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    Clinical Trial Results:
    A Phase 2 Study Evaluating the Efficacy and Safety of Selinexor (KPT-330) in Subjects with Recurrent Gliomas

    Summary
    EudraCT number
    2013-003668-30
    Trial protocol
    DK   NL  
    Global end of trial date
    23 Jan 2020

    Results information
    Results version number
    v1(current)
    This version publication date
    20 Aug 2021
    First version publication date
    20 Aug 2021
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    KCP-330-004
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT01986348
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    Karyopharm Therapeutics Inc.
    Sponsor organisation address
    85 Wells Avenue, Newton, MA, United States, 02459
    Public contact
    Clinical Trials Information, Karyopharm Therapeutic Inc., +1 617658 0600, clinicaltrials@karyopharm.com
    Scientific contact
    Clinical Trials Information, Karyopharm Therapeutic Inc., +1 617658 0600, clinicaltrials@karyopharm.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    23 Jan 2020
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    23 Jan 2020
    Was the trial ended prematurely?
    Yes
    General information about the trial
    Main objective of the trial
    To determine the efficacy of selinexor in adults with recurrent glioblastoma (GBM) as determined by the 6-months progression-free survival 6mPFS rate (Arms B, C, and D).
    Protection of trial subjects
    The study was conducted in accordance with the ethical principles originating in the Declaration of Helsinki in place at the time of study conduct. The study was conducted in compliance with the International Council for Harmonisation (ICH) E6 Guideline for Good Clinical Practice (GCP) (Committee for Proprietary Medicinal Products [CPMP] guideline CPMP/ICH/135/95), United States Code of Federal Code of Regulations, and all applicable local regulatory requirements.
    Background therapy
    -
    Evidence for comparator
    -
    Actual start date of recruitment
    03 Mar 2014
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Netherlands: 12
    Country: Number of subjects enrolled
    Denmark: 19
    Country: Number of subjects enrolled
    United States: 45
    Worldwide total number of subjects
    76
    EEA total number of subjects
    31
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    63
    From 65 to 84 years
    13
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    This study was conducted at 6 sites across the United States of America, Denmark and Netherland between 03 March 2014 and 23 January 2020.

    Pre-assignment
    Screening details
    A total of 76 subjects were enrolled, randomized and treated in this study.

    Period 1
    Period 1 title
    Overall Study (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Randomised - controlled
    Blinding used
    Not blinded

    Arms
    Are arms mutually exclusive
    Yes

    Arm title
    Arm A: Selinexor 60mg and Surgery
    Arm description
    Subjects who required surgery received up to 3 doses of selinexor oral tablets 60 milligrams (mg) twice weekly (BIW) on Day1, Day 3 and between 2 and 48 hours prior to surgery, subsequently underwent surgery for resection of their tumor and resumed selinexor oral tablets 60 mg BIW after recovery, during Week 1 to 4 of each 4-week cycle, until progression of disease (PD) or development of unacceptable toxicities.
    Arm type
    Experimental

    Investigational medicinal product name
    Selinexor
    Investigational medicinal product code
    KPT-330
    Other name
    Pharmaceutical forms
    Coated tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Subjects who required surgery received up to 3 doses of oral selinexor tablets 60 mg twice weekly (BIW).

    Arm title
    Arm B: Selinexor 50mg/m^2
    Arm description
    Subjects who were not eligible for surgery received selinexor oral tablets 50 mg per square meter (mg/m^2) BIW during Week 1 to 4 of each 4-week cycle until PD or development of unacceptable toxicities.
    Arm type
    Experimental

    Investigational medicinal product name
    Selinexor
    Investigational medicinal product code
    KPT-330
    Other name
    Pharmaceutical forms
    Coated tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Subjects who were not eligible for surgery received selinexor oral tablets 50 mg/m^2 BIW.

    Arm title
    Arm C: Selinexor 60 mg
    Arm description
    Subjects who were not eligible for surgery received selinexor oral tablets 60 mg BIW during Week 1 to 4 of each 4-week cycle until PD or development of unacceptable toxicities.
    Arm type
    Experimental

    Investigational medicinal product name
    Selinexor
    Investigational medicinal product code
    KPT-330
    Other name
    Pharmaceutical forms
    Coated tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Subjects who were not eligible for surgery received selinexor oral tablets 60mg.

