Thus, to better use SINEs for MM treatment, it is important to (1) identify the predictive biomarkers (such as genetic abnormalities and/or gene expression profiling) to determine which patients are likely to respond to such inhibitors, avoiding unnecessary toxicity; (2) define novel and more effective selinexor combination regimens in order to improve response and reduce adverse effects; and (3) develop more selective and potentially less-toxic XPO1 inhibitors. This evidence concerns the gene XPO1 and Miyoshi myopathy.