Clinical Trials /

Selinexor and Backbone Treatments of Multiple Myeloma Patients

NCT02343042

Description:

This study will independently assess the efficacy and safety of 10 combination therapies in 11 arms, in dose-escalation/-evaluation and expansion phases, for the treatment of patients with relapsed/refractory multiple myeloma (RRMM) and newly diagnosed multiple myeloma (NDMM). The combinations to be evaluated are: - Arm 1: Selinexor + dexamethasone + pomalidomide (SPd) - Arm 2: Selinexor + dexamethasone + bortezomib (SVd); enrollment complete - Arm 3: Selinexor + dexamethasone + lenalidomide (SRd) in RRMM; enrollment complete - Arm 4: Selinexor + dexamethasone + pomalidomide + bortezomib (SPVd) - Arm 5: Selinexor + dexamethasone + daratumumab (SDd); enrollment complete - Arm 6: Selinexor + dexamethasone + carfilzomib (SKd) - Arm 7: Selinexor + dexamethasone + lenalidomide (SRd) in NDMM - Arm 8: Selinexor + dexamethasone + ixazomib (SNd) - Arm 9: Selinexor + dexamethasone + pomalidomide + elotuzumab (SPEd) - Arm 10: Selinexor + dexamethasone + belantamab mafodotin (SBd) - Arm 11: Selinexor + dexamethasone + pomalidomide + daratumumab (SDPd) Selinexor pharmacokinetics: - PK Run-in (Days 1-14): Starting in protocol version 8.0, patients enrolled to any arm in the Dose Escalation Phase (i.e., Arm 4 [SPVd], Arm 6 [SKd], Arm 8 [SNd], Arm 9 [SPEd], Arm 10 [SBd], and Arm 11 [SDPd]) will also first be enrolled to a pharmacokinetics (PK) Run-in period until 9 patients have been enrolled to this period to evaluate the PK of selinexor before and after co-administration with a strong CYP3A4 inhibitor.

Related Conditions:
  • Multiple Myeloma
Recruiting Status:

Recruiting

Phase:

Phase 1/Phase 2

Trial Eligibility

Document

Title

  • Brief Title: Selinexor and Backbone Treatments of Multiple Myeloma Patients
  • Official Title: A Phase 1b/2 Study of Selinexor (KPT-330) in Combination With Backbone Treatments for Relapsed/Refractory Multiple Myeloma and Newly Diagnosed Multiple Myeloma

Clinical Trial IDs

  • ORG STUDY ID: KCP-330-017
  • NCT ID: NCT02343042

Conditions

  • Multiple Myeloma

Interventions

DrugSynonymsArms
SelinexorKPT-330, XPOVIO®10. Selinexor, Dexamethasone, and Belantamab Mafodotin (SBd)
DexamethasoneDecadron®10. Selinexor, Dexamethasone, and Belantamab Mafodotin (SBd)
LenalidomideRevlimid®3: Selinexor, Low-dose DEX, and Lenalidomide (SRd) in RRMM
PomalidomidePomalyst®11. Selinexor, Dexamethasone, Pomalidomide, and Daratumumab (SDPd)
BortezomibVelcade®2: Selinexor, Low-dose Dexamethasone and Bortezomib (SVd)
DaratumumabDarzalex®11. Selinexor, Dexamethasone, Pomalidomide, and Daratumumab (SDPd)
CarfilzomibKyprolis®6: Selinexor, Low-dose dexamethasone, and Carfilzomib (SKd)
IxazomibNinlaro®8: Selinexor, Low-dose dexamethasone, and Ixazomib (SNd)
ElotuzumabEmpliciti®9: Selinexor, Low-dose DEX, Pomalidomide and Elotuzumab (SPEd)
ClarithromycinBiaxin4:Selinexor, Low-dose dexamethasone, Pomalidomide, Velcade (SPVd)
Belantamab MafodotinBLENREP10. Selinexor, Dexamethasone, and Belantamab Mafodotin (SBd)