    Arm title
    Arm D: Selinexor 80 mg
    Arm description
    Subjects who were not eligible for surgery received selinexor oral tablets 80 mg once weekly (QW) during Week 1 to 4 of each 4-week cycle until PD or development of unacceptable toxicities.
    Arm type
    Experimental

    Investigational medicinal product name
    Selinexor
    Investigational medicinal product code
    KPT-330
    Other name
    Pharmaceutical forms
    Coated tablet
    Routes of administration
    Oral use
    Dosage and administration details
    Subjects who were not eligible for surgery received selinexor oral tablets 80 mg.

    Number of subjects in period 1
    Arm A: Selinexor 60mg and Surgery Arm B: Selinexor 50mg/m^2 Arm C: Selinexor 60 mg Arm D: Selinexor 80 mg
    Started
    8
    24
    14
    30
    Completed
    0
    0
    0
    0
    Not completed
    8
    24
    14
    30
         Consent withdrawn by subject
    -
    1
    2
    1
         Physician decision
    -
    -
    -
    1
         Death
    8
    22
    10
    21
         Study terminated by sponsor
    -
    -
    -
    3
         Unspecified
    -
    1
    -
    2
         Progressive disease
    -
    -
    2
    -
         Lost to follow-up
    -
    -
    -
    2

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    Arm A: Selinexor 60mg and Surgery
    Reporting group description
    Subjects who required surgery received up to 3 doses of selinexor oral tablets 60 milligrams (mg) twice weekly (BIW) on Day1, Day 3 and between 2 and 48 hours prior to surgery, subsequently underwent surgery for resection of their tumor and resumed selinexor oral tablets 60 mg BIW after recovery, during Week 1 to 4 of each 4-week cycle, until progression of disease (PD) or development of unacceptable toxicities.

    Reporting group title
    Arm B: Selinexor 50mg/m^2
    Reporting group description
    Subjects who were not eligible for surgery received selinexor oral tablets 50 mg per square meter (mg/m^2) BIW during Week 1 to 4 of each 4-week cycle until PD or development of unacceptable toxicities.

    Reporting group title
    Arm C: Selinexor 60 mg
    Reporting group description
    Subjects who were not eligible for surgery received selinexor oral tablets 60 mg BIW during Week 1 to 4 of each 4-week cycle until PD or development of unacceptable toxicities.

    Reporting group title
    Arm D: Selinexor 80 mg
    Reporting group description
    Subjects who were not eligible for surgery received selinexor oral tablets 80 mg once weekly (QW) during Week 1 to 4 of each 4-week cycle until PD or development of unacceptable toxicities.

    Reporting group values
    Arm A: Selinexor 60mg and Surgery Arm B: Selinexor 50mg/m^2 Arm C: Selinexor 60 mg Arm D: Selinexor 80 mg Total
    Number of subjects
    8 24 14 30 76
    Age categorical
    Units: Subjects
    Age continuous
    Units: years
        arithmetic mean (standard deviation)
    56.6 ( 6.70 ) 51.1 ( 13.04 ) 49.5 ( 12.36 ) 54.3 ( 11.98 ) -
    Gender categorical
    Units: Subjects
        Female
    1 5 5 11 22
        Male
    7 19 9 19 54
    Ethnicity
    Units: Subjects
        Hispanic or Latino
    0 0 0 3 3
        Not Hispanic or Latino
    8 20 8 24 60
        Unknown or Not Reported
    0 4 6 3 13
    Race
    Units: Subjects
        Asian
    0 0 0 1 1
        White
    8 24 8 25 65
        Unknown/Not Provided
    0 0 6 4 10

    End points

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    End points reporting groups
    Reporting group title
    Arm A: Selinexor 60mg and Surgery
    Reporting group description
    Subjects who required surgery received up to 3 doses of selinexor oral tablets 60 milligrams (mg) twice weekly (BIW) on Day1, Day 3 and between 2 and 48 hours prior to surgery, subsequently underwent surgery for resection of their tumor and resumed selinexor oral tablets 60 mg BIW after recovery, during Week 1 to 4 of each 4-week cycle, until progression of disease (PD) or development of unacceptable toxicities.

    Reporting group title
    Arm B: Selinexor 50mg/m^2
    Reporting group description
    Subjects who were not eligible for surgery received selinexor oral tablets 50 mg per square meter (mg/m^2) BIW during Week 1 to 4 of each 4-week cycle until PD or development of unacceptable toxicities.

    Reporting group title
    Arm C: Selinexor 60 mg
    Reporting group description
    Subjects who were not eligible for surgery received selinexor oral tablets 60 mg BIW during Week 1 to 4 of each 4-week cycle until PD or development of unacceptable toxicities.

