A Phase 2/3, Multicenter Randomized Study of Rituximab-Gemcitabine-Dexamethasone-Platinum (R-GDP) With or Without Selinexor in Patients With Relapsed/Refractory Diffuse Large B-cell Lymphoma (RR DLBCL)

Who is this study for? Adult patients with diffuse large B-cell lymphoma
What treatments are being studied? Selinexor
Status: Recruiting
Location: See all (57) locations...
Intervention Type: Drug
Study Type: Interventional
Study Phase: Phase 2/Phase 3
SUMMARY

The purpose of this Phase 2/3 study is to evaluate efficacy and safety of the combination of selinexor and R-GDP (SR-GDP) in patients with RR DLBCL who are not intended to receive hematopoetic stem cell transplantation (HSCT) or chimeric antigen receptor T cell (CAR-T) therapy. This study consists of 3 arms each in Phase 2 and 3. Phase 2 portion of the study will assess the two doses of selinexor (40 milligram \[mg\] or 60 mg) in combination with R-GDP, for up to 6 cycles (21-day per cycle), followed by 60 mg selinexor single agent continuous therapy for those who have reached a partial or complete response. Phase 3 portion of the study will evaluate the selected dose of SR-GDP (identified in Phase 2) versus standard R-GDP + matching placebo, for up to 6 cycles (21-day per cycle), followed by placebo or 60 mg selinexor single agent continuous therapy for those who have reached partial or complete response.

Eligibility
Participation Requirements
Sex: All
Minimum Age: 18
Healthy Volunteers: f
View:

• Have pathologically confirmed de novo DLBCL or DLBCL transformed from previously diagnosed indolent lymphoma (e.g., follicular lymphoma). Patient with high-grade lymphoma with c-MYC, Bcl2 and/or Bcl6 rearrangements are eligible (only for Phase 2). (Documentation to be provided).

• Have received at least 1 but no more than 3 prior lines of systemic therapy for the treatment of DLBCL with relapsed or refractory disease following their most recent regimen.

‣ Salvage chemoimmunotherapy followed by stem cell transplantation will be considered as 1 line of systemic therapy.

⁃ Maintenance therapy will not be counted as a separate line of systemic therapy.

⁃ Radiation with curative intent for localized DLBCL will not be counted as 1 line of systemic therapy.

• Positron emission tomography (PET) positive measurable disease with at least 1 node having the longest diameter (LDi) greater than (\>) 1.5 centimeter (cm) or 1 extranodal lesion with LDi \>1 cm (per the Lugano Criteria 2014). The Deauville 5-point scale (D5PS) score assessed on the FDG PET/CT should be between 3 to 5.

• Not intended for HSCT or CAR-T cell therapy based on objective clinical criteria determined by the treating physician. Patients who cannot receive HSCT due to active disease are allowed on study (up to approximately 15 percent \[%\] of patients enrolled in each Phase). Documentation on lack of intention to proceed to receive HSCT or CAR-T therapy must be provided by the treating physician.

• Adequate bone marrow function at screening, defined as:

‣ Absolute neutrophil count (ANC) ≥1\*10\^9 per liter (/L).

⁃ Platelet count ≥100\*10\^9/L (without platelet transfusion less than \[\<\] 14 days prior to Cycle 1 Day 1 \[C1D1\]).

⁃ Hemoglobin ≥8.5 gram per deciliter (g/dL) (without red blood cell transfusion \<14 days prior to C1D1).

• Circulating lymphocytes less than or equal to (≤) 50\*10\^9/L.

• Adequate liver and kidney function, defined as:

‣ Aspartate transaminase (AST) or alanine transaminase (ALT) ≤2.5\*upper limit of normal (ULN), or ≤5\*ULN in cases with known lymphoma involvement in the liver.

⁃ Serum total bilirubin ≤2\*ULN, or ≤5\*ULN if due to Gilbert syndrome or in cases with known lymphoma involvement in the liver.

⁃ Calculated creatinine clearance (CrCl) ≥30 milliliter per minute (mL/min) based on Cockcroft-Gault formula.

• Eastern Cooperative Oncology Group (ECOG) performance status of ≤2.

