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A Phase Ib Study of Oral Selinexor in Adult Patients With Relapsed/Refractory B-cell Lymphoma Receiving R-DHAOx or R-GDP (SELINDA)

Primary Purpose

B-cell Lymphoma

Status
Completed
Phase
Phase 1
Locations
International
Study Type
Interventional
Intervention
selinexor
Rituximab
Dexamethasone
Oxaliplatin
Cisplatin
Cytarabine
Gemcitabine
Sponsored by
The Lymphoma Academic Research Organisation
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for B-cell Lymphoma focused on measuring selinexor, lymphoma, inhibitor of nuclear export

Eligibility Criteria

18 Years - 70 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Patients with any type of relapsed or refractory B-cell lymphoma
  2. Eligible to receive R-DHAOx or R-GDP regarding the investigator's opinion
  3. Who received prior therapy with at least one but no more than two lines therapies for B-Cell Lymphoma
  4. Patient must have measurable disease defined by at least one single node or tumor lesion > 1.5 cm
  5. Aged between 18 years and 70 years (included) on date of consent signature
  6. Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1 or 2
  7. With a life expectancy of ≥ 3 months
  8. Having signed a written informed consent
  9. Male patients (if sexually active with a woman of childbearing potential) must agree to use a reliable method of birth control during the study treatment and for at least 6 months after the last study drug administration. Male patients must agree to not donate sperm during the study treatment and for at least 6 months after the last study drug administration
  10. Female patients of childbearing potential must agree to use two reliable methods of birth control during study treatment and for 6 months after the last dose and have a negative serum human chorionic gonadotropin (hCG) pregnancy test within 3 days prior to C1D1. Reliable methods of contraception include intrauterine devices, hormonal contraceptives [contraceptive pills, implants, transdermal patches, hormonal vaginal devices or injections with prolonged release], abstinence or sterilization of the partner.

Exclusion Criteria:

  1. Previous treatment with selinexor
  2. Known central nervous system or meningeal involvement by lymphoma
  3. Contraindication to any drug contained in these regimen
  4. Subjects with known Human Immunodeficiency Virus (HIV) positivity
  5. Subjects with known active Hepatitis B (HB) infection (positive Ag HBs) or positive serology to hepatitis B (Ag HBs or antibody anti-HB c or positive DNA PCR) or active Hepatitis C (HCV) infection (patients with positive HCV serology are eligible only if PCR is negative for known HCV RNA)
  6. Subjects with any uncontrolled active systemic infection requiring intravenous (IV) antibiotics
  7. Any of the following laboratory abnormalities within 14 days prior to first administration (C1D1) of study treatment:

    1. Absolute neutrophil count (ANC) < 1,000 cells/mm3 (1.0 x 109/L)
    2. Spontaneous (within 7 days of any platelet transfusion) platelet count < 100,000/mm3 (100 x 109/L) (75 x 109/L if due to lymphoma)
    3. Aspartate aminotransferase (AST) or Alanine aminotransferase (ALT) > 5.0 x upper limit of normal (ULN)
    4. Serum total bilirubin > 2x Upper Limit of Normal (ULN), or > 5x ULN if due to Gilbert syndrome or lymphoma involvement
  8. Creatinine clearance < 50 mL /min (for patients who will receive DHAOx) or < 70 mL/min (for GDP)
  9. Subjects with pre-existing ≥ Grade 2 neuropathy
  10. Prior history of malignancies other than lymphoma (except for basal cell or squamous cell carcinoma of the skin or in situ carcinoma of the cervix or breast) unless the subject has been free of the disease for ≥ 3 years
  11. Any life-threatening illness, serious active disease or co-morbid medical condition, laboratory abnormality, organ system dysfunction or psychiatric illness which, in the investigator's opinion, could compromise the patient's safety, interfere with the absorption or metabolism of selinexor, or put the study outcomes at undue risk, or that would prevent the subject from signing the informed consent form
  12. Pregnant or breastfeeding women
  13. Use of any standard or experimental anti-cancer drug therapy within 28 days of the initiation (Day 1) of study drug therapy (administration of glucocorticoids should not exceed 1mg/kg/day in the 14 days prior to C1D1)