    Reporting group title
    Arm D: Selinexor 80 mg
    Reporting group description
    Subjects who were not eligible for surgery received selinexor oral tablets 80 mg once weekly (QW) during Week 1 to 4 of each 4-week cycle until PD or development of unacceptable toxicities.

    Primary: Percentage of Subjects With 6-Month Progression-Free Survival

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    End point title
    Percentage of Subjects With 6-Month Progression-Free Survival [1] [2]
    End point description
    Analysis of 6mPFS was performed by calculating estimated survival probability of having PFS ≥ 6 months based on Kaplan-Meier method, where PFS was defined as time from the start of study treatment until first documented progression based on Response Assessment in Neuro-Oncology (RANO) criteria, or death from any cause. Progressive disease occurs when either of the criteria was present: ≥ 25% increase in T1 gadolinium enhancing disease, increase in T2/ Fluid-attenuated inversion recovery (FLAIR), detection of new lesions, or decreased clinical status. Modified intent-to-treat (mITT) population consisted of all enrolled subjects in Arms B, C and D who had received at least 1 dose of study medication and have at least 1 post-baseline efficacy follow-up assessment, unless the subject discontinued treatment prior to the first post baseline assessment due to death, toxicity, or PD. Data for this endpoint was not planned to be collected and analysed for Arm A: Selinexor 60 mg and Surgery.
    End point type
    Primary
    End point timeframe
    From start of study treatment up to disease progression or death, whichever occurred first (assessed up to Month 6)
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: Per protocol, only descriptive analyses was planned for this endpoint.
    [2] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Data for this endpoint was not planned to be collected and analyzed for Arm A: Selinexor 60 mg and Surgery.
    End point values
    Arm B: Selinexor 50mg/m^2 Arm C: Selinexor 60 mg Arm D: Selinexor 80 mg
    Number of subjects analysed
    24
    13
    30
    Units: Percentage of subjects
        number (confidence interval 95%)
    9.72 (2.67 to 35.39)
    7.69 (1.17 to 50.57)
    17.24 (7.77 to 38.27)
    No statistical analyses for this end point

    Secondary: Overall Response Rate (ORR)

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    End point title
    Overall Response Rate (ORR) [3]
    End point description
    The ORR was determined as percentage of subjects who had either complete response (CR) or partial response (PR) using the RANO criteria. CR: No T1 gadolinium enhancing disease, stable or decreasing T2/FLAIR, no new lesions, no corticosteroid use and stable, or increasing clinical status. PR: ≥50% decrease in T1 gadolinium enhancing disease, stable or decreasing T2/FLAIR, no new lesions, stable or decreased use of corticosteroids, and stable or increased clinical status. mITT population consisted of all enrolled subjects in Arms B, C and D who had received at least 1 dose of study medication and have at least 1 post-baseline efficacy follow-up assessment, unless the subject discontinued treatment prior to the first post baseline assessment due to death, toxicity, or disease progression. Data for this outcome measure was not planned to be collected and analyzed for Arm A: Selinexor 60 mg and Surgery.
    End point type
    Secondary
    End point timeframe
    Up to 71 months
    Notes
    [3] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Data for this endpoint was not planned to be collected and analyzed for Arm A: Selinexor 60 mg and Surgery.
    End point values
    Arm B: Selinexor 50mg/m^2 Arm C: Selinexor 60 mg Arm D: Selinexor 80 mg
    Number of subjects analysed
    24
    13
    30
    Units: Percentage of subject
        number (confidence interval 95%)
    8.3 (1.0 to 27.0)
    7.7 (0.2 to 36.0)
    10.0 (2.1 to 26.5)
    No statistical analyses for this end point

    Secondary: Overall Survival (OS)

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    End point title
    Overall Survival (OS) [4]
    End point description
    The OS was calculated from the date of start of study treatment to the date of death. Subjects who were still alive prior to the data cut-off for final efficacy analysis, or who dropout prior to study end, were censored on the day they were last known to be alive. The OS was estimated using Kaplan-Meier method. mITT population consisted of all enrolled Subjects in Arms B, C and D who had received at least 1 dose of study medication and have at least 1 post-baseline efficacy follow-up assessment, unless the subject discontinued treatment prior to the first post baseline assessment due to death, toxicity, or disease progression. Data for this outcome measure was not planned to be collected and analyzed for Arm A: Selinexor 60 mg and Surgery. Here, "99999" represent data could not be estimated due to higher number (>50%) of censored subjects.
    End point type
    Secondary
    End point timeframe
    From date of study treatment up to date of death (assessed up to 71 months)
    Notes
    [4] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Data for this endpoint was not planned to be collected and analyzed for Arm A: Selinexor 60 mg and Surgery.
    End point values
    Arm B: Selinexor 50mg/m^2 Arm C: Selinexor 60 mg Arm D: Selinexor 80 mg
    Number of subjects analysed
    24
    13
    30
    Units: Months
        median (confidence interval 95%)
    10.51 (4.93 to 16.95)
    8.48 (7.29 to 99999)
    10.15 (7.03 to 15.38)
    No statistical analyses for this end point

