Table 1 Treatment schedule, dose levels and DLTs.

Dose levels	Selinexor, days 1, 8, 15 and 22	Dexamethasone, days 1, 8, 15 and 22	Carfilzomib, days 1, 8, and 15	Patients enrolled	Patients DLT evaluable	Patients with DLT	DLTs
1	100 mg PO	40 mg IV or PO	56 mg/m² IV	3	2^a	2^b	Selinexor dose reduction due to Grade 3 thrombocytopenia; selinexor dose reduction due to Grade 3 vomiting
−1	80 mg PO	40 mg IV or PO	56 mg/m² IV	6	6^c	0	No DLTs
−1a	80 mg PO	40 mg IV or PO	70 mg/m² IV	3	3	2^c	Grade 4 thrombocytopenia and Grade 3 pneumonia; Grade 4 thrombocytopenia
−1b	60 mg PO	40 mg IV or PO	70 mg/m² IV	3	ND	ND	ND
n1	100 mg PO—not on Day 22	40 mg IV or PO	56 mg/m² IV	2	ND	ND	ND
n−1	80 mg PO—not on Day 22	40 mg IV or PO	70 mg/m² IV	3	ND	ND	ND

PO oral, IV intravenous, DLT dose-limiting toxicities, ND not determined, QW once weekly.
^aOne patient was not DLT evaluable because the platelet count was <50 × 10⁹/L on C1D1.
^dOne patient had dose reduction of selinexor (due to Grade 3 thrombocytopenia without bleeding) to 80 mg in cycle 1 and then to 60 mg (cycle 2) continuing with treatment through C13; the other had dose reduction of selinexor (due to Grade 3 vomiting) to 80 mg in cycle 1 and of carfilzomib to 37.3 mg/m2 continuing with treatment through C5.
^cPatients enrolled after the first six patients were not included in the DLT assessment.
^bOne patient had dose reduction of selinexor to 60 and then to 40 mg, and of carfilzomib to 56 mg/m² continuing with treatment through cycle 16. The other had dose reduction of selinexor to 60, 40 and finally 20 mg and of carfilzomib to 56 mg/m² by further reductions continuing with treatment through week 3 of C26.

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