Copiktra (duvelisib) vs Xpovio (selinexor)

Copiktra (duvelisib) is a dual inhibitor of phosphoinositide 3-kinase (PI3K)-delta and PI3K-gamma, indicated for the treatment of adult patients with relapsed or refractory chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) and follicular lymphoma. Xpovio (selinexor) is a selective inhibitor of nuclear export (SINE) compound that blocks the exportin 1 (XPO1) protein and is used for multiple myeloma and certain types of diffuse large B-cell lymphoma (DLBCL). The choice between Copiktra and Xpovio would depend on the specific type of blood cancer a patient has, their previous treatments, and their overall health profile, as each medication has a distinct mechanism of action and side effect profile.

Difference between Copiktra and Xpovio

Metric	Copiktra (duvelisib)	Xpovio (selinexor)
Generic name	Duvelisib	Selinexor
Indications	Relapsed or refractory chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) and follicular lymphoma	Relapsed or refractory multiple myeloma, diffuse large B-cell lymphoma (DLBCL)
Mechanism of action	Phosphoinositide 3-kinase (PI3K) inhibitor	Selective inhibitor of nuclear export (SINE) compounds that inhibits exportin 1 (XPO1)
Brand names	Copiktra	Xpovio
Administrative route	Oral	Oral
Side effects	Diarrhea, neutropenia, rash, fatigue, pyrexia, cough, nausea, anemia, upper respiratory infection	Nausea, thrombocytopenia, fatigue, anemia, decreased appetite, weight loss, diarrhea, vomiting, hyponatremia
Contraindications	History of severe allergic reactions to duvelisib or any of its components	None known
Drug class	Antineoplastic agent, PI3K inhibitor	Antineoplastic agent, XPO1 inhibitor
Manufacturer	Secura Bio, Inc.	Karyopharm Therapeutics Inc.

Efficacy

Copiktra (Duvelisib) Efficacy in Treating Lymphoma

Copiktra, with the generic name duvelisib, is an oral inhibitor of phosphoinositide 3-kinase (PI3K) and is approved for the treatment of adult patients with relapsed or refractory chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) and follicular lymphoma (FL). Its efficacy in treating lymphoma was demonstrated in a clinical trial known as DUO, a randomized, multicenter, open-label study that compared the safety and efficacy of duvelisib to ofatumumab in patients with relapsed or refractory CLL/SLL. The study showed that duvelisib significantly improved the median progression-free survival (PFS) compared to ofatumumab, indicating its effectiveness in delaying disease progression in this patient population.

In addition to CLL/SLL, Copiktra has shown efficacy in FL, which was supported by a single-arm, multicenter study called DYNAMO. This trial enrolled patients with indolent non-Hodgkin lymphoma (iNHL) who were refractory to rituximab and either chemotherapy or radioimmunotherapy. The results demonstrated an objective response rate (ORR) with duvelisib monotherapy in patients with FL, highlighting its potential as a treatment option for those with this type of lymphoma.

Xpovio (Selinexor) Efficacy in Treating Lymphoma

Xpovio, with the active ingredient selinexor, is a selective inhibitor of nuclear export (SINE) compound that blocks the nuclear export protein exportin 1 (XPO1). It is approved for use in combination with dexamethasone for the treatment of adult patients with relapsed or refractory multiple myeloma (RRMM). Additionally, Xpovio has shown promising results in the treatment of diffuse large B-cell lymphoma (DLBCL), a subtype of non-Hodgkin lymphoma. In a study known as SADAL, which was a single-arm, open-label, multicenter trial, selinexor demonstrated a meaningful ORR in patients with relapsed or refractory DLBCL who had received at least two prior therapies.

The efficacy of Xpovio in lymphoma is further supported by its mechanism of action, which involves the restoration of tumor suppressor proteins and the inhibition of oncogenic mRNA translation, leading to the selective induction of apoptosis in cancer cells. While selinexor is not yet approved for the treatment of lymphoma beyond clinical trials, its clinical efficacy in DLBCL suggests a potential new therapeutic avenue for patients with this aggressive form of lymphoma.

Regulatory Agency Approvals

Copiktra

European Medical Agency (EMA), European Union
Food and Drug Administration (FDA), USA

Xpovio

European Medical Agency (EMA), European Union
Food and Drug Administration (FDA), USA

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