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A Phase 1 and Randomized Phase 2 Trial of Selinexor and Temozolomide in Recurrent Glioblastoma

Status: Recruiting
Location: See all (36) locations...
Intervention Type: Procedure, Drug
Study Type: Interventional
Study Phase: Phase 1/Phase 2
SUMMARY

This phase I/II trial tests the safety, side effects and best dose of selinexor given in combination with the usual chemotherapy (temozolomide) and compares the effect of this combination therapy versus the usual chemotherapy alone (temozolomide) in treating patients with glioblastoma that has come back (recurrent). Selinexor is in a class of medications called selective inhibitors of nuclear export (SINE). It works by blocking a protein called CRM1, which may keep cancer cells from growing and may kill them. Temozolomide is in a class of medications called alkylating agents. It works by damaging the cell's deoxyribonucleic acid and may kill tumor cells and slow down or stop tumor growth. Giving selinexor in combination with usual chemotherapy (temozolomide) may shrink or stabilize the tumor better than the usual chemotherapy with temozolomide alone in patients with recurrent glioblastoma.

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

• Patients must have histologically confirmed glioblastoma (IDH wild-type, MGMT promoter methylated) that has undergone resection or biopsy upon first recurrence. Recurrence at site of prior involvement is defined by histopathological evidence of viable neoplastic cells associated with any of the following: mitotic activity, increased proliferation rate, micro-endothelial proliferation, or pseudo-palisading necrosis

• Prior to resection or biopsy, patients must have measurable disease, defined as at least one bi-dimensional contrast-enhancing lesion with clearly defined margins, with 2 perpendicular diameters of at least 10 mm, visible on \>= 2 axial slices

• Patients must have received first-line treatment of temozolomide plus radiotherapy

• Patients must not have received any prior therapy aside from resection or biopsy for their recurrent disease

• Age \>= 18 years. Because no dosing or adverse event data are currently available on the use of selinexor (KPT-330) in combination with temozolomide in patients \< 18 years of age, children are excluded from this study

• Karnofsky performance status \>= 60% (Eastern Cooperative Oncology Group \[ECOG\] =\< 2)

• Absolute neutrophil count \>= 1,500/mcL

• Platelets \>= 100,000/mcL

• Hemoglobin \>= 10 g/dL

• Total bilirubin =\< 2 x institutional upper limit of normal (ULN)

• Aspartate aminotransferase (AST) (serum glutamic oxaloacetic transaminase \[SGOT\])/alanine transaminase (ALT) (serum glutamic-pyruvic transaminase \[SGPT\]) =\< 3 x institutional ULN

• Glomerular filtration rate (GFR) \>= 30 mL/min/1.73 m\^2

• Human immunodeficiency virus (HIV)-infected patients on effective anti-retroviral therapy with undetectable viral load within 6 months are eligible for this trial

• For patients with evidence of chronic hepatitis B virus (HBV) infection, the HBV viral load must be undetectable on suppressive therapy, if indicated

• Patients with a history of hepatitis C virus (HCV) infection must have been treated and cured. For patients with HCV infection who are currently on treatment, they are eligible if they have an undetectable HCV viral load

• Patients with a prior or concurrent malignancy whose natural history or treatment does not have the potential to interfere with the safety or efficacy assessment of the investigational regimen are eligible for this trial

• Patients with known history or current symptoms of cardiac disease, or history of treatment with cardiotoxic agents, should have a clinical risk assessment of cardiac function using the New York Heart Association Functional Classification. To be eligible for this trial, patients should be class 2B or better

• The effects of selinexor (KPT-330) and temozolomide on the developing human fetus are unknown. For this reason and because selective nuclear export inhibitors as well as deoxyribonucleic acid (DNA) alkylating agents are known to be teratogenic, women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry and for the duration of study participation, and for 180 days after the last dose of temozolomide. Should a woman become pregnant or suspect she is pregnant while she or her partner is participating in this study, she should inform her treating physician immediately. Men treated or enrolled on this protocol must also agree to use adequate contraception prior to the study, for the duration of study participation, and 90 days after completion of study treatment administration