Sites / Locations

  • Institut Jules Bordet
  • CHU Dijon
  • CHRU de Lille - Hôpital Claude Huriez
  • CHU Montpellier - Hôpital Saint Eloi
  • CHU Nancy - Hôpital de Brabois
  • Hôpital Saint-Louis
  • CHU Bordeaux - Centre François Magendie
  • Centre Henri Becquerel

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Selinexor + immunochemotherapy

Arm Description

Selinexor will be administered orally on Day1, 3, 8 and 10 of each 3-week cycle with an immunochemotherapy, R-DHAOx (Group A: rituximab + dexamethasone + oxaliplatin + cytarabine) or R-GDP (Group B: rituximab + dexamethasone + gemcitabine + cisplatin) for 3 cycles (choice of the immunochemotherapy left at the investigator's decision before patient's inclusion). Different dose levels of selinexor will be examined sequentially in each group: 20 mg flat (DL-1), 40 mg flat (DL1), 60 mg flat (DL2), 80 mg flat (DL3).

Outcomes

Primary Outcome Measures

Incidence rate of dose-limiting toxicities (DLTs) observed during the DLT assessment period (cycle 1) at each dose level examined

Secondary Outcome Measures

Response rates
Response rates will be evaluated according to the Lugano 2014 response criteria based on disease response assessment on Positron emission tomography-computed tomography (PET-CT) performed after completion of the 3 cycles of treatment (for patients who received all 3 cycles) or at permanent discontinuation of treatment (PTD evaluation, within 4 weeks after the last drug administration).
Duration of response
Duration of response is defined as the time of attainment of complete response (CR) or partial response (PR) to the date of first documented disease progression, relapse or death from any cause.
Progression-free survival (PFS)
PFS is defined as the time from inclusion into the study to the first observation of documented disease progression or death due to any cause.
Time to next anti-lymphoma treatment (TTNLT)
TTNLT is defined as the time from the date of inclusion to the date of first documented administration of any new anti-lymphoma treatment (chemotherapy, radiotherapy, radio-immunotherapy or immunotherapy, with the exception of High Dose Therapy/ASCT).
Overall survival (OS)
Overall survival is defined as the time from the date of inclusion to the date of death from any cause.
Incidence of grade ≥ 2 renal toxicities, grade ≥ 2 neuropathy, and grade ≥ 3 toxicities

Full Information

First Posted
April 14, 2016
Last Updated
December 6, 2021
Sponsor
The Lymphoma Academic Research Organisation
Collaborators
Karyopharm Therapeutics Inc
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1. Study Identification

Unique Protocol Identification Number
NCT02741388
Brief Title
A Phase Ib Study of Oral Selinexor in Adult Patients With Relapsed/Refractory B-cell Lymphoma Receiving R-DHAOx or R-GDP
Acronym
SELINDA
Official Title
A Phase Ib Study of Oral Selinexor in Adult Patients With Relapsed/Refractory B-cell Lymphoma Receiving R-DHAOx or R-GDP
Study Type
Interventional

2. Study Status

Record Verification Date
December 2021
Overall Recruitment Status
Completed
Study Start Date
October 2016 (Actual)
Primary Completion Date
September 29, 2021 (Actual)
Study Completion Date
September 29, 2021 (Actual)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
The Lymphoma Academic Research Organisation
Collaborators
Karyopharm Therapeutics Inc

