Description:
Background:
Glioblastoma is a type of brain cancer. Treatments include radiation, chemotherapy, and
surgery. But survival rates are poor. Researchers think that the drug selinexor, when
combined with chemotherapy and radiation, might help.
Objective:
To learn the highest dose of selinexor that people with brain cancer can tolerate when given
with temozolomide and radiation therapy.
Eligibility:
People ages 18 and older with brain cancer that has not been treated with chemotherapy or
radiation
Design:
Participants will be screened under another protocol.
Before participants start treatment, they will have tests:
Neurological and physical evaluations
Blood and urine tests
Possible CT scan or MRI of the brain if they have not had one in 3 weeks. Participants will
lie in a machine that takes pictures of the body. They may have a dye injected into a vein.
Surveys about their well-being
Participants will have radiation to the brain for up to 6 weeks. This will usually be given
once a day, Monday through Friday.
Starting the second day of radiation, participants will take selinexor by mouth once a week.
They will take it in weeks 1, 2, 4, and 5. The timing may be changed.
Starting the first day of radiation, participants will take temozolomide by mouth once a day
until they complete radiation.
Participants will have blood tests once per week during treatment.
Participants will have a follow-up visit 1 month after they complete treatment. Then they
will have visits at least every 2 months for the first 2 years, then at least every 3 months
for another year. Visits will include MRIs and blood tests.
...
Title
- Brief Title: Selinexor (KPT-330) in Combination With Temozolomide and Radiation Therapy in Patients With Newly Diagnosed Glioblastoma
- Official Title: A Phase I Clinical Trial of Selinexor (KPT-330) in Combination With Temozolomide and Radiation Therapy in Patients With Newly Diagnosed Glioblastoma
Clinical Trial IDs
- ORG STUDY ID:
200027
- SECONDARY ID:
20-C-0027
- NCT ID:
NCT04216329
Conditions
- Gliosarcoma
- Newly Diagnosed
- Glioblastoma
Interventions
Drug | Synonyms | Arms |
---|
Selinexor | | 1/Experimental therapy |
Temozolomide | | 1/Experimental therapy |
Purpose
Background:
Glioblastoma is a type of brain cancer. Treatments include radiation, chemotherapy, and
surgery. But survival rates are poor. Researchers think that the drug selinexor, when
combined with chemotherapy and radiation, might help.
Objective:
To learn the highest dose of selinexor that people with brain cancer can tolerate when given
with temozolomide and radiation therapy.
Eligibility:
People ages 18 and older with brain cancer that has not been treated with chemotherapy or
radiation
Design:
Participants will be screened under another protocol.
Before participants start treatment, they will have tests:
Neurological and physical evaluations
Blood and urine tests
Possible CT scan or MRI of the brain if they have not had one in 3 weeks. Participants will
lie in a machine that takes pictures of the body. They may have a dye injected into a vein.
Surveys about their well-being
Participants will have radiation to the brain for up to 6 weeks. This will usually be given
once a day, Monday through Friday.
Starting the second day of radiation, participants will take selinexor by mouth once a week.
They will take it in weeks 1, 2, 4, and 5. The timing may be changed.
Starting the first day of radiation, participants will take temozolomide by mouth once a day
until they complete radiation.
Participants will have blood tests once per week during treatment.
Participants will have a follow-up visit 1 month after they complete treatment. Then they
will have visits at least every 2 months for the first 2 years, then at least every 3 months
for another year. Visits will include MRIs and blood tests.
...
Detailed Description
Background:
- Although radiation has been shown to improve outcomes in patients with glioblastoma
(GBM), median survival remains poor. Even with the addition of temozolomide (TMZ) to
surgical resection and radiotherapy, most GBMs will recur in field or adjacent to the
high dose radiation volume.
- High rates of local failure indicate that GBM cells in situ are relatively
radioresistant and that the effectiveness of GBM radiotherapy would benefit from
additional radiosensitization.
- Selinexor has recently been shown to enhance the radiosensitivity of glioma cells both
in vitro and in vivo.
Objectives:
-Assess the safety, tolerability, and maximum tolerated dose of selinexor when combined with
temozolomide and radiotherapy in patients with newly diagnosed glioblastoma and gliosarcoma.
Eligibility:
- Men and women greater than 18 years old
- Histologically confirmed newly diagnosed glioblastoma or gliosarcoma
- Karnofsky Performance Scale (KPS) greater than or equal to 70
- Patients who have not previously been treated with chemotherapy or radiation therapy
Design:
- This is a Phase I trial to determine the safety and tolerability of selinexor in
combination with external beam radiation therapy (RT) and temozolomide in patients with
newly diagnosed glioblastoma or gliosarcoma using a "3 plus 3 design," and three dose
escalation levels, with 3 patients per dose level (provided no DLT), a maximum of 21
patients will be enrolled.