• Ability to understand and the willingness to sign a written informed consent document. Participants with impaired decision-making capacity who have a legally-authorized representative (LAR) and/or family member available will also be eligible

Locations
United States
Arizona
Mayo Clinic Hospital in Arizona
RECRUITING
Phoenix
California
City of Hope Comprehensive Cancer Center
RECRUITING
Duarte
UC San Diego Moores Cancer Center
RECRUITING
La Jolla
Keck Medicine of USC Koreatown
RECRUITING
Los Angeles
Los Angeles General Medical Center
RECRUITING
Los Angeles
USC / Norris Comprehensive Cancer Center
RECRUITING
Los Angeles
University of California Davis Comprehensive Cancer Center
RECRUITING
Sacramento
Colorado
UCHealth University of Colorado Hospital
RECRUITING
Aurora
Florida
UM Sylvester Comprehensive Cancer Center at Coral Gables
RECRUITING
Coral Gables
UM Sylvester Comprehensive Cancer Center at Deerfield Beach
RECRUITING
Deerfield Beach
Mayo Clinic in Florida
RECRUITING
Jacksonville
University of Miami Miller School of Medicine-Sylvester Cancer Center
RECRUITING
Miami
Moffitt Cancer Center
RECRUITING
Tampa
Georgia
Emory University Hospital Midtown
RECRUITING
Atlanta
Emory University Hospital/Winship Cancer Institute
RECRUITING
Atlanta
Illinois
University of Chicago Comprehensive Cancer Center
RECRUITING
Chicago
University of Chicago Medicine-Orland Park
RECRUITING
Orland Park
Kentucky
University of Kentucky/Markey Cancer Center
RECRUITING
Lexington
Minnesota
Mayo Clinic in Rochester
RECRUITING
Rochester
North Carolina
Wake Forest University Health Sciences
RECRUITING
Winston-salem
New Jersey
Saint Barnabas Medical Center
RECRUITING
Livingston
Rutgers Cancer Institute of New Jersey
RECRUITING
New Brunswick
Rutgers New Jersey Medical School
RECRUITING
Newark
New York
Roswell Park Cancer Institute
ACTIVE_NOT_RECRUITING
Buffalo
Laura and Isaac Perlmutter Cancer Center at NYU Langone
RECRUITING
New York
NYP/Columbia University Medical Center/Herbert Irving Comprehensive Cancer Center
ACTIVE_NOT_RECRUITING
New York
Ohio
University of Cincinnati Cancer Center-UC Medical Center
RECRUITING
Cincinnati
Ohio State University Comprehensive Cancer Center
RECRUITING
Columbus
University of Cincinnati Cancer Center-West Chester
RECRUITING
West Chester
Oklahoma
University of Oklahoma Health Sciences Center
RECRUITING
Oklahoma City
Pennsylvania
University of Pittsburgh Cancer Institute (UPCI)
RECRUITING
Pittsburgh
Utah
Huntsman Cancer Institute/University of Utah
ACTIVE_NOT_RECRUITING
Salt Lake City
Virginia
University of Virginia Cancer Center
ACTIVE_NOT_RECRUITING
Charlottesville
VCU Massey Comprehensive Cancer Center
RECRUITING
Richmond
Wisconsin
University of Wisconsin Carbone Cancer Center - Eastpark Medical Center
RECRUITING
Madison
University of Wisconsin Carbone Cancer Center - University Hospital
RECRUITING
Madison
Time Frame
Start Date: 2023-03-20
Estimated Completion Date: 2027-06-30
Participants
Target number of participants: 97
Treatments
Active_comparator: Group I (temozolomide)
Patients receive temozolomide PO QD on days 1-5 of each cycle and placebo PO QD on days 8 and 15 of each cycle. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity.
Experimental: Group II (temozolomide, selinexor)
Patients receive temozolomide PO QD on days 1-5 of each cycle and selinexor PO QD on days 8 and 15 of each cycle. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients undergo MRI throughout the study and blood sample collection while on study.
Sponsors
Leads: National Cancer Institute (NCI)

This content was sourced from clinicaltrials.gov