ClinicalTrials.gov
ClinicalTrials.gov Menu
Trial record 1 of 1 for:    NCT02323880
Previous Study | Return to List | Next Study

Selinexor in Treating Younger Patients With Recurrent or Refractory Solid Tumors or High-Grade Gliomas

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details.
ClinicalTrials.gov Identifier: NCT02323880
Recruitment Status : Recruiting
First Posted : December 24, 2014
Last Update Posted : October 31, 2018
Sponsor:
Collaborator:
National Cancer Institute (NCI)
Information provided by (Responsible Party):
Children's Oncology Group

Brief Summary:
This phase I trial studies the side effects and best dose of selinexor in treating younger patients with solid tumors or high-grade gliomas that have come back (recurred) or do not respond to treatment (refractory). Drugs used in chemotherapy, such as selinexor, work in different ways to stop the growth of tumor cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading.

Condition or disease Intervention/treatment Phase
Malignant Glioma Recurrent Brain Neoplasm Recurrent Childhood Central Nervous System Neoplasm Recurrent Childhood Glioblastoma Recurrent Lymphoma Recurrent Malignant Solid Neoplasm Refractory Central Nervous System Neoplasm Refractory Lymphoma Refractory Malignant Solid Neoplasm WHO Grade III Glioma Other: Pharmacological Study Drug: Selinexor Phase 1

Detailed Description:

PRIMARY OBJECTIVES:

I. To determine the recommended phase 2 dose (RP2D) or the maximum tolerated dose (MTD) of the tablet formulation of selinexor in children with recurrent/refractory solid and central nervous system (CNS) tumors.

II. To describe the toxicities of selinexor in children with recurrent/refractory solid and CNS tumors.

III. To characterize the pharmacokinetics of the tablet formulation of selinexor in children with recurrent/refractory solid and CNS tumors.

SECONDARY OBJECTIVES:

I. To determine the antitumor effect of selinexor in a preliminary manner in children with recurrent/refractory solid and CNS tumors.

II. To determine the pharmacodynamic properties of selinexor in children and adolescents with refractory solid tumors in plasma proteins and whole blood ribonucleic acid (RNA).

III. To explore the penetration, pharmacodynamic effects, and biologic effects of selinexor in tumor tissue of patients with recurrent/refractory high-grade gliomas (HGG) requiring resection.

IV. To further assess the toxicity and antitumor effects of selinexor in children with recurrent/refractory HGG in expanded cohorts following dose-escalation by measuring rate of objective radiographic response (medical patients) and rate of progression-free survival (PFS) six months from the start of treatment (surgical patients).

OUTLINE: This is a dose escalation study.

Patients receive selinexor orally (PO) twice weekly (days 1, 3, 8, 10, 15, and 17). Treatment repeats every 28 days for up to 24 courses in the absence of disease progression or unacceptable toxicity.

After completion of study treatment, patients are followed up for 30 days.


Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 81 participants
Intervention Model: Single Group Assignment
Masking: None (Open Label)
Primary Purpose: Treatment
Official Title: A Phase 1 Study of Selinexor (KPT-330), a Selective XPO1 Inhibitor, in Recurrent and Refractory Pediatric Solid Tumors, Including CNS Tumors
Actual Study Start Date : October 5, 2015
Estimated Primary Completion Date : March 31, 2021

Resource links provided by the National Library of Medicine


Arm Intervention/treatment
Experimental: Treatment (selinexor)
Patients receive selinexor PO twice weekly (days 1, 3, 8, 10, 15, and 17). Treatment repeats every 28 days for up to 24 courses in the absence of disease progression or unacceptable toxicity.
Other: Pharmacological Study
Correlative studies

Drug: Selinexor
Given PO
Other Names:
  • CRM1 Nuclear Export Inhibitor KPT-330
  • KPT-330
  • Selective Inhibitor of Nuclear Export KPT-330
  • SINE KPT-330




Primary Outcome Measures :
  1. Recommended phase 2 dose (RP2D) or maximum tolerated dose (MTD) of selinexor [ Time Frame: Up to 28 days ]
    The MTD will be the maximum dose at which fewer than one-third of patients experience dose limiting toxicity, graded according to National Cancer Institute Common Terminology Criteria for Adverse Events (National Cancer Institute [NCI] Common Terminology Criteria for Adverse Events [CTCAE]) version 4.0.

  2. Incidence of adverse events [ Time Frame: Up to 30 days after completion of study treatment ]
    Will be graded according to NCI CTCAE version 4.0.

  3. Pharmacokinetics (PK) of selinexor [ Time Frame: Pre-dose and 30 minutes and 1, 2, 3, 4, 6, 8, and 24 hours after the first dose on day 1 of course 1 ]
    The PK parameters will be summarized with simple summary statistics, including means, medians, ranges, and standard deviations (if numbers and distribution permit).


Secondary Outcome Measures :
  1. Antitumor effect of selinexor [ Time Frame: Up to 30 days after completion of study treatment ]
    Will be measured.

  2. Pharmacodynamics of selinexor [ Time Frame: Pre-dose and 4 hours after dose on day 1 of course 1 ]
    Will be measured.