4. Oversight

Data Monitoring Committee
Yes

5. Study Description

Brief Summary
This is an open label, multicenter, dose escalation, phase Ib study to determine the recommended phase II dose (RP2D), by assessing the maximum tolerated dose (MTD), safety and preliminary efficacy of selinexor in adult patients with relapsed/refractory B-cell malignancies receiving either R-DHAOx (Group A) or R-GDP (Group B). This dose escalation phase will be followed by an exploratory expansion phase in the same population with 12 patients enrolled in each group, who will receive selinexor at the RP2D. The "3+3" design will be applied for dose escalation. The escalation will be performed independently in two distinct groups: Group A : Oral selinexor + R-DHAOx for 3 cycles (3-week cycles) Group B: Oral selinexor + R-GDP for 3 cycles (3-week cycles) The choice of the conventional immunotherapy regimen which will be administered to each patient, R-DHAOx (Group A) or R-GDP (Group B), is left at the investigator's decision before patient's inclusion. Different dose levels for selinexor administration will be examined sequentially in each group by the Dose Escalation Committee (DEC): 4 doses of selinexor per 3-week cycle at 20 mg flat (Dose Level -1, DL-1), 40 mg flat (DL1), 60 mg flat (DL2) or 80 mg flat (DL3) will be taken orally by the patient on D1, D3, D8 and D10 of each cycle (dosing weeks = week 1 and week 2 of each 3-week cycle). Dose escalation will begin at DL1 and will continue until the MTD is exceeded or until the highest dose level defined in the study (DL3) is reached. Dose escalation to the next planned dose level will be decided by the DEC based on the number of DLTs observed during the DLT assessment period. The dose escalation phase will be followed by an exploratory expansion phase in the same two groups (Groups A and B), depending on the decision of the Independent Data Monitoring Committee (IDMC) after review of safety data at the end of dose escalation part. Patients enrolled in the expansion phase will receive selinexor at the RP2D defined by the IDMC, together with either of the conventional regimen R-DHAOx or R-GDP (left at the investigator's choice).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
B-cell Lymphoma
Keywords
selinexor, lymphoma, inhibitor of nuclear export