    Secondary: Progression-free Survival (PFS)

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    End point title
    Progression-free Survival (PFS) [5]
    End point description
    The PFS was calculated from the date of start of study treatment to the date of disease progression based on RANO criteria, or date of death should progression not have occurred. Progressive disease occurs when either of the criteria was present: ≥25% increase in T1 gadolinium enhancing disease, increased T2/FLAIR, detection of new lesions, or decreased clinical status. mITT population consisted of all enrolled subjects in Arms B, C and D who had received at least 1 dose of study medication and have at least 1 post-baseline efficacy follow-up assessment, unless the subject discontinued treatment prior to the first post baseline assessment due to death, toxicity, or disease progression. Data for this outcome measure was not planned to be collected and analyzed for Arm A: Selinexor 60 mg and Surgery.
    End point type
    Secondary
    End point timeframe
    From start of study treatment up to disease progression (assessed up to 71 months)
    Notes
    [5] - The end point is not reporting statistics for all the arms in the baseline period. It is expected all the baseline period arms will be reported on when providing values for an end point on the baseline period.
    Justification: Data for this endpoint was not planned to be collected and analyzed for Arm A: Selinexor 60 mg and Surgery.
    End point values
    Arm B: Selinexor 50mg/m^2 Arm C: Selinexor 60 mg Arm D: Selinexor 80 mg
    Number of subjects analysed
    24
    13
    30
    Units: Months
        median (confidence interval 95%)
    1.64 (1.18 to 3.15)
    1.87 (1.84 to 14.88)
    1.87 (1.81 to 3.02)
    No statistical analyses for this end point

    Secondary: Number of Subjects With Treatment-emergent Adverse Events (TEAEs) and Treatment-emergent Serious Adverse Events (TESAEs)

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    End point title
    Number of Subjects With Treatment-emergent Adverse Events (TEAEs) and Treatment-emergent Serious Adverse Events (TESAEs)
    End point description
    An adverse event (AE) was defined as any untoward medical occurrence in a subject or clinical investigation subject administered a pharmaceutical product and that does not necessarily have a causal relationship with this treatment. A serious adverse event (SAE) was defined as an AE that was fatal; life threatening (places the subject at immediate risk of death); requires in-patient hospitalization or prolongation of existing hospitalization; results in persistent or significant disability/incapacity; was a congenital anomaly/birth defect; and other important medical events. TEAE was defined as any AE with onset or worsening of a pre-existing condition on or after the first administration of study medication through 30 days following last dose or any event considered drug-related by the Investigator through the end of the study. TEAEs included both serious and non-serious TEAEs. Safety population consisted of all subjects who had received any amount of study treatment.
    End point type
    Secondary
    End point timeframe
    From start of study treatment administration up to 71 months
    End point values
    Arm A: Selinexor 60mg and Surgery Arm B: Selinexor 50mg/m^2 Arm C: Selinexor 60 mg Arm D: Selinexor 80 mg
    Number of subjects analysed
    8
    24
    14
    30
    Units: Subjects
        Subjects with TEAEs
    8
    24
    14
    30
        Subjects with TESAEs
    5
    7
    7
    7
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    From start of study treatment administration up to 71 months
    Assessment type
    Non-systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    23.0
    Reporting groups
    Reporting group title
    Arm A: Selinexor 60 mg and Surgery
    Reporting group description
    Subjects who required surgery received up to 3 doses of selinexor oral tablets 60 mg BIW on Day 1, Day 3 and between 2 and 48 hours prior to surgery, subsequently underwent surgery for resection of their tumor and resumed selinexor oral tablets 60 mg BIW after recovery, during Week 1 to 4 of each 4-week cycle, until PD or development of unacceptable toxicities.

    Reporting group title
    Arm B: Selinexor 50 mg/m^2
    Reporting group description
    Subjects who were not eligible for surgery received selinexor oral tablets 50 mg/m^2 BIW during Week 1 to 4 of each 4-week cycle until PD or development of unacceptable toxicities.

