Xpovio (selinexor) vs Ezharmia (valemetostat tosilate)

Xpovio (selinexor) vs Ezharmia (valemetostat tosilate)

Xpovio (selinexor) is a nuclear export inhibitor approved for use in certain types of cancer, including multiple myeloma and diffuse large B-cell lymphoma, working by blocking the export of tumor suppressor proteins from the nucleus of cancer cells, thereby promoting their anti-cancer activity. Ezharmia (valemetostat tosilate), on the other hand, is an EZH1/2 dual inhibitor with a different mechanism of action, targeting epigenetic regulation by inhibiting the activity of the EZH enzymes, and is being investigated for the treatment of hematological malignancies such as adult T-cell leukemia/lymphoma. The choice between Xpovio and Ezharmia would depend on the specific type of cancer, its molecular characteristics, the patient's overall health status, and the treatment regimen recommended by the healthcare provider based on the latest clinical evidence.

Difference between Xpovio and Ezharmia

Metric Xpovio (selinexor) Ezharmia (valemetostat tosilate)
Generic name Selinexor Valemetostat tosilate
Indications Multiple myeloma, diffuse large B-cell lymphoma Currently under investigation for T-cell lymphoma
Mechanism of action Selective inhibitor of nuclear export (SINE) compounds that inhibits exportin 1 (XPO1) Dual inhibitor of EZH1 and EZH2 methyltransferase
Brand names Xpovio Ezharmia (not yet commercially available)
Administrative route Oral Oral (assumed as it is still under investigation)
Side effects Nausea, vomiting, fatigue, anorexia, weight loss, diarrhea, fever, thrombocytopenia, neutropenia, anemia Not fully characterized yet, as it is still in clinical trials
Contraindications Known hypersensitivity to selinexor or any of its components Not fully established yet
Drug class XPO1 inhibitor EZH1/2 inhibitor
Manufacturer Karyopharm Therapeutics Daiichi Sankyo

Efficacy

Xpovio (Selinexor) Efficacy in Treating Lymphoma

Xpovio (selinexor) is an oral selective inhibitor of nuclear export (SINE) that has shown efficacy in the treatment of multiple types of lymphoma, including diffuse large B-cell lymphoma (DLBCL). The drug functions by inhibiting the nuclear export protein XPO1, leading to the accumulation of tumor suppressor proteins in the cell nucleus and inducing cancer cell death. In clinical trials, selinexor has demonstrated a significant therapeutic effect in patients with relapsed or refractory DLBCL, particularly in those who have exhausted other treatment options.

The efficacy of Xpovio in lymphoma was highlighted in the SADAL study, a single-arm, open-label, multicenter trial specifically designed for patients with relapsed or refractory DLBCL. In this study, selinexor showed an overall response rate (ORR) that was deemed encouraging, particularly given the heavily pretreated nature of the patient population. The complete response (CR) rate was also noteworthy, suggesting that selinexor can induce a deep and durable response in a subset of patients.

Ezharmia (Valemetostat Tosilate) Efficacy in Treating Lymphoma

Ezharmia (valemetostat tosilate) is an investigational, orally bioavailable, selective dual inhibitor of the enhancer of zeste homolog 1 and 2 (EZH1/2) enzymes. These enzymes are part of the polycomb repressive complex 2 (PRC2), which is known to play a role in the epigenetic regulation of genes involved in cancer progression. Valemetostat has shown promise in preclinical models and early clinical trials for the treatment of various subtypes of lymphoma, including T-cell lymphoma and B-cell lymphoma.

In early clinical studies, valemetostat tosilate has demonstrated antitumor activity in patients with relapsed or refractory lymphomas. The drug has been evaluated in terms of ORR and CR rates, with initial results indicating a potential therapeutic benefit. However, as valemetostat is still under investigation, further clinical trials are necessary to fully establish its efficacy profile in lymphoma. The ongoing research is expected to provide more comprehensive data on the efficacy and safety of valemetostat in the treatment of different lymphoma subtypes.

Regulatory Agency Approvals

Xpovio
  • European Medical Agency (EMA), European Union
  • Food and Drug Administration (FDA), USA
Ezharmia
  • Pharmaceuticals and Medical Devices Agency (PMDA), Japan

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If Xpovio or Ezharmia are not approved or available in your country (e.g. due to supply issues), you can access them via Everyone.org.

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