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
39 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Selinexor + immunochemotherapy
Arm Type
Experimental
Arm Description
Selinexor will be administered orally on Day1, 3, 8 and 10 of each 3-week cycle with an immunochemotherapy, R-DHAOx (Group A: rituximab + dexamethasone + oxaliplatin + cytarabine) or R-GDP (Group B: rituximab + dexamethasone + gemcitabine + cisplatin) for 3 cycles (choice of the immunochemotherapy left at the investigator's decision before patient's inclusion). Different dose levels of selinexor will be examined sequentially in each group: 20 mg flat (DL-1), 40 mg flat (DL1), 60 mg flat (DL2), 80 mg flat (DL3).
Intervention Type
Drug
Intervention Name(s)
selinexor
Other Intervention Name(s)
KPT-330
Intervention Type
Drug
Intervention Name(s)
Rituximab
Intervention Type
Drug
Intervention Name(s)
Dexamethasone
Intervention Type
Drug
Intervention Name(s)
Oxaliplatin
Intervention Type
Drug
Intervention Name(s)
Cisplatin
Intervention Type
Drug
Intervention Name(s)
Cytarabine
Intervention Type
Drug
Intervention Name(s)
Gemcitabine
Primary Outcome Measure Information:
Title
Incidence rate of dose-limiting toxicities (DLTs) observed during the DLT assessment period (cycle 1) at each dose level examined
Time Frame
Up to 35 days
Secondary Outcome Measure Information:
Title
Response rates
Description
Response rates will be evaluated according to the Lugano 2014 response criteria based on disease response assessment on Positron emission tomography-computed tomography (PET-CT) performed after completion of the 3 cycles of treatment (for patients who received all 3 cycles) or at permanent discontinuation of treatment (PTD evaluation, within 4 weeks after the last drug administration).
Time Frame
3 months
Title
Duration of response
Description
Duration of response is defined as the time of attainment of complete response (CR) or partial response (PR) to the date of first documented disease progression, relapse or death from any cause.
Time Frame
3 years
Title
Progression-free survival (PFS)
Description
PFS is defined as the time from inclusion into the study to the first observation of documented disease progression or death due to any cause.
Time Frame
3 years
Title
Time to next anti-lymphoma treatment (TTNLT)
Description
TTNLT is defined as the time from the date of inclusion to the date of first documented administration of any new anti-lymphoma treatment (chemotherapy, radiotherapy, radio-immunotherapy or immunotherapy, with the exception of High Dose Therapy/ASCT).
Time Frame
3 years
Title
Overall survival (OS)
Description
Overall survival is defined as the time from the date of inclusion to the date of death from any cause.
Time Frame
3 years
Title
Incidence of grade ≥ 2 renal toxicities, grade ≥ 2 neuropathy, and grade ≥ 3 toxicities
Time Frame
3 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
70 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Patients with any type of relapsed or refractory B-cell lymphoma Eligible to receive R-DHAOx or R-GDP regarding the investigator's opinion Who received prior therapy with at least one but no more than two lines therapies for B-Cell Lymphoma Patient must have measurable disease defined by at least one single node or tumor lesion > 1.5 cm Aged between 18 years and 70 years (included) on date of consent signature Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1 or 2 With a life expectancy of ≥ 3 months Having signed a written informed consent Male patients (if sexually active with a woman of childbearing potential) must agree to use a reliable method of birth control during the study treatment and for at least 6 months after the last study drug administration. Male patients must agree to not donate sperm during the study treatment and for at least 6 months after the last study drug administration Female patients of childbearing potential must agree to use two reliable methods of birth control during study treatment and for 6 months after the last dose and have a negative serum human chorionic gonadotropin (hCG) pregnancy test within 3 days prior to C1D1. Reliable methods of contraception include intrauterine devices, hormonal contraceptives [contraceptive pills, implants, transdermal patches, hormonal vaginal devices or injections with prolonged release], abstinence or sterilization of the partner. Exclusion Criteria: Previous treatment with selinexor Known central nervous system or meningeal involvement by lymphoma Contraindication to any drug contained in these regimen Subjects with known Human Immunodeficiency Virus (HIV) positivity Subjects with known active Hepatitis B (HB) infection (positive Ag HBs) or positive serology to hepatitis B (Ag HBs or antibody anti-HB c or positive DNA PCR) or active Hepatitis C (HCV) infection (patients with positive HCV serology are eligible only if PCR is negative for known HCV RNA) Subjects with any uncontrolled active systemic infection requiring intravenous (IV) antibiotics Any of the following laboratory abnormalities within 14 days prior to first administration (C1D1) of study treatment: Absolute neutrophil count (ANC) < 1,000 cells/mm3 (1.0 x 109/L) Spontaneous (within 7 days of any platelet transfusion) platelet count < 100,000/mm3 (100 x 109/L) (75 x 109/L if due to lymphoma) Aspartate aminotransferase (AST) or Alanine aminotransferase (ALT) > 5.0 x upper limit of normal (ULN) Serum total bilirubin > 2x Upper Limit of Normal (ULN), or > 5x ULN if due to Gilbert syndrome or lymphoma involvement Creatinine clearance < 50 mL /min (for patients who will receive DHAOx) or < 70 mL/min (for GDP) Subjects with pre-existing ≥ Grade 2 neuropathy Prior history of malignancies other than lymphoma (except for basal cell or squamous cell carcinoma of the skin or in situ carcinoma of the cervix or breast) unless the subject has been free of the disease for ≥ 3 years Any life-threatening illness, serious active disease or co-morbid medical condition, laboratory abnormality, organ system dysfunction or psychiatric illness which, in the investigator's opinion, could compromise the patient's safety, interfere with the absorption or metabolism of selinexor, or put the study outcomes at undue risk, or that would prevent the subject from signing the informed consent form Pregnant or breastfeeding women Use of any standard or experimental anti-cancer drug therapy within 28 days of the initiation (Day 1) of study drug therapy (administration of glucocorticoids should not exceed 1mg/kg/day in the 14 days prior to C1D1)
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Hervé TILLY, MD
Organizational Affiliation
Centre Henri Becquerel, Rouen, France - LYSA
Official's Role
Study Chair
First Name & Middle Initial & Last Name & Degree
Marie MAEREVOET, MD
Organizational Affiliation
Institut Jules Bordet, Bruxelles, Belgium - LYSA
Official's Role
Study Chair
Facility Information:
Facility Name
Institut Jules Bordet
City
Bruxelles
Country
Belgium
Facility Name
CHU Dijon
City
Dijon
Country
France
Facility Name
CHRU de Lille - Hôpital Claude Huriez
City
Lille
Country
France
Facility Name
CHU Montpellier - Hôpital Saint Eloi
City
Montpellier
Country
France
Facility Name
CHU Nancy - Hôpital de Brabois
City
Nancy
Country
France
Facility Name
Hôpital Saint-Louis
City
Paris
Country
France
Facility Name
CHU Bordeaux - Centre François Magendie
City
Pessac
Country
France
Facility Name
Centre Henri Becquerel
City
Rouen
Country
France

12. IPD Sharing Statement

Plan to Share IPD
No

Learn more about this trial

A Phase Ib Study of Oral Selinexor in Adult Patients With Relapsed/Refractory B-cell Lymphoma Receiving R-DHAOx or R-GDP

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