  3. Penetration, pharmacodynamic effects, and biologic effects of selinexor in tumor tissue of patients with recurrent/refractory HGG requiring resection [ Time Frame: Up to time of surgical resection during course 1 ]
    Will be measured.

  4. Rate of objective radiographic response (medical patients) [ Time Frame: Up to 30 days after completion of study treatment ]
    Response will be defined as either partial response or complete response on two consecutive 2-dimensional measurements on standard imaging done 4 weeks apart.

  5. Progression free survival (surgical patients) [ Time Frame: Six months from the start of treatment ]
    Will be measured.



Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.


Ages Eligible for Study:   12 Months to 21 Years   (Child, Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Patients must have a body surface area (BSA) >= 0.84 m^2
  • Diagnosis:

    • Part A: Patients with recurrent or refractory solid tumors, including lymphoma and CNS tumors, are eligible; patients must have had histologic verification of malignancy at original diagnosis or relapse except in patients with intrinsic brain stem tumors, optic pathway gliomas, or patients with pineal tumors and elevations of cerebrospinal fluid (CSF) or serum tumor markers including alpha-fetoprotein or beta-human chorionic gonadotropin (HCG)
    • Part B: Patients with recurrent or refractory high grade glioma (World Health Organization [WHO] grade III/IV) including disseminated tumors (excluding diffuse intrinsic pontine glioma [DIPG]), not requiring surgical resection; patients must have had histologic verification of malignancy at original diagnosis or relapse
    • Part C: Patients with recurrent or refractory high grade glioma (WHO grade III/IV) and requiring surgical resection (excluding DIPG and disseminated tumors), who in the opinion of treating physicians, are medically stable to receive 3-4 doses of selinexor (8-10 days of treatment) before undergoing surgery without compromising the success of the procedure; note that if, in the opinion of treating physicians, current symptoms necessitate surgery before 3-4 doses will be able to be received, surgery should not be delayed to administer selinexor, and the patient would be ineligible for protocol therapy
  • Disease status:

    • Part A: Patients must have either measurable or evaluable disease
    • Parts B and C: Patients must have measurable disease on imaging
  • Patient?s current disease state must be one for which there is no known curative therapy or therapy proven to prolong survival with an acceptable quality of life
  • Karnofsky >= 50% for patients > 16 years of age and Lansky >= 50 for patients =< 16 years of age; Note: Neurologic deficits in patients with CNS tumors must have been relatively stable for at least 7 days prior to study enrollment; patients who are unable to walk because of paralysis, but who are up in a wheelchair, will be considered ambulatory for the purpose of assessing the performance score
  • Patients must have fully recovered from the acute toxic effects of all prior anti-cancer therapy and must meet the following minimum duration from prior anti-cancer directed therapy prior to enrollment; if after the required timeframe, the numerical eligibility criteria are met, e.g. blood count criteria, the patient is considered to have recovered adequately

    • Myelosuppressive chemotherapy: At least 21 days after the last dose of myelosuppressive chemotherapy (42 days if prior nitrosourea)
    • Hematopoietic growth factors: At least 14 days after the last dose of a long-acting growth factor (e.g. Neulasta) or 7 days for short-acting growth factor; for agents that have known adverse events occurring beyond 7 days after administration, this period must be extended beyond the time during which adverse events are known to occur; the duration of this interval must be discussed with the study chair
    • Biologic (anti-neoplastic agent): At least 7 days after the last dose of a biologic agent; for agents that have known adverse events occurring beyond 7 days after administration, this period must be extended beyond the time during which adverse events are known to occur; the duration of this interval must be discussed with the study chair
    • Immunotherapy: At least 42 days after the completion of any type of immunotherapy, e.g. tumor vaccines
    • Antibodies: >= 21 days must have elapsed from infusion of last dose of antibody, and toxicity related to prior antibody therapy must be recovered to grade =< 1
    • Corticosteroids: If used to modify immune adverse events related to prior therapy, >= 14 days must have elapsed since last dose of corticosteroid
    • External beam radiation therapy (XRT): At least 14 days after local palliative XRT (small port); at least 150 days must have elapsed if prior total body irradiation (TBI), craniospinal XRT or if >= 50% radiation of pelvis; at least 42 days must have elapsed if other substantial bone marrow (BM) radiation
    • Stem cell infusion without TBI: No evidence of active graft vs. host disease and at least 56 days must have elapsed after transplant or stem cell infusion
    • Patients must not have received prior exposure to selinexor
  • For patients with solid tumors without known bone marrow involvement:
  • * Peripheral absolute neutrophil count (ANC) >= 1000/mm^3
  • * Platelet count >= 100,000/mm^3 (transfusion independent, defined as not receiving platelet transfusions for at least 7 days prior to enrollment)
  • * Hemoglobin >= 8.0 g/dL at baseline (may receive red blood cell [RBC] transfusions)
  • Patients with known bone marrow metastatic disease will be eligible for study if they meet the blood counts (may receive transfusions provided they are not known to be refractory to red cell or platelet transfusions); these patients will not be evaluable for hematologic toxicity; at least 5 of every cohort of 6 patients must be evaluable for hematologic toxicity for the dose-escalation part of the study; if dose-limiting hematologic toxicity is observed, all subsequent patients enrolled on Part A must be evaluable for hematologic toxicity
  • Creatinine clearance or radioisotope glomerular filtration rate (GFR) >= 70 ml/min/1.73 m^2 or
  • A serum creatinine based on age/gender as follows:

