15

Exportin 1 (XPO1) is a nuclear receptor that is involved in the phenomenon of nuclear export. A high expression of XPO1 is associated with reduced survival in hematologic malignancies. The inhibition of XPO1 was shown to be effective in multiple preclinical models. Selinexor was the main inhibitor tested in clinical trials, both in lymphoid and myeloid hemopathies. Its efficacy is generally moderate with an average pathology-dependent tolerability profile. Selinexor currently has temporary authorization for use in France in the treatment of multiple myeloma after failure of four lines of treatment and in non-Hodgkin lymphomas after failure of two lines. A better selection of patients with higher susceptibility to XPO1 inhibition and the development of second-generation inhibitors with lower digestive toxicity may revive the clinical development of XPO1 inhibitors.