Selinexor developed by Karyopharm Therapeutics is the first orally available small-molecule inhibitor of exportin-1 (XPO1). XPO-1 is a protein transporter responsible for the export of macromolecules such as tumor suppressor proteins and oncoprotein mRNAs from the nucleus to the cytoplasm; its inhibition results in blocking of multiple oncogenic pathways. Overexpression of XPO1 is seen in multiple myeloma and various other malignancies and is a poor prognostic marker. Pivotal positive trials have resulted in the approval of selinexor for use in refractory or relapsed diffuse large B cell lymphoma and multiple myeloma. In this review, we briefly cover the drug development, mechanism of action, indications, and toxicities of the drug, and the major pivotal trials.
Objective To observe variations in the fissures, in the lobes, and in the hilar pattern of lungs and correlate these findings with clinical implications. Materials and Methods The present study was performed on random lung specimens available in the Department of Anatomy. A total of 96 lungs (47 right and 49 left) were studied for variations in the fissures and lobes, and 92 lungs (45 right and 47 left) for variations in the hilar pattern. Results Among the right-sided lungs, 70% presented incomplete horizontal fissure, 15% with absence of the horizontal fissure, and 51% with incomplete oblique fissure. Accessory fissures were also seen, but incomplete, and accounted for 17% of the total number of right lungs.Among the left-sided lungs, 62% presented incomplete oblique fissures, and 4% with absence of the oblique fissure. Accessory fissures accounted for 6% of the total number of left lungs.Regarding hilar pattern variations, 11% of the right-sided lungs showed > 2 bronchi, 69% showed > 2 pulmonary veins, and 37% showed > 1 pulmonary artery.Among the left-sided lungs, 57% showed > 1 bronchi, 21% showed > 2 pulmonary veins, and 17% showed > 1 pulmonary artery. Conclusion The field of pulmonary surgery is now highly advanced, with well-developed radiological and endoscopic techniques. Hence, a proper understanding and knowledge of these morphological variations of lung fissures and of the hilar pattern would be advantageous for surgeons, as well as for radiologists.
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