• An estimated life expectancy of \>3 months at Screening.

• Patients with primary refractory DLBCL defined as no response or relapse within 6 months after ending first-line treatment, will be allowed in the study.

• Agree to highly effective contraception during the duration of the study with contraception use continuing for 12 months after the last dose of study treatment

• Female patients 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 12 months following the last dose of study treatment (except patients with Non-Childbearing potential: Age \>50 years and naturally amenorrhoeic for \>1 year, or previous bilateral salpingo-oophorectomy, or hysterectomy).

• Male patients who are sexually active must use highly effective methods of contraception throughout the study and for 12 months following the last dose of study treatment. Male patients must agree not to donate sperm during the study treatment period and for 12 months following the last dose of study treatment.

Locations
United States
Arizona
Ironwood Physicians P.C. dba Ironwood Cancer and Research Centers
COMPLETED
Chandler
Arizona Oncology Associates
RECRUITING
Tucson
California
The Oncology Institute (TOI) Clinical Research
RECRUITING
Cerritos
Indiana
Investigative Clinical Research of Indiana, LLC
WITHDRAWN
Indianapolis
Kentucky
Norton Cancer Institute, St. Matthews
RECRUITING
Louisville
Louisiana
Tulane Cancer Center
WITHDRAWN
New Orleans
Maryland
University of Maryland Greenebaum Comprehensive Cancer Center
RECRUITING
Baltimore
New Mexico
New Mexico Cancer Care Alliance
WITHDRAWN
Albuquerque
Nevada
Comprehensive Cancer Centers of Nevada - Town Center
WITHDRAWN
Las Vegas
New York
Stony Brook
RECRUITING
Stony Brook
Ohio
Gabrail Cancer Center Research LLC
WITHDRAWN
Canton
Texas
Texas Oncology - Medical City Dallas
WITHDRAWN
Dallas
Texas Oncology - Presbyterian Dallas Cancer Center
WITHDRAWN
Dallas
Texas Oncology - Sammons
WITHDRAWN
Dallas
Texas Oncology - Fort Worth
WITHDRAWN
Fort Worth
Texas Oncology - Plano East
WITHDRAWN
Plano
Texas Oncology - Tyler
RECRUITING
Tyler
The University of Texas Health Science Center at Tyler DBA UT Health East Texas HOPE Cancer Center
COMPLETED
Tyler
Washington
Providence Regional Cancer Partnership
WITHDRAWN
Everett
Other Locations
Austria
Kepler Universitaetskrankenhaus Med Campu III - Onkologie
WITHDRAWN
Linz
Hospital Hietzing
WITHDRAWN
Vienna
University of Vienna, Medical Clinic I, Hematology
WITHDRAWN
Vienna
China
Huaxi Hospital Sichuan University
COMPLETED
Chengdu
The first affiliated Hospital, Zhejiang University
COMPLETED
Hangzhou
Ruijin Hospital Affiliated to The Shanghai Jiao Tong University Medical School
COMPLETED
Huangpu
Jiangsu Province Hospital
COMPLETED
Nanjing
The First Affiliated Hospital of Soochow University
COMPLETED
Suzhou
Zhongshan Hospital Fudan University
COMPLETED
Xuhui
Israel
Assuta Ashdod Medical Center
RECRUITING
Ashdod
Soroka Medical Center
COMPLETED
Beersheba
Rambam health care campus (Department of Hematology & Bone Marrow Transplantation)
WITHDRAWN
Haifa
Wolfson Medical Center
WITHDRAWN
Holon
Hadassah Medical Center
WITHDRAWN
Jerusalem
Rabin Medical Center
COMPLETED
Petah Tikva
Assuta medical centers - Ramat Hachayal
COMPLETED
Tel Aviv
Sourasky Medical Center
WITHDRAWN
Tel Aviv
Italy
AOU Ospedali Riuniti-Università Politecnica delle Marche Clinica di Ematologia
RECRUITING
Ancona
AOU Policlinico S.Orsola Malpighi di Bologna, University of Bologna
WITHDRAWN
Bologna
UOC Ematologia ad Indirizzo Oncologico, AORN Sant'Anna e San Sebastiano