Purpose

This study will independently assess the efficacy and safety of 10 combination therapies in 11 arms, in dose-escalation/-evaluation and expansion phases, for the treatment of patients with relapsed/refractory multiple myeloma (RRMM) and newly diagnosed multiple myeloma (NDMM). The combinations to be evaluated are: - Arm 1: Selinexor + dexamethasone + pomalidomide (SPd) - Arm 2: Selinexor + dexamethasone + bortezomib (SVd); enrollment complete - Arm 3: Selinexor + dexamethasone + lenalidomide (SRd) in RRMM; enrollment complete - Arm 4: Selinexor + dexamethasone + pomalidomide + bortezomib (SPVd) - Arm 5: Selinexor + dexamethasone + daratumumab (SDd); enrollment complete - Arm 6: Selinexor + dexamethasone + carfilzomib (SKd) - Arm 7: Selinexor + dexamethasone + lenalidomide (SRd) in NDMM - Arm 8: Selinexor + dexamethasone + ixazomib (SNd) - Arm 9: Selinexor + dexamethasone + pomalidomide + elotuzumab (SPEd) - Arm 10: Selinexor + dexamethasone + belantamab mafodotin (SBd) - Arm 11: Selinexor + dexamethasone + pomalidomide + daratumumab (SDPd) Selinexor pharmacokinetics: - PK Run-in (Days 1-14): Starting in protocol version 8.0, patients enrolled to any arm in the Dose Escalation Phase (i.e., Arm 4 [SPVd], Arm 6 [SKd], Arm 8 [SNd], Arm 9 [SPEd], Arm 10 [SBd], and Arm 11 [SDPd]) will also first be enrolled to a pharmacokinetics (PK) Run-in period until 9 patients have been enrolled to this period to evaluate the PK of selinexor before and after co-administration with a strong CYP3A4 inhibitor.

Detailed Description

      This is a multi-center, open-label, clinical study with Dose Escalation (Phase 1) and
      Expansion (Phase 2) to independently assess the MTD, efficacy , and safety of 10 combination
      therapies in 11 arms in patients with RRMM and NDMM. Patients will be assigned to treatment
      arms based on their diagnoses and treatment histories. For 9 patients, a PK Run-in period
      will precede Cycle 1 (DLT evaluation) to assess selinexor PK when co-administered with a
      strong CYP3A4 inhibitor. In the Dose Escalation Phase (Phase 1): (a) in Arm 1 (SPd), Arm 2
      (SVd), and Arm 3 (SRd in RRMM), patients will be randomized to either QW or BIW selinexor
      dosing cohorts; (b) in Arm 5 (SDd), patients will be sequentially assigned in blocks of 3 to
      either QW or BIW selinexor dosing; (c) in Arm 4 (SPVd), Arm 6 (SKd), Arm 7 (Srd in NDMM), Arm
      8 (SNd), Arm 9 (SPEd), Arm 10 (SBd), and Arm 11 (SDPd) patients will be assigned to QW
      selinexor dosing.

      Cohort 1.4 is included from Version 10 to study safety and tolerability of SPd with selinexor
      40 mg QW, is lower than RP2D (ie, selinexor 60 mg QW) in combination with pomalidomide 4 mg.
      Cohort 1.4 is a different expansion cohort from the one with RP2D (ie, Cohort 1.3). In Cohort
      1.4, 20 patients will be enrolled in total.

      Starting in protocol Version 8.0, patients enrolled to the Dose Escalation Phase of Arm 4
      (SPVd), Arm 6 (SKd), Arm 8 (SNd), Arm 9 (SPEd), Arm 10 (SBd), and Arm 11 (SDPd) will first be
      enrolled to a 14-day PK Run-in period (selinexor +/- clarithromycin) until 9 patients have
      been enrolled. During this 14-day PK Run-in period, selinexor 40 milligrams (mg) will be
      administered alone on Day 1, clarithromycin 500 mg twice daily (BID) will be administered on
      Days 2-8, and selinexor 40 mg will again be administered on Day 8 with the morning
      clarithromycin dose. Blood samples for PK analysis will be collected pre-dose and 1 (± 10
      min), 1.5 (± 10 min), 2 (± 10 min), 3 (± 10 min), 4 (± 10 min), 5 (± 10 min), 6 (± 10 min), 8
      (± 10 min), and 24 h (± 30 min) hours after selinexor is dosed on Day 1 (without
      clarithromycin) and Day 8 (with clarithromycin). Patients will then proceed to the DLT
      evaluation period that will begin after the completion of the 14-day PK Run-in period; this
      day will be designated as Cycle 1 Day 1 (C1D1) in the Dose Escalation Phase.
    

