference between Truxima and Xpovio

Metric Truxima (rituximab) Xpovio (selinexor)
Generic name Rituximab Selinexor
Indications Non-Hodgkin's lymphoma, chronic lymphocytic leukemia, rheumatoid arthritis, granulomatosis with polyangiitis, microscopic polyangiitis Multiple myeloma, diffuse large B-cell lymphoma
Mechanism of action Monoclonal antibody that targets the CD20 antigen on B lymphocytes Selective inhibitor of nuclear export (SINE) that blocks the export of tumor suppressor proteins
Brand names Truxima, Rituxan, MabThera Xpovio
Administrative route Intravenous infusion Oral
Side effects Infusion reactions, infections, cytopenias, cardiotoxicity, pulmonary toxicity Nausea, vomiting, fatigue, anorexia, weight loss, diarrhea, pyrexia, dyspnea, hyponatremia
Contraindications Severe, active infections; severe immunodeficiency; hypersensitivity to rituximab or mouse proteins Thrombocytopenia, neutropenia, hypersensitivity to selinexor or any of the excipients
Drug class Monoclonal antibody XPO1 inhibitor
Manufacturer Celltrion Healthcare, Genentech (a member of the Roche Group) Karyopharm Therapeutics

Efficacy

Truxima (Rituximab) for Lymphoma

Truxima is a biosimilar to the original monoclonal antibody therapy, rituximab, which targets the CD20 antigen on the surface of pre-B and mature B lymphocytes. It is used for the treatment of non-Hodgkin lymphoma (NHL) and is effective in both newly diagnosed and relapsed or refractory cases. Clinical trials have shown that when combined with chemotherapy, Truxima significantly improves survival rates in patients with follicular lymphoma and diffuse large B-cell lymphoma, the two most common types of NHL. The efficacy of Truxima in the treatment of lymphoma has been demonstrated in numerous studies, which have reported improvements in progression-free survival and overall survival when used as part of a combination regimen.

Xpovio (Selinexor) for Lymphoma

Xpovio (selinexor) is a selective inhibitor of nuclear export, which works by trapping tumor suppressor proteins within the nucleus of cancer cells, leading to the death of these cells. It has been approved for use in combination with dexamethasone for the treatment of multiple myeloma and has shown efficacy in relapsed or refractory diffuse large B-cell lymphoma (DLBCL), a type of non-Hodgkin lymphoma. In a pivotal Phase 2b clinical trial, selinexor demonstrated a meaningful overall response rate in patients with DLBCL who had previously received multiple lines of therapy, including those who were refractory to rituximab.

Comparative Efficacy in Lymphoma Treatment

While Truxima and Xpovio target different mechanisms within lymphoma cells, both have shown efficacy in the treatment of lymphoma. Truxima is often used in the first-line setting in combination with chemotherapy and has become a standard of care for certain types of B-cell non-Hodgkin lymphoma. Xpovio, on the other hand, is generally used in patients with relapsed or refractory disease and offers a novel mechanism of action for those who have exhausted other treatment options. The efficacy of each drug is influenced by the specific type of lymphoma, the stage of the disease, and prior treatments received by the patient.

Conclusion on the Efficacy of Truxima and Xpovio

In conclusion, both Truxima and Xpovio have demonstrated efficacy in the treatment of lymphoma, albeit in different settings and lines of therapy. Truxima is a well-established treatment that improves survival outcomes in patients with B-cell non-Hodgkin lymphoma when used in combination with chemotherapy. Xpovio provides a valuable treatment option for patients with relapsed or refractory diffuse large B-cell lymphoma, especially for those who have not responded to other therapies. The choice of treatment depends on individual patient factors and the treating physician's clinical judgment, taking into account the specific characteristics of the lymphoma and the patient's overall health status.

Regulatory Agency Approvals

Truxima
  • European Medical Agency (EMA), European Union
  • Food and Drug Administration (FDA), USA
  • Health Canada
  • Therapeutic Goods Administration (TGA), Australia
  • Medsafe (NZ)
Xpovio
  • European Medical Agency (EMA), European Union
  • Food and Drug Administration (FDA), USA

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