Description:
This is a Phase 2, multicenter, two-arm, open-label study to evaluate the safety and efficacy
of selinexor versus treatment per physician's choice (PC) in participants with myelofibrosis
(MF) who had at least 6 months of treatment with a Janus kinase (JAK)1/2 inhibitor. Study
participants will be randomized in a 1:1 ratio to either receive selinexor or physicians'
choice of treatment.
Title
- Brief Title: A Study to Evaluate Safety and Efficacy of Selinexor Versus Treatment of Physician's Choice in Participants With Previously Treated Myelofibrosis
- Official Title: A Phase 2, Randomized, Open-Label, Multicenter Study to Evaluate Safety and Efficacy of Single Agent Selinexor Versus Treatment of Physician's Choice in Patients With Previously Treated Myelofibrosis
Clinical Trial IDs
- ORG STUDY ID:
XPORT-MF-035
- SECONDARY ID:
2020-003809-60
- NCT ID:
NCT04562870
Conditions
Interventions
Drug | Synonyms | Arms |
---|
Selinexor | | Arm S: Selinexor |
Purpose
This is a Phase 2, multicenter, two-arm, open-label study to evaluate the safety and efficacy
of selinexor versus treatment per physician's choice (PC) in participants with myelofibrosis
(MF) who had at least 6 months of treatment with a Janus kinase (JAK)1/2 inhibitor. Study
participants will be randomized in a 1:1 ratio to either receive selinexor or physicians'
choice of treatment.
Trial Arms
Name | Type | Description | Interventions |
---|
Arm S: Selinexor | Experimental | Participants with MF who had previously received at least 6 months of treatment with JAK 1/2 inhibitor will receive Selinexor 60 mg oral tablets once weekly (QW) on Days 1, 8, 15, and 22 of each 28-day cycle. | |
Arm PC: Physician's Choice Treatment | Active Comparator | Participants with MF who had previously received at least 6 months of treatment with JAK 1/2 inhibitor will receive Physician's choice treatment which will be administered as per clinical practice. | |
Eligibility Criteria
Inclusion Criteria:
- A diagnosis of primary MF or post-essential thrombocythemia (ET) or post-polycythemia
(PV) MF according to the 2016 World Health Organization (WHO) classification of
myeloproliferative neoplasms (MPN), confirmed by the most recent local pathology
report.
- Previous treatment with JAK inhibitors for at least 6 months.
- Measurable splenomegaly during the screening period as demonstrated by spleen volume
of ≥450 centimeter cube (cm^3) by magnetic resonance imaging (MRI) or computerized
tomography (CT) scan.
- Relapsed, Refractory or Intolerant to JAK inhibitors as defined as meeting one of the
criteria below:
- less than (<) 35% spleen volume reduction by MRI or CT-scan (from baseline) or
- <50% decrease in spleen size by palpation (from baseline) or an increase of at
least 3 cm with the spleen at least 5 cm below the left costal margin or
- Spleen volume increase greater than (>) 25% from nadir or a return to within 10%
of baseline after any initial response or
- Treatment with JAK inhibitor was complicated by development of red blood cells
(RBC) transfusion requirement (2 units per month for 2 month); or grade 3
thrombocytopenia, anemia, hematoma/hemorrhage; or grade 2 non-hematologic
toxicity while on JAK inhibitors
- Participants ≥18 years of age.
- Eastern Cooperative Oncology Group (ECOG) less than or equal to (≤) 2.
- Platelet count ≥100*10^9 per liter (/L).
- Absolute neutrophil count (ANC) ≥1.5*10^9/L.
- Serum direct bilirubin ≤1.5*upper limit of normal (ULN); aspartate aminotransferase
(AST) and alanine aminotransferase (ALT) ≤2.5*ULN.
- Calculated creatinine clearance (CrCl) >15 milliliter (mL)/minute (min) based on the
Cockcroft and Gault formula.
- Participants with active hepatitis B virus (HBV) are eligible if antiviral therapy for
hepatitis B has been given for >8 weeks and viral load is <100 International Units
(IU)/mL.
- Participants with untreated hepatitis C virus (HCV) are eligible if there is a
documentation of negative viral load per institutional standard.
- Participants with history of human immunodeficiency virus (HIV) are eligible if they
have cluster of differentiation 4 (CD4)+ T-cell counts ≥350 cells/microliter (mcL),
negative viral load per institutional standard, and no history of acquired
immunodeficiency syndrome (AIDS)-defining opportunistic infections in the last year.
- Female participants of childbearing potential must have a negative serum pregnancy
test at screening and agree to use highly effective methods of contraception
throughout the study and for one month following the last dose of study treatment.
Childbearing potential excludes: Age >50 years and naturally amenorrhoeic for >1 year,
or previous bilateral salpingo-oophorectomy, or hysterectomy.
- Male participants who are sexually active must use highly effective methods of
contraception throughout the study and for one month following the last dose of study
treatment. Male Participants must agree not to donate sperm during the study treatment
period.
- Participants must sign written informed consent in accordance with federal, local and
institutional guidelines.