Trial Arms

NameTypeDescriptionInterventions
1: Selinexor, Low-dose Dexamethasone and Pomalidomide (SPd)ExperimentalEach cycle is of 28 days Cohort 1.1: Selinexor (SEL) 60/80/100 mg orally (PO) once weekly (QW); Dexamethasone (DEX) 40 mg PO once weekly; Pomalidomide (POM) 2/3/4 mg PO Days 1-21. Cohort 1.2: SEL 40/60/80 mg PO twice weekly (BIW); DEX 20 mg PO twice weekly; POM 3/4 mg PO Days 1-21. Cohort 1.3: Selinexor, Dexamethasone and Pomalidomide will be dosed at RP2D-1. Cohort 1.4: SEL 40 mg PO QW; DEX 40 mg PO QW; POM 4mg PO once daily (QD) Days 1-21.
  • Selinexor
  • Dexamethasone
  • Pomalidomide
2: Selinexor, Low-dose Dexamethasone and Bortezomib (SVd)ExperimentalEach cycle is of 35 days Cohort 2.1: SEL 60/80/100 mg PO once weekly; DEX 40 mg PO once weekly; Bortezomib (BOR) 1.3 milligram per meter square (mg/m^2) subcutaneous (SC) once weekly. Cohort 2.2: SEL 40/60/80 mg PO twice weekly; DEX 20 mg PO twice weekly; BOR 1.3 mg/m^2 subcutaneous (SC) once weekly. Cohort 2.3: Selinexor, Dexamethasone and Bortezomib will be dosed at RP2D-2.
  • Selinexor
  • Dexamethasone
  • Bortezomib
3: Selinexor, Low-dose DEX, and Lenalidomide (SRd) in RRMMExperimentalEach cycle is of 28 days Cohort 3.1: SEL 40/60/80/100 mg PO once weekly; DEX 40 mg PO once weekly; Lenalidomide (LEN) 15/25 mg PO Days 1-21. Cohort 3.2: SEL 40/60/80 mg PO twice weekly; DEX 20 mg PO twice weekly; LEN 15/25 mg PO Days 1-21. Cohort 3.3: Selinexor, Dexamethasone and Lenalidomide will be dosed at RP2D-3.
  • Selinexor
  • Dexamethasone
  • Lenalidomide
4:Selinexor, Low-dose dexamethasone, Pomalidomide, Velcade (SPVd)ExperimentalPK Run-in Period: Selinexor and Clarithromycin: For the first 9 patients enrolled into this dose escalation arm 14 day run-in period after which patients will proceed to Dose-Escalation Phase C1D1 Selinexor 40 mg will be dosed on Days 1 and 8. Clarithromycin 500 mg will be dosed twice daily on Days 2-8. PK samples will be collected on Days 1 and 8 at 1, 1.5, 2, 3, 4, 5, 6, 8, and 24 hours post dose. Dose-escalation Phase: All patients enrolled into this Arm Each cycle is of 28 days. Cohort 4.1: SEL 40/60 mg PO once weekly; DEX 40 mg PO once weekly; POM 4 mg PO Days 1-21; BOR 1.3 mg/m^2 subcutaneous (SC) once weekly. Cohort 4.3: Selinexor, Dexamethasone, Pomalidomide, Velcade (Bortezomib) will be dosed at RP2D-4.
  • Selinexor
  • Dexamethasone
  • Pomalidomide
  • Bortezomib
  • Clarithromycin
5: Selinexor, Low-dose dexamethasone, and Daratumumab (SDd)ExperimentalEach cycle is of 28 days Cohort 5.1: SEL 80/100 mg PO once weekly; DEX 40 mg once weekly (IV or PO); DARA: 16 mg/kg IV infusion Cycle 1-2: Once weekly, Cycle 3-6: Every other week, Cycle 6 and greater: Once a month. Cohort 5.2: SEL: 60 mg PO twice weekly; DEX: 40 mg weekly (IV or PO); DARA: 16 milligram per kilogram (mg/kg) IV infusion Cycle 1-2: Once. weekly, Cycle 3-6: Every other week, Cycle 6 and greater: Once a month. Cohort 5.3: Selinexor, Dexamethasone and Daratumumab will be dosed at RP2D-5.
  • Selinexor
  • Dexamethasone
  • Daratumumab
6: Selinexor, Low-dose dexamethasone, and Carfilzomib (SKd)ExperimentalPK Run-in Period: Selinexor and Clarithromycin: For the first 9 patients enrolled into this dose escalation arm 14 day run-in period after which patient will proceed to Dose-Escalation Phase C1D1 Selinexor 40 mg will be dosed on Days 1 and 8. Clarithromycin 500 mg will be dosed twice daily on Days 2-8. PK samples will be collected on Days 1 and 8 at 1, 1.5, 2, 3, 4, 5, 6, 8, and 24 hours post dose. Dose-Escalation Phase: All patients enrolled into this Arm Each cycle is of 28 days Cohort 6.1: SEL 40/60/80/100 mg PO once weekly on days 1, 8, 15, and 22; DEX 40 mg IV or PO once weekly; Carfilzomib (CAR) 56 or 70 mg/m^2 IV infusion once weekly on days 1, 8, and 15. Cohort 6.2: SEL 60/80/100 mg PO once weekly on days 1, 8, and 15; DEX 40 mg IV or PO once weekly; CAR 56 or 70 mg/m^2 IV infusion once weekly on days 1, 8, and 15. Cohort 6.3: Selinexor, Dexamethasone and Carfilzomib will be dosed at RP2D-6.