    Reporting group title
    Arm C: Selinexor 60 mg
    Reporting group description
    Subjects who were not eligible for surgery received selinexor oral tablets 60 mg BIW during Week 1 to 4 of each 4-week cycle until PD or development of unacceptable toxicities.

    Reporting group title
    Arm D: Selinexor 80 mg
    Reporting group description
    Subjects who were not eligible for surgery received selinexor oral tablets 80 mg QW during Week 1 to 4 of each 4-week cycle until PD or development of unacceptable toxicities.

    Serious adverse events
    Arm A: Selinexor 60 mg and Surgery Arm B: Selinexor 50 mg/m^2 Arm C: Selinexor 60 mg Arm D: Selinexor 80 mg
    Total subjects affected by serious adverse events
         subjects affected / exposed
    5 / 8 (62.50%)
    7 / 24 (29.17%)
    7 / 14 (50.00%)
    7 / 30 (23.33%)
         number of deaths (all causes)
    8
    22
    10
    21
         number of deaths resulting from adverse events
    0
    0
    0
    0
    Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    Basal cell carcinoma
         subjects affected / exposed
    0 / 8 (0.00%)
    0 / 24 (0.00%)
    0 / 14 (0.00%)
    1 / 30 (3.33%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Intracranial tumour haemorrhage
         subjects affected / exposed
    0 / 8 (0.00%)
    1 / 24 (4.17%)
    0 / 14 (0.00%)
    0 / 30 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Injury, poisoning and procedural complications
    Acetabulum fracture
         subjects affected / exposed
    0 / 8 (0.00%)
    0 / 24 (0.00%)
    1 / 14 (7.14%)
    0 / 30 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Concussion
         subjects affected / exposed
    0 / 8 (0.00%)
    0 / 24 (0.00%)
    1 / 14 (7.14%)
    0 / 30 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Shunt malfunction
         subjects affected / exposed
    0 / 8 (0.00%)
    0 / 24 (0.00%)
    1 / 14 (7.14%)
    0 / 30 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Vascular disorders
    Embolism
         subjects affected / exposed
    1 / 8 (12.50%)
    0 / 24 (0.00%)
    0 / 14 (0.00%)
    0 / 30 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Hypertension
         subjects affected / exposed
    0 / 8 (0.00%)
    0 / 24 (0.00%)
    0 / 14 (0.00%)
    1 / 30 (3.33%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Nervous system disorders
    Brain oedema
         subjects affected / exposed
    0 / 8 (0.00%)
    0 / 24 (0.00%)
    0 / 14 (0.00%)
    1 / 30 (3.33%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Cerebrospinal fluid leakage
         subjects affected / exposed
    1 / 8 (12.50%)
    0 / 24 (0.00%)
    0 / 14 (0.00%)
    0 / 30 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Cerebrovascular accident
         subjects affected / exposed
    1 / 8 (12.50%)
    0 / 24 (0.00%)
    0 / 14 (0.00%)
    0 / 30 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Dizziness
         subjects affected / exposed
    0 / 8 (0.00%)
    1 / 24 (4.17%)
    0 / 14 (0.00%)
    0 / 30 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Headache
         subjects affected / exposed
    0 / 8 (0.00%)
    1 / 24 (4.17%)
    1 / 14 (7.14%)
    0 / 30 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Pneumocephalus
         subjects affected / exposed
    1 / 8 (12.50%)
    0 / 24 (0.00%)
    0 / 14 (0.00%)
    0 / 30 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Seizure
         subjects affected / exposed
    0 / 8 (0.00%)
    1 / 24 (4.17%)
    3 / 14 (21.43%)
    2 / 30 (6.67%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 3
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Syncope
         subjects affected / exposed
    0 / 8 (0.00%)
    0 / 24 (0.00%)
    0 / 14 (0.00%)
    3 / 30 (10.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 3
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    General disorders and administration site conditions
    Asthenia
         subjects affected / exposed
    0 / 8 (0.00%)
    0 / 24 (0.00%)
    0 / 14 (0.00%)
    1 / 30 (3.33%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Fatigue
         subjects affected / exposed
    0 / 8 (0.00%)
    2 / 24 (8.33%)
    0 / 14 (0.00%)
    0 / 30 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 2
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    General physical health deterioration