Exclusion Criteria:
- >5% blasts in peripheral blood or >10% blasts in bone marrow (i.e., accelerated
phase).
- Previous treatment with selinexor or other exportin 1 (XPO1) inhibitors.
- Use of any standard or experimental anti-MF therapy <21 days prior to Cycle 1 Day 1
(hydroxyurea is allowed).
- Impairment of gastrointestinal (GI) function or GI disease that could significantly
alter the absorption of selinexor (Example: vomiting, or diarrhea that is Common
Terminology Criteria for Adverse Events (CTCAE) grade >1).
- Received strong cytochrome P450 3A (CYP3A) inhibitors ≤7 days prior to selinexor
dosing or strong CYP3A inducers ≤14 days prior to selinexor dosing.
- Major surgery <28 days prior to cycle 1 day 1 (C1D1).
- Uncontrolled (ie, clinically unstable) infection requiring parenteral antibiotics,
antivirals, or antifungals within 7 days prior to first dose of study treatment;
however, prophylactic use of these agents is acceptable (including parenteral).
- Any life-threatening illness, medical condition, or organ system dysfunction which, in
the Investigator's opinion, could compromise the participants safety, prevent the
participant from giving informed consent, or being compliant with the study
procedures.
- Female participants who are pregnant or lactating.
Maximum Eligible Age: | N/A |
Minimum Eligible Age: | 18 Years |
Eligible Gender: | All |
Healthy Volunteers: | No |
Primary Outcome Measures
Measure: | Percentage of Participants with Spleen Volume Reduction of Greater Than or Equal to (≥) 35 Percent (%) (SVR35) Assessed by Independent Review Committee (IRC) |
Time Frame: | From Baseline up to Week 48 |
Safety Issue: | |
Description: | |
Secondary Outcome Measures
Measure: | Percentage of Participants with Total Symptom Score Reduction of ≥50% (TSS50) Measured by Myelofibrosis Symptom Assessment Form (MFSAF) V4.0, Based on Local Assessment |
Time Frame: | From Baseline up to end of last cycle (approximately 48 months) |
Safety Issue: | |
Description: | |
Measure: | Percentage of Participants with Spleen Volume Reduction of ≥25% (SVR25) Assessed by IRC |
Time Frame: | From Baseline up to Week 48 |
Safety Issue: | |
Description: | |
Measure: | Overall Survival (OS) |
Time Frame: | From Baseline up to 12 months after end of treatment (approximately 60 months) |
Safety Issue: | |
Description: | |
Measure: | Percentage of Participants with Anemia Response Assessed by International Working Group-Myeloproliferative Neoplasms Research and Treatment (IWG-MRT ) |
Time Frame: | From Baseline up to 28 Days after last dose (approximately 48 months) |
Safety Issue: | |
Description: | |
Measure: | Duration of Spleen Volume Reduction of ≥35% (SVR35) Assessed by IRC |
Time Frame: | From Baseline up to 28 Days after last dose (approximately 48 months) |
Safety Issue: | |
Description: | |
Measure: | Duration of Spleen Volume Reduction of ≥25% (SVR25) Assessed by IRC |
Time Frame: | From Baseline up to 28 Days after last dose (approximately 48 months) |
Safety Issue: | |
Description: | |
Measure: | Duration of Total Symptom Score is ≥50% (TSS50) Based on Local Assessment |
Time Frame: | From Baseline up to 28 Days after last dose (approximately 48 months) |
Safety Issue: | |
Description: | |
Measure: | Overall Response Rate (ORR) Assessed by IWG-MRT |
Time Frame: | From Baseline up to 28 Days after last dose (approximately 48 months) |
Safety Issue: | |
Description: | |
Measure: | Number of Participants With Treatment-emergent Adverse Events (TEAEs) by Severity Grade ≥3, Serious Adverse event (SAEs), and AEs Leading to Treatment Discontinuation |
Time Frame: | From first dose of study treatment up to 30 days after end of treatment (approximately 48 months) |
Safety Issue: | |
Description: | |
Measure: | Pharmacokinetic (PK) Parameter: Area Under the Plasma Concentration-time Curve (AUC) of Selinexor |
Time Frame: | Cycle 2 Day 1: 1, 2, 4, 6, and 24 hours post dose (each cycle is 28 days) |
Safety Issue: | |
Description: | |
Measure: | PK Parameter: Maximum Plasma Concentration (Cmax) of Selinexor |
Time Frame: | Cycle 2 Day 1: 1, 2, 4, 6, and 24 hours post dose (each cycle is 28 days) |
Safety Issue: | |
Description: | |
Details
Phase: | Phase 2 |
Primary Purpose: | Interventional |
Overall Status: | Recruiting |
Lead Sponsor: | Karyopharm Therapeutics Inc |
Trial Keywords
- Myelofibrosis
- Selinexor
- Total Symptom Score
- Spleen Volume Reduction
- Anemia response
- TSS50
- SVR35
- SVR25
- KPT-330
- JAK1
- JAK2
- XPOVIO
- SINE
- XPORT-MF-035
- Karyopharm
Last Updated
July 21, 2021