  • Selinexor
  • Dexamethasone
  • Carfilzomib
  • Clarithromycin
7: Selinexor, Low-dose DEX and Lenalidomide (SRd) in NDMMExperimentalEach cycle is of 28 days Cohort 7.1: SEL 40/60/80 mg PO once weekly; DEX 40 mg PO once weekly; LEN 25 mg PO Days 1-21. Cohort 7.3: Selinexor, Dexamethasone and Lenalidomide will be dosed at RP2D-7.
  • Selinexor
  • Dexamethasone
  • Lenalidomide
8: Selinexor, Low-dose dexamethasone, and Ixazomib (SNd)ExperimentalPK Run-in Period: Selinexor & Clarithromycin: For the first 9 patients enrolled into this dose escalation arm 14 day run-in period after which patient will proceed to Dose-Escalation Phase C1D1 Selinexor 40 mg will be dosed on Days 1 and 8. Clarithromycin 500 mg will be dosed twice daily on Days 2-8. PK samples will be collected on Days 1 and 8 at 1, 1.5, 2, 3, 4, 5, 6, 8, and 24 hours post dose. Dose-Escalation Phase: All patients enrolled into this Arm Each cycle is of 28 days Cohort 8.1: SEL 40/60/80/100 mg PO once weekly; DEX 20 mg PO twice weekly; IXA 3/4 mg PO once weekly. Cohort 8.3: Selinexor, Dexamethasone and Ixazomib will be dosed at RP2D-8.
  • Selinexor
  • Dexamethasone
  • Ixazomib
  • Clarithromycin
9: Selinexor, Low-dose DEX, Pomalidomide and Elotuzumab (SPEd)ExperimentalPK Run-in Period: Selinexor and Clarithromycin: For the first 9 patients enrolled into this dose escalation arm 14 day run-in period after which patient will proceed to Dose-Escalation Phase C1D1 Selinexor 40 mg will be dosed on Days 1 and 8. Clarithromycin 500 mg will be dosed twice daily on Days 2-8. PK samples will be collected on Days 1 and 8 at 1, 1.5, 2, 3, 4, 5, 6, 8, and 24 hours post dose. Dose-Escalation Phase: All patients enrolled into this Arm Each cycle is of 28 days Cohort 9.1: SEL 20/40/60 mg PO once weekly; DEX 28/20 mg PO twice weekly; POM 4 mg PO QD Days 1-21; Elotuzumab (ELO) 10/20 mg/kg IV will be given once weekly on Days 1,8, 15 and 22 of Cycles 1-2. Starting on Cycle 3 and continuing for future cycles, elotuzumab will be dosed at 20 mg/kg on Day 1 of each cycle only. Cohort 9.3: Selinexor, Dexamethasone, Pomalidomide and Elotuzumab will be dosed at RP2D-9.
  • Selinexor
  • Dexamethasone
  • Pomalidomide
  • Elotuzumab
10. Selinexor, Dexamethasone, and Belantamab Mafodotin (SBd)ExperimentalEach cycle is of 21 days Cohort 10.1: SEL 40/60/80 mg PO once weekly on Days 1, 8, and 15; DEX 40 mg PO QW on Days 1, 8, and 15; Belantamab Mafodotin (BEL) 2.5 mg/kg IV infusion every 3 weeks (Q3W) Day 1 of each cycle. Cohort 10.3: Selinexor, Dexamethasone, and Belantamab Mafodotin will be dosed at RP2D-10.
  • Selinexor
  • Dexamethasone
  • Belantamab Mafodotin
11. Selinexor, Dexamethasone, Pomalidomide, and Daratumumab (SDPd)ExperimentalEach Cycle is of 28 days Cohort 11.1 SEL 40/60 mg PO once weekly on Days 1, 8, and 15; DEX total 40 mg weekly (IV or PO) single or divided doses on Days 1, 8, 15, and 22; POM 4 mg PO QW Days 1-21; DARA 16 mg/kg IV or SC QW on Days 1, 8, 15 and 22 of Cycles 1-2 and on Days 1 and 15 of Cycles 3-6, Day 1 of every Cycle greater than (>6). Cohort 11.3 Selinexor, Dexamethasone, Pomalidomide, and Daratumumab will be dosed at RP2D-11.
  • Selinexor
  • Dexamethasone
  • Pomalidomide
  • Daratumumab