- Patients will be treated with external beam radiation therapy in a standard manner with
temozolomide given daily during radiation. Selinexor will be administered concurrent
with the RT/temozolomide.
- We anticipate accrual of 21 evaluable patients which will take approximately 2 years.
The accrual ceiling has been set to 24 patients
Trial Arms
Name | Type | Description | Interventions |
---|
1/Experimental therapy | Experimental | Selinexor with temozolomide and radiation | |
Eligibility Criteria
- INCLUSION CRITERIA:
1. Histological diagnosis
--Pathologically confirmed glioblastoma or gliosarcoma
2. Patients must be eligible for definitive external beam radiotherapy and
temozolomide.
3. Age >18 years. Because no dosing or adverse event data are currently available on
the use of Selinexor in combination with Temodar in patients <18 years of age,
children are excluded from this study.
4. Patients should have a KPS greater than or equal to 70
5. Absolute neutrophil count (ANC) >1.5x10^9/L; platelet count >100x10^9/L; and
hemoglobin (Hb) >9.0 g/dL within 7 days prior to enrollment. Note: the use of
transfusion or other intervention prior to cycle 1 day 1 to achieve Hb >9.0 g/dL
is acceptable.
6. Ability of subject or Legally Authorized Representative (LAR) to understand and
the willingness to sign a written informed consent document.
7. The effects of Selinexor on the developing human fetus are unknown. For this
reason and because Selinexor agents as well as other therapeutic agents used in
this trial are known to be teratogenic, women of child-bearing potential and men
must agree to use
adequate contraception (hormonal or barrier method of birth control; abstinence)
prior to study entry, for the duration of study treatment and for one month after
treatment. Should a woman become pregnant or suspect she is pregnant while she or
her partner is participating in this study, she should inform her treating
physician immediately.
8. Patients must have had surgery and/or biopsy not greater than 8 weeks prior to
initial evaluation to be eligible for this study.
EXCLUSION CRITERIA:
1. Patients who are receiving any other investigational agents and have had prior therapy
including:
- Patients who have previously received radiation therapy (RT) to the brain.
- Patients who received chemotherapy for the treatment of their glioma
- Patients who are being treated with implanted gliadel wafers
- Patients who are being treated with tumor treating fields
2. History of allergic reactions attributed to compounds of similar chemical or biologic
composition to selinexor or temozolomide used in study.
3. Patients with coagulation problems and medically significant bleeding in the month
prior to start of treatment (peptic ulcers, epistaxis, spontaneous bleeding). Prior
history of DVT or PE is not exclusionary
4. Patients with active uncontrolled or suspected infections
5. Patients with severe liver dysfunction defined as:
- Total bilirubin greater than or equal to 1.5 x upper limit of normal (ULN)
- Serum glutamate pyruvate transaminase (SGPT) or called as Alanine
aminotransferase (ALT) greater than or equal to 3 x ULN = 135 U/L; for the purpose of
this study, the ULN for SGPT is 45 U/L
- Serum glutamic oxaloacetic transaminase (SGOT) or called as Aspartate
aminotransferase (AST) greater than or equal to 3 x ULN = 150 U/L; for the
purpose of this study, the ULN for SGOT is 50 U/L
- Serum albumin less than or equal to 2 x ULN
6. Known active hepatitis A, B, or C infection
7. HIV patients are not eligible because of their immunocompromised status and overlap of
side effects between HAART therapy and radiation therapy.
8. Patients must not have significantly diseased or obstructed gastrointestinal tract
malabsorption, uncontrolled vomiting or diarrhea, or inability to swallow oral
medication
9. Pregnant women are excluded from this study because Selinexor could have the potential
for teratogenic or abortifacient effects. Because there is an unknown but potential
risk for adverse events in nursing infants secondary to treatment of the mother with
Selinexor, breastfeeding should be discontinued if the mother is treated with
Selinexor. These potential risks may also apply to temozolomide used in this study.
10. Patients with pre-existing known or suspected radiation sensitivity syndromes will be
excluded due to potential confounding effect on outcome.
Maximum Eligible Age: | N/A |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | All |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | MTD |
Time Frame: | 7 weeks |
Safety Issue: | |
Description: | The MTD is the dose level at which no more than 1 of up to 6 patients experience DLT within 1 month of completion of treatment, and the dose below that at which at least 2 (of< =6) patients have DLT as a result of selinexor/RT/temozolomide. |
Secondary Outcome Measures
Measure: | Dose-limiting toxicities |
Time Frame: | DLT |
Safety Issue: | |
Description: | Define the dose-limiting toxicities including effects on QOL and neurocognition in the setting of the addition of Selinexor to concurrent radiation therapy and temozolomide. |
Details
Phase: | Phase 1 |
Primary Purpose: | Interventional |
Overall Status: | Recruiting |
Lead Sponsor: | National Cancer Institute (NCI) |
Trial Keywords
- Radiotherapy
- GBM
- Gliosarcoma
Last Updated
August 17, 2021