Study of Selinexor (KPT- 330), Lenalidomide, & Dexamethasone in Relapsed/Refractory Multiple Myeloma Patients (SLAM)
Multiple Myeloma
About this trial
This is an interventional treatment trial for Multiple Myeloma focused on measuring KPT-330, Selinexor, Multiple Myeloma, Relapsed/refractory, Lenalidomide, Dexamethasone, Karyopharm
Eligibility Criteria
Inclusion Criteria:
- Histologically confirmed diagnosis, measurable disease and evidence of disease progression of MM.
- Relapsed or refractory to the most recently received therapy. Relapsed is defined as documented evidence of PD after achieving at least SD for ≥ 1 cycle. Refractory disease is defined as ≤ 25% response (i.e., patients never achieved minimal response or better) or progression during therapy or within 60 days after completion of therapy.
- Symptomatic MM, based on IMWG guidelines. Patients must have measurable disease.
Exclusion Criteria:
- Smoldering MM.
- Multiple myeloma that does not express M-protein or FLC (i.e., non-secretory MM is excluded), and quantitative immunoglobulin levels cannot be used instead.
- Polyneuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes (POEMS) syndrome
- Active MM involving the central nervous system (CNS).
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Experimental
Experimental
A: Selinexor (1x/week), Lenalidomide, & Dexamethasone
B: Selinexor (2x/week), Lenalidomide, & Dexamethasone
Lenalidomide will be dosed initially at 15 mg daily, and if that dose is tolerated per dose-limiting toxicity (DLT criteria,) it will be increased to 25 mg for that arm. Selinexor will be started at 80 mg (~45 mg/m2) once weekly in combination with dexamethasone 40 mg once weekly with each dose of selinexor. If the selinexor 80 mg dose is tolerated per DLT criteria, the dose will be increased to 100 mg (~60 mg/m2) and evaluated for MTD, tolerability and efficacy.
Lenalidomide will be dosed initially at 15 mg daily, and if that dose is tolerated per DLT criteria, it will be increased to 25 mg for that arm. Selinexor will be started at 60 mg (~35 mg/m2) twice weekly in combination with dexamethasone 20 mg twice weekly with each dose of selinexor; dexamethasone 20 mg will also be given, without selinexor, on Days 22 and 24. If the selinexor 60 mg dose is tolerated per DLT criteria, the dose will be increased to 80 mg (~45 mg/m2) and evaluated for MTD, tolerability and efficacy.