Purpose

This is a global, multicenter, 2-part study to evaluate the efficacy and safety of selinexor plus ruxolitinib in JAK inhibitor (JAKi) treatment-naïve myelofibrosis (MF) participants. The study will be conducted in two phases: Phase 1 (open-label) and Phase 3 (double-blind). Phase 1 (enrollment completed) was an open-label evaluation of the safety and recommended Phase 2 dose (RP2D) of selinexor in combination with ruxolitinib and included a dose escalation using a standard 3+3 design (Phase 1a) and a dose expansion part (Phase 1b). Phase 3 (ongoing), double-blind, placebo-controlled part of the study comparing the efficacy and safety of combination therapy of selinexor + ruxolitinib with combination of placebo + ruxolitinib.

Condition

Eligibility

Eligible Ages
Over 18 Years
Eligible Genders
All
Accepts Healthy Volunteers
No

Inclusion Criteria

  • Aged ≥ 18 years - A diagnosis of primary MF or post-essential thrombocythemia (ET) or postpolycythemia- vera (PV) MF. - Active symptoms of MF as determined by presence of at least 2 symptoms using the Myelofibrosis Symptom Assessment Form (MFSAF) V4.0. - Participants with international prognostic scoring system (DIPSS) risk category of intermediate-1, or intermediate-2, or high-risk. - Measurable splenomegaly during the screening period as demonstrated by spleen volume of greater than or equal to (>=) 450 cubic centimeter (cm^3) . - Eastern Cooperative Oncology Group (ECOG) Performance Status less than or equal to (<=) 2.

Exclusion Criteria

  • More than 10% blasts in peripheral blood or bone marrow (accelerated or blast phase). - Previous treatment with JAK inhibitors for MF. - Previous treatment with selinexor or other XPO1 inhibitors.

Study Design

Phase
Phase 3
Study Type
Interventional
Allocation
Randomized
Intervention Model
Parallel Assignment
Intervention Model Description
Phase 1, open-label, selinexor dose escalation and expansion part (enrollment completed). Phase 3, randomized, double-blind, placebo-controlled part.
Primary Purpose
Treatment
Masking
Double (Participant, Investigator)

Arm Groups

ArmDescriptionAssigned Intervention
Experimental
Phase 1a: Cohort 1: Selinexor 40 mg + Ruxolitinib BID
Participants with MF will receive a dose of 40 milligrams (mg) selinexor oral tablets once weekly (QW) on Days 1, 8, 15, and 22 of each 28-day cycle in combination with 15 or 20 mg ruxolitinib twice a day (BID) based on the participants baseline platelet count.
  • Drug: Selinexor
    Participants will receive a dose of 40 or 60 mg selinexor oral tablets QW.
    Other names:
    • KPT-330
  • Drug: Ruxolitinib
    Participants will receive a dose of 15 or 20 mg ruxolitinib oral tablets BID.
Experimental
Phase 1a: Cohort 2: Selinexor 60 mg + Ruxolitinib BID
Participants with MF will receive a dose of 60 mg selinexor oral tablets QW on Days 1, 8, 15, and 22 of each 28-day cycle in combination with 15 or 20 mg ruxolitinib BID based on the participants baseline platelet count.
  • Drug: Selinexor
    Participants will receive a dose of 40 or 60 mg selinexor oral tablets QW.
    Other names:
    • KPT-330
  • Drug: Ruxolitinib
    Participants will receive a dose of 15 or 20 mg ruxolitinib oral tablets BID.
Experimental
Phase 1b: Selinexor and Ruxolitinib BID
Participants with MF will receive a dose of 40 or 60 mg selinexor oral tablets QW on Days 1, 8, 15, and 22 of each 28-day cycle in combination with 15 or 20 mg ruxolitinib BID based on the participants baseline platelet count.
  • Drug: Selinexor
    Participants will receive a dose of 40 or 60 mg selinexor oral tablets QW.
    Other names:
    • KPT-330
  • Drug: Ruxolitinib
    Participants will receive a dose of 15 or 20 mg ruxolitinib oral tablets BID.
Experimental
Phase 3: Selinexor 60 mg + Ruxolitinib BID
Participants with MF will receive a fixed starting dose of 60 mg selinexor (RD) oral tablets QW on Days 1, 8, 15, and 22 of each 28-day cycle in combination with a starting dose of 15 or 20 mg ruxolitinib BID based on the participants baseline platelet count.
  • Drug: Selinexor
    Participants will receive a dose of 60 mg selinexor oral tablets QW.
    Other names:
    • KPT-330
  • Drug: Ruxolitinib
    Participants will receive a dose of 15 or 20 mg ruxolitinib oral tablets BID.
Active Comparator
Phase 3: Placebo + Ruxolitinib BID
Participants with MF will receive a matching placebo of selinexor oral tablets QW on Days 1, 8, 15, and 22 of each 28-day cycle in combination with a starting dose of 15 or 20 mg ruxolitinib BID based on the participants baseline platelet count.
  • Other: Placebo
    Participants will receive a matching placebo of selinexor oral tablets QW
  • Drug: Ruxolitinib
    Participants will receive a dose of 15 or 20 mg ruxolitinib oral tablets BID.

Recruiting Locations

Vanderbilt Ingram Cancer Center
Nashville, Tennessee 37232
Contact:
Sanjay Mohan, MD
+1 (615)936-8422
sanjay.mohan@vumc.org

More Details

Status
Recruiting
Sponsor
Karyopharm Therapeutics Inc

Study Contact

Karyopharm Medical Information
(888) 209-9326
clinicaltrials@karyopharm.com

Notice

Study information shown on this site is derived from ClinicalTrials.gov (a public registry operated by the National Institutes of Health). The listing of studies provided is not certain to be all studies for which you might be eligible. Furthermore, study eligibility requirements can be difficult to understand and may change over time, so it is wise to speak with your medical care provider and individual research study teams when making decisions related to participation.