Eligibility Criteria

        Inclusion Criteria:

          1. Written informed consent signed in accordance with federal, local, and institutional
             guidelines.

          2. Age greater than or equal to (≥) 18 years at the time of informed consent.

          3. Histologically confirmed diagnosis with measurable disease for relapsed/refractory
             myeloma.

          4. Symptomatic MM, based on IMWG guidelines.

          5. Patients must have measurable disease as defined by at least one of the following:

               1. Serum M-protein ≥ 0.5 gram per deciliter (g/dL) by serum protein electrophoresis
                  (SPEP) or, for immunoglobulin A (IgA) myeloma, by quantitative IgA

               2. Urinary M-protein excretion at least 200 mg/24 hours

               3. Serum free light chain (FLC) ≥ 100 milligram per liter (mg/L), provided that FLC
                  ratio is abnormal

               4. If SPEP is felt to be unreliable for routine M-protein measurement (example, for
                  IgA MM), then quantitative immunoglobulin (Ig) levels by nephelometry or
                  turbidometry are acceptable

          6. Any non-hematological toxicities (except for peripheral neuropathy as described in
             exclusion criterion #22) that patients had from treatments in previous clinical
             studies must have resolved to less than or equal (≤) Grade 2 by C1D1.

          7. Eastern Cooperative Oncology Group (ECOG) Performance Status of ≤ 2.

          8. Adequate hepatic function within 28 days prior to C1D1:

               -  For SPd, SRd, and SPEd: Total bilirubin < 2* upper limit of normal (ULN) (except
                  patients with Gilbert's syndrome [hereditary indirect hyperbilirubinemia] who
                  must have a total bilirubin of ≤ 3* ULN) and both aspartate aminotransferase
                  (AST) and alanine aminotransferase (ALT) < 2.5* ULN

               -  For SVd, SPVd, SDd, SNd, SBd and SDPd: Total bilirubin of < 1.5* ULN (except
                  patients with Gilbert's syndrome [hereditary indirect hyperbilirubinemia] who
                  must have a total bilirubin of ≤ 3* ULN) and both AST and ALT < 2.0* ULN

               -  For SKd: Total bilirubin < 2* ULN (except patients with Gilbert's syndrome
                  [hereditary indirect hyperbilirubinemia] who must have a total bilirubin of ≤ 3*
                  ULN) and both AST and ALT < 3.0* ULN

          9. Adequate renal function within 28 days prior to C1D1. Estimated creatinine clearance
             (CrCl) calculated using the formula of Cockroft and Gault (1976):

               -  ≥ 20 milliliter per minute (mL/min) for SVd, SDd, and SKd arms

               -  ≥ 30 mL/min for SNd and SBd arms

               -  ≥ 45 mL/min for SPd, SPVd, SPEd and SDPd arms

               -  > 60 mL/min for SRd arm

         10. Adequate hematopoietic function within 28 days prior to C1D1: total white blood cell
             (WBC) count ≥ 1,500/millimeter cube (mm^3), absolute neutrophil count (ANC) ≥
             1,000/mm^3, hemoglobin (Hb) ≥ 8.0 g/dL, and platelet count ≥ 100,000/mm^3.

               -  SPVd (Arm 4) and SKd (Arm 6) only: platelet count ≥150,000.

