| Multiple Myeloma

Pomalyst vs Xpovio

Side-by-side clinical, coverage, and cost comparison for multiple myeloma.

Deep comparison between: Pomalyst vs Xpovio with Prescriber.AI

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Safety signalsXpovio has a higher rate of injection site reactions vs Pomalyst based on FDA-approved prescribing information

Coverage gaps3 major payers require step therapy for Xpovio but not Pomalyst, including UnitedHealthcare

Category

Pomalyst

Xpovio

At A Glance

RouteOral

FrequencyOnce daily, Days 1-21 of 28-day cycles

ClassThalidomide analogue (immunomodulatory)

RouteOral

FrequencyOnce or twice weekly

ClassXPO1 inhibitor

Indications

Multiple Myeloma
Kaposi Sarcoma

Multiple Myeloma
Diffuse Large B-Cell Lymphoma

Dosing

Multiple Myeloma 4 mg once daily orally with or without food on Days 1 through 21 of each 28-day cycle until disease progression; given in combination with dexamethasone.

Kaposi Sarcoma 5 mg once daily orally with or without food on Days 1 through 21 of each 28-day cycle until disease progression or unacceptable toxicity; continue HAART as HIV treatment in patients with AIDS-related KS.

Multiple Myeloma (with Bortezomib and Dexamethasone) 100 mg orally once weekly on Day 1 of each week in combination with bortezomib 1.3 mg/m2 SC once weekly and dexamethasone 20 mg orally twice weekly on Days 1 and 2.

Multiple Myeloma (with Dexamethasone) 80 mg orally on Days 1 and 3 of each week in combination with dexamethasone 20 mg orally on Days 1 and 3 of each week.

Diffuse Large B-Cell Lymphoma 60 mg orally on Days 1 and 3 of each week until disease progression or unacceptable toxicity.

Contraindications

Pregnancy
Severe hypersensitivity (e.g., angioedema, anaphylaxis) to pomalidomide or any excipient

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Drug Interactions

1413View drug interactions

897View drug interactions

Adverse Reactions

Most common (>=10%) Neutropenia, anemia, fatigue/asthenia, constipation, nausea, diarrhea, dyspnea, upper respiratory tract infection, pneumonia, back pain, peripheral neuropathy, edema peripheral, pyrexia, thrombocytopenia, rash

Serious Venous and arterial thromboembolism, hematologic toxicity (neutropenia, thrombocytopenia, febrile neutropenia), hepatotoxicity, severe cutaneous reactions, pneumonia, sepsis, dizziness and confusional state, neuropathy, tumor lysis syndrome

Postmarketing Pancytopenia, hepatic failure, Stevens-Johnson Syndrome, toxic epidermal necrolysis, DRESS, progressive multifocal leukoencephalopathy, hepatitis B virus reactivation, herpes zoster, tumor lysis syndrome, basal cell carcinoma, squamous cell carcinoma of the skin

Most common (>=20%) Fatigue, nausea, thrombocytopenia, decreased appetite, diarrhea, vomiting, weight decreased, anemia, peripheral neuropathy, upper respiratory tract infection, hyponatremia, cataract

Serious Thrombocytopenia, neutropenia, gastrointestinal toxicity (nausea, vomiting, diarrhea, weight loss), hyponatremia, serious infection (including pneumonia and sepsis), neurological toxicity, cataract

Pharmacology

Pomalidomide is a thalidomide analogue with immunomodulatory, antiangiogenic, and antineoplastic properties; it acts through cereblon (a cullin ring E3 ubiquitin ligase component), targeting substrate proteins Aiolos and Ikaros for ubiquitination and degradation, producing direct cytotoxic and immunomodulatory effects including enhanced T cell- and NK cell-mediated immunity and inhibition of pro-inflammatory cytokines (TNF-alpha and IL-6).

Selinexor reversibly inhibits exportin 1 (XPO1), blocking nuclear export of tumor suppressor proteins and oncogenic mRNAs, causing nuclear accumulation of tumor suppressors, downregulation of oncoproteins such as c-myc and cyclin D1, cell cycle arrest, and apoptosis of cancer cells.

View Full FDA Information

View full FDA information

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Most Common Insurance

Anthem BCBS

Pomalyst