KPT-330 Plus RICE for Relapsed/Refractory Aggressive B-Cell Lymphoma (KPT-330+RICE)
Diffuse Large B-Cell Lymphoma
About this trial
This is an interventional treatment trial for Diffuse Large B-Cell Lymphoma focused on measuring DLBCL, Aggressive, Diffuse, Large
Eligibility Criteria
Inclusion Criteria:
Patients must have histologically confirmed aggressive B-cell non-Hodgkin lymphomas:
- DLBCL including ABC, GCB or PMBCL subtypes
- Double/triple hit lymphomas
- Indolent lymphomas transformed to aggressive lymphomas
- Follicular lymphomas grade 3B
Patients must have received at least two cycles of anthracycline based chemotherapy administered with curative intent and one of the following:
- failed to have achieve at least a partial response after 2 or more cycles
- failed to achieve a complete response after 6 or more cycles
- progressed after an initial response
- Patients must be age ≥18 years.
- Patients must have at least one site of measurable disease, 1.5 cm in diameter or greater.
- Patients must have ECOG performance status of 0-2.
Patients must have laboratory test results within these ranges:
- Absolute neutrophil count ≥ 1500/mm³
- Platelet count ≥ 100,000/mm³
- Serum creatinine clearance ≥40 mL/min
- Total bilirubin ≤ 1.5x ULN. Higher levels are acceptable if these can be attributed to active hemolysis or ineffective erythropoiesis.
- AST (SGOT) and ALT (SGPT) ≤ 2x ULN
Women of childbearing potential must agree to use dual methods of contraception and have a negative serum pregnancy test prior to selinexor treatment. Male patients must use an effective barrier method of contraception if sexually active with a female of child-bearing potential.
- Acceptable methods of contraception are condoms with contraceptive foam, oral, implantable or injectable contraceptives, contraceptive patch, intrauterine device, diaphragm with spermicidal gel, or a sexual partner who is surgically sterilized or post-menopausal.
- For both male and female patients, effective methods of contraception must be used throughout the study and for three months following the last dose.
- Patients must be able to understand and willing to sign a written informed consent document.
- Patients must be able to adhere to the study visit schedule and other protocol requirements.
- Patients must not have any serious medical condition, laboratory abnormality, or psychiatric illness that would prevent the subject from signing the informed consent form.
- Patients must not have any condition, including the presence of laboratory abnormalities, which places the subject at unacceptable risk if he/she were to participate in the study or confounds the ability to interpret data from the study.
Exclusion Criteria:
- Patients with hyperuricemia or other potential signs of tumor lysis syndrome
- Patients with more than minimally symptomatic disease (i.e. > grade 1), high tumor burden, or other indication for urgent treatment.
- Patients who have had prior malignancies (other than B-cell lymphomas) for ≤5 years with exception of currently treated basal cell, squamous cell carcinoma of the skin, or carcinoma "in situ" of the cervix or breast.
- Patients who have had other anti-cancer therapy, including radiation or experimental drug or therapy, within 28 days of enrollment.
- Patients with known HIV, active hepatitis B, active hepatitis C.
- Patients with known central nervous system involvement by lymphoma.
Sites / Locations
- Weill Cornell Medical College
Arms of the Study
Arm 1
Experimental
All subjects
All subjects will receive KPT-330 (selinexor) on days -5 and -3 starting one week before RICE chemotherapy is started. Once chemotherapy starts, selinexor will be given on days 1, 3, and 5 of each chemotherapy cycle. RICE chemotherapy will consist of Rituximab, ifosfamide, carboplatin, etoposide, and dexamethasone.