RECRUITING
Caserta
National Cancer Institute
RECRUITING
Naples
AOU Maggiore della Carità SCDU Ematologia
RECRUITING
Novara
Azienda Ospedaliera Ospedali Riuniti Villa Sofia Cervello
RECRUITING
Palermo
DIP. Oncologia- Ematologia, UOSD Centro Diagnosie TerapiaDei Linfomi
COMPLETED
Pescara
Fondatione Policlinico Universitario A. Gemelli
RECRUITING
Rome
AOU City of Health and Science of Turin
COMPLETED
Turin
Poland
Szpitale pomorskie gdynia dept of haematology
RECRUITING
Gdynia
Pratia Onkologia Katowice
COMPLETED
Katowice
Pratia MCM Krakow
RECRUITING
Krakow
CM Pratia Poznań
COMPLETED
Skorzewo
Department of Lymphoid Malignancies, Maria Sklodowska-Curie National Research Institute of Oncology
COMPLETED
Warsaw
Institute of Hematology and Transfusion Medicine
COMPLETED
Warsaw
Klinika Hematologii, Nowotworów Krwi i Transplantacji Szpiku Uniwersytecki Szpital Kliniczny im. Jana Mikulicza - Radeckiego we Wrocławiu
COMPLETED
Wroclaw
Spain
Institut català d'oncologia-hospital germans trias i pujol
RECRUITING
Badalona
Hospital Vall Hebron
COMPLETED
Barcelona
Institut Catala D'oncolocia
RECRUITING
Barcelona
Hospital Universitario La Paz
COMPLETED
Madrid
Hospital Virgen del Rocío
COMPLETED
Seville
Contact Information
Primary
Karyopharm Medical Information
clinicaltrials@karyopharm.com
(888) 209-9326
Time Frame
Start Date: 2020-09-03
Estimated Completion Date: 2025-12
Participants
Target number of participants: 501
Treatments
Experimental: Phase 2: Selinexor 40 mg + R-GDP
Patients with RR DLBCL will receive combination therapy of selinexor 40 mg orally at Day 1 and Day 8 of each 21-day cycle for up to 6 cycles in combination with R-GDP followed by single-agent continuous therapy with selinexor 60 mg orally once weekly (QW) for each 28-day cycle until progressive disease (PD) or unacceptable toxicity.
Experimental: Phase 2: Selinexor 60 mg + R-GDP
Patients with RR DLBCL will receive combination therapy of selinexor 60 mg orally at Day 1 and Day 8 of each 21-day cycle for up to 6 cycles in combination with R-GDP followed by single-agent continuous therapy with selinexor 60 mg orally QW for each 28-day cycle until PD or unacceptable toxicity.
Active_comparator: Phase 2: R-GDP
Patients with RR DLBCL will receive R-GDP on specified days (Days 1, 2, 3, 4, and 8) for each 21-day cycle for up to 6 cycles.
Experimental: Phase 3: Selinexor (Selected Dose) + R-GDP followed by Selinexor 60 mg
Patients with RR DLBCL will receive combination therapy of selinexor (selected dose from Phase 2) at Day 1 and Day 8 of each 21-day cycle for up to 6 cycles in combination with R-GDP followed by selinexor 60 mg orally QW for each 28-day cycle until PD or unacceptable toxicity.
Experimental: Phase 3: Selinexor (Selected Dose) + R-GDP followed by Placebo
Patients with RR DLBCL will receive combination therapy of selinexor (selected dose from Phase 2) at Day 1 and Day 8 of each 21-day cycle for up to 6 cycles in combination with R-GDP followed by matching placebo for selinexor orally QW for each 28-day cycle until PD or unacceptable toxicity.
Placebo_comparator: Phase 3: Placebo + R-GDP followed by Placebo
Patients with RR DLBCL will receive combination therapy of placebo matching for selinexor (selected dose from Phase 2) at Day 1 and Day 8 of each 21-day cycle for up to 6 cycles in combination with R-GDP followed by matching placebo for selinexor orally QW for each 28-day cycle until PD or unacceptable toxicity.
Sponsors
Leads: Karyopharm Therapeutics Inc

This content was sourced from clinicaltrials.gov