         11. Female patients of childbearing potential must have a negative serum pregnancy test at
             Screening. Female patients of childbearing potential and fertile male patients must
             use highly effective methods of contraception throughout the study and for 1 week
             following the last dose of study treatment.

             SPd (Arm 1) Only:

         12. Relapsed or refractory MM with:

               1. Documented evidence of progressive disease (PD) after achieving at least stable
                  disease (SD) for ≥ 1 cycle during a previous MM regimen (i.e., relapsed MM)

               2. ≤ 25 percent (%) response (i.e., patients never achieved ≥ MR) or PD during or
                  within 60 days from the end of the most recent MM regimen (i.e., refractory MM)

               3. Previously undergone ≥ 2 cycles of lenalidomide and a PI (in separate therapeutic
                  regimens [not for maintenance] or in combination)

               4. In the expansion arm at RP2D, patients must not be pomalidomide refractory

             SVd (Arm 2) Only:

         13. Relapsed or refractory MM with:

               1. Documented evidence of relapse after ≥ 1 previous line of therapy

               2. Not refractory to bortezomib in their most recent line of therapy

             SRd in RRMM (Arm 3) Only:

         14. Patients who received ≥ 1 prior therapeutic regimen (prior lenalidomide is allowed as
             long as patient's MM was not refractory to prior lenalidomide; patients whose MM was
             refractory to lenalidomide maintenance regimens will be allowed in this cohort).

             SPVd (Arm 4) Only:

         15. Patients who received 1- 3 prior lines of therapy, including ≥ 2 cycles of
             lenalidomide and have demonstrated disease progression on their last therapy (may
             include prior bortezomib, as long as the patient's MM was not refractory to bortezomib
             therapy), but patients must be pomalidomide-naïve in the Dose Expansion at RP2D
             (Cohort 4.3 ONLY).

             SDd (Arm 5) Only:

         16. Patients who received ≥ 3 prior lines of therapy, including a PI and an
             immunomodulatory agent (IMiD), or patients with MM refractory to both a PI and an
             IMiD.

         17. Patients must not have received prior anti-cluster of differentiation 38 (anti-CD38)
             monoclonal antibodies (Cohort 5.3 ONLY - Dose Expansion at RP2D).

             SKd (Arm 6) Only:

         18. Patients may have received prior PIs; however, their MM must NOT be refractory to
             carfilzomib.

             SRd in NDMM (Arm 7) Only:

         19. Patients must have symptomatic myeloma per IMWG guidelines with either CRAB criteria
             (calcium elevation, renal failure, anemia, lytic bone lesions) or myeloma-defining
             events and need systemic therapy. No prior systemic therapy for NDMM is permitted
             other than pulse dose dexamethasone (maximum dose of 160 mg) or corticosteroid
             equivalent.

             SNd (Arm 8) Only:

         20. Patients must have MM that relapsed after 1 - 3 prior lines of therapy (may not
             include those with MM refractory to bortezomib or carfilzomib but patients must be
             ixazomib-naïve).

             SPEd (Arm 9) Only:

         21. Patients who received ≥ 2 prior therapies, including lenalidomide and a proteasome
             inhibitor (in separate or the same regimens), but patients must be pomalidomide-naive
             and elotuzumab-naive in the Dose Expansion at RP2D (Cohort 9.3 ONLY).

             SBd (Arm 10) Only:

         22. Patients who have MM that was refractory to an IMiD, a proteasome inhibitor, and
             refractory or intolerant (or both) to an anti-CD38 monoclonal antibody. Patients must
             be belantamab mafodotin-naive in the Dose Expansion cohort at RP2D (Cohort 10.3 ONLY).

        SDPd (Arm 11) Only:

        Patients who received 1-3 prior therapies, including lenalidomide and a proteasome
        inhibitor (in separate or the same regimen), but patients must be pomalidomide-naive and
        daratumumab-naive in the Dose Expansion cohort at RP2D (Cohort 11.3 ONLY).

        Exclusion Criteria:

        Patients meeting any of the following exclusion criteria are not eligible to enroll in this
        study:

          1. Smoldering MM.

          2. MM that does not express M-protein or FLC (i.e., non-secretory MM is excluded), and
             quantitative immunoglobulin levels cannot be used instead.