    • =< 0.6 mg/dL (patients age 1 to < 2 years)
    • =< 0.8 mg/dL (patients age 2 to < 6 years)
    • =< 1 mg/dL (patients age 6 to < 10 years)
    • =< 1.2 mg/dL (patients age 10 to < 13 years)
    • =< 1.4 mg/dL (female patients age >= 13 years)
    • =< 1.5 mg/dL (male patients age 13 to < 16 years)
    • =< 1.7 mg/dL (male patients age >= 16 years)
  • Total bilirubin =< 1.5 x upper limit of normal (ULN) for age
  • Serum glutamate pyruvate transaminase (SGPT) (alanine aminotransferase [ALT]) =< 3 x ULN = 135 U/L; for the purpose of this study, the ULN for SGPT is 45 U/L
  • Serum glutamic oxaloacetic transaminase (SGOT) (aspartate aminotransferase [AST]) =< 3 x ULN = 150 U/L; for the purpose of this study, the ULN for SGOT is 50 U/L
  • Serum albumin >= 2 g/dL
  • Serum amylase =< 1.5 x ULN
  • Serum lipase =< 1.5 x ULN
  • Patients with seizure disorder may be enrolled if on anticonvulsants and well controlled
  • Patients must be able to swallow tablets whole
  • Part C: Archived paraffin-embedded tissue (20 unstained slides or a tumor block) from a prior resection must be available as a control for correlative studies; if tissue blocks or slides are unavailable, the study chair must be notified prior to enrollment
  • All patients and/or their parents or legally authorized representatives must sign a written informed consent; assent, when appropriate, will be obtained according to institutional guidelines

Exclusion Criteria:

  • Pregnant or breast-feeding women will not be entered on this study; pregnancy tests must be obtained in girls who are post-menarchal; males or females of reproductive potential may not participate unless they have agreed to use an effective contraceptive use two effective methods of birth control- including a medically accepted barrier method of contraceptive method (e.g., male or female condom) for the entire period in which they are receiving protocol therapy; abstinence is an acceptable method of birth control
  • Concomitant medications

    • Corticosteroids: Patients receiving corticosteroids who have not been on a stable or decreasing dose of corticosteroid for at least 7 days prior to enrollment are not eligible; if used to modify immune adverse events related to prior therapy, >= 14 days must have elapsed since last dose of corticosteroid
    • Investigational drugs: Patients who are currently receiving another investigational drug are not eligible
    • Anti-cancer agents: Patients who are currently receiving other anti-cancer agents are not eligible
  • Patients who have an uncontrolled infection are not eligible
  • Patients who have received a prior solid organ transplantation are not eligible
  • Patients who, in the opinion of the investigator, may not be able to comply with the safety monitoring requirements of the study are not eligible
  • Patients with body mass index (BMI) < 3rd percentile for age, as defined by WHO criteria for patients 1-2 years of age and Centers for Disease Control and Prevention (CDC) criteria for patients > 2 years of age, are not eligible
  • Patients with grade 3 ataxia or grade >1 extrapyramidal movement disorder are not eligible
  • Patients with known macular degeneration, uncontrolled glaucoma, or cataracts are not eligible

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02323880


  Show 22 Study Locations
Sponsors and Collaborators
Children's Oncology Group
National Cancer Institute (NCI)
Investigators
Principal Investigator: Julia Glade-Bender COG Phase I Consortium

Responsible Party: Children's Oncology Group
ClinicalTrials.gov Identifier: NCT02323880     History of Changes
Other Study ID Numbers: ADVL1414
NCI-2014-02410 ( Registry Identifier: CTRP (Clinical Trial Reporting Program) )
ADVL1414
ADVL1414 ( Other Identifier: COG Phase I Consortium )
ADVL1414 ( Other Identifier: CTEP )
UM1CA097452 ( U.S. NIH Grant/Contract )
First Posted: December 24, 2014    Key Record Dates
Last Update Posted: October 31, 2018
Last Verified: November 2017

Additional relevant MeSH terms:
Lymphoma
Neoplasms
Glioblastoma
Glioma
Brain Neoplasms
Nervous System Neoplasms
Central Nervous System Neoplasms
Neoplasms by Histologic Type
Lymphoproliferative Disorders
Lymphatic Diseases
Immunoproliferative Disorders
Immune System Diseases
Astrocytoma
Neoplasms, Neuroepithelial
Neuroectodermal Tumors
Neoplasms, Germ Cell and Embryonal
Neoplasms, Glandular and Epithelial
Neoplasms, Nerve Tissue
Neoplasms by Site
Brain Diseases
Central Nervous System Diseases
Nervous System Diseases