          3. Documented active systemic amyloid light chain amyloidosis.

          4. Active plasma cell leukemia.

          5. Red Blood Cell (RBC) and platelet transfusions and blood growth factors within 14 days
             of C1D1.

          6. Radiation, chemotherapy, or immunotherapy or any other anticancer therapy ≤ 2 weeks
             prior to C1D1, and radio-immunotherapy within 6 weeks prior to C1D1. Patients on
             long-term glucocorticoids during Screening do not require a washout period. Prior
             radiation is permitted for treatment of fractures or to prevent fractures as well as
             for pain management.

          7. Patients with history of spinal cord compression with residual paraplegia (Dose
             Escalation Phase only).

          8. Treatment with an investigational anti-cancer therapy within 3 weeks prior to C1D1.

          9. Prior autologous stem cell transplantation < 1 month, or allogeneic stem cell
             transplantation < 3 months prior to C1D1.

         10. Active graft versus host disease after allogeneic stem cell transplantation.

         11. Life expectancy < 3 months.

         12. Major surgery within 4 weeks prior to C1D1.

         13. Active, unstable cardiovascular function:

               1. Symptomatic ischemia, or

               2. Uncontrolled clinically-significant conduction abnormalities (e.g., patients with
                  ventricular tachycardia on antiarrhythmics are excluded; patients with 1st degree
                  atrioventricular (AV) block or asymptomatic left anterior fascicular block/right
                  bundle branch block (LAFB/RBBB) will not be excluded), or

               3. Congestive heart failure (CHF) of New York Heart Association (NYHA) Class ≥ 3, or

               4. Myocardial infarction (MI) within 3 months prior to C1D1

               5. Ejection fraction (EF) < 50% at Screening

         14. Uncontrolled active hypertension.

         15. Uncontrolled active infection requiring parenteral antibiotics, antivirals, or
             antifungals within one week prior to first dose.

         16. Known active hepatitis A, B or C.

         17. Known human immunodeficiency virus (HIV) infection or HIV seropositivity.

         18. Any active gastrointestinal dysfunction that prevents the patient from swallowing
             tablets or interferes with absorption of study treatment.

         19. Currently pregnant or breastfeeding.

         20. A serious active psychiatric or active medical condition which, in the opinion of the
             Investigator, could interfere with treatment.

         21. Hypersensitivity to any of the treatments for the arm in which the patient is
             enrolled.

         22. SVd Arm (Arm 2), SPVd (Arm 4), and SNd Arm (Arm 8) only: Prior history of neuropathy
             Grade > 2, or Grade ≥ 2 neuropathy with pain at Screening (within 28 days prior to
             C1D1).

         23. Patients who are eligible for the selinexor PK Run-in only: Treatment with moderate or
             strong inhibitors/inducers of CYP3A within 7 days prior to Day 1 of the PK Run-in
             period.

         24. Patients who are eligible for the selinexor PK Run-in only: Not able to receive a
             strong CYP3A4 inhibitor due to concomitant medications.

         25. SKd arm only: HBs Ag + plus HBc Ab + even though no active hepatitis B virus (HBV)
             hepatitis. If HBs Ag - plus HBc Ab +, treating physician needs to contact the medical
             monitor.

         26. Prior exposure to a selective inhibitor of nuclear export (SINE) compound, including
             selinexor.

             SBd (Arm 10): Only:

         27. Current corneal epithelial disease except mild punctate keratopathy.
      
Maximum Eligible Age:N/A
Minimum Eligible Age:18 Years
Eligible Gender:All
Healthy Volunteers:No

Primary Outcome Measures

Measure:Phase 1 (Dose-escalation): Maximum Tolerated Dose (MTD)
Time Frame:12 months
Safety Issue:
Description:MTD for once weekly and twice weekly selinexor dose cohorts in the 11 Arms will be evaluated.

Details

Phase:Phase 1/Phase 2
Primary Purpose:Interventional
Overall Status:Recruiting
Lead Sponsor:Karyopharm Therapeutics Inc

Trial Keywords

  • Selinexor
  • KCP-330
  • STOMP
  • Multiple Myeloma
  • Relapsed/Refractory
  • Dexamethasone
  • Pomalidomide
  • Bortezomib
  • Karyopharm
  • Lenalidomide
  • Daratumumab
  • Newly Diagnosed
  • Carfilzomib
  • Ixazomib
  • Elotuzumab
  • Clarithromycin
  • Belantamab mafodotin

Last Updated

April 28, 2021