         subjects affected / exposed
    0 / 8 (0.00%)
    0 / 24 (0.00%)
    0 / 14 (0.00%)
    1 / 30 (3.33%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Gastrointestinal disorders
    Diarrhoea
         subjects affected / exposed
    1 / 8 (12.50%)
    0 / 24 (0.00%)
    0 / 14 (0.00%)
    0 / 30 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Pulmonary embolism
         subjects affected / exposed
    0 / 8 (0.00%)
    0 / 24 (0.00%)
    1 / 14 (7.14%)
    1 / 30 (3.33%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Psychiatric disorders
    Confusional state
         subjects affected / exposed
    1 / 8 (12.50%)
    0 / 24 (0.00%)
    0 / 14 (0.00%)
    0 / 30 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Musculoskeletal and connective tissue disorders
    Back pain
         subjects affected / exposed
    0 / 8 (0.00%)
    0 / 24 (0.00%)
    1 / 14 (7.14%)
    0 / 30 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Infections and infestations
    Meningitis bacterial
         subjects affected / exposed
    1 / 8 (12.50%)
    0 / 24 (0.00%)
    0 / 14 (0.00%)
    0 / 30 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Pneumonia
         subjects affected / exposed
    0 / 8 (0.00%)
    0 / 24 (0.00%)
    1 / 14 (7.14%)
    0 / 30 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 1
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Staphylococcal infection
         subjects affected / exposed
    1 / 8 (12.50%)
    0 / 24 (0.00%)
    0 / 14 (0.00%)
    0 / 30 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Urinary tract infection
         subjects affected / exposed
    0 / 8 (0.00%)
    0 / 24 (0.00%)
    0 / 14 (0.00%)
    2 / 30 (6.67%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 2
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Metabolism and nutrition disorders
    Decreased appetite
         subjects affected / exposed
    1 / 8 (12.50%)
    0 / 24 (0.00%)
    0 / 14 (0.00%)
    0 / 30 (0.00%)
         occurrences causally related to treatment / all
    0 / 1
    0 / 0
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Hyperglycaemia
         subjects affected / exposed
    0 / 8 (0.00%)
    1 / 24 (4.17%)
    0 / 14 (0.00%)
    0 / 30 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Hyperlipasaemia
         subjects affected / exposed
    0 / 8 (0.00%)
    1 / 24 (4.17%)
    0 / 14 (0.00%)
    0 / 30 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Hypophosphataemia
         subjects affected / exposed
    0 / 8 (0.00%)
    1 / 24 (4.17%)
    0 / 14 (0.00%)
    0 / 30 (0.00%)
         occurrences causally related to treatment / all
    0 / 0
    0 / 1
    0 / 0
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    0 / 0
    0 / 0
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    Arm A: Selinexor 60 mg and Surgery Arm B: Selinexor 50 mg/m^2 Arm C: Selinexor 60 mg Arm D: Selinexor 80 mg
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    8 / 8 (100.00%)
    24 / 24 (100.00%)
    14 / 14 (100.00%)
    30 / 30 (100.00%)
    Vascular disorders
    Hypotension
         subjects affected / exposed
    1 / 8 (12.50%)
    0 / 24 (0.00%)
    0 / 14 (0.00%)
    6 / 30 (20.00%)
         occurrences all number
    1
    0
    0
    6
    Flushing
         subjects affected / exposed
    1 / 8 (12.50%)
    1 / 24 (4.17%)
    0 / 14 (0.00%)
    0 / 30 (0.00%)
         occurrences all number
    1
    1
    0
    0
    Embolism
         subjects affected / exposed
    0 / 8 (0.00%)
    0 / 24 (0.00%)
    1 / 14 (7.14%)
    0 / 30 (0.00%)
         occurrences all number
    0
    0
    1
    0
    Hypertension
         subjects affected / exposed
    0 / 8 (0.00%)
    0 / 24 (0.00%)
    1 / 14 (7.14%)
    0 / 30 (0.00%)
         occurrences all number
    0
    0
    1
    0
    General disorders and administration site conditions
    Fatigue
         subjects affected / exposed
    5 / 8 (62.50%)
    19 / 24 (79.17%)
    11 / 14 (78.57%)
    16 / 30 (53.33%)
         occurrences all number
    5
    19
    11
    16
    Gait disturbance
         subjects affected / exposed
    5 / 8 (62.50%)
    5 / 24 (20.83%)
    3 / 14 (21.43%)
    3 / 30 (10.00%)
         occurrences all number
    5
    5
    3
    3
    Oedema peripheral
         subjects affected / exposed
    3 / 8 (37.50%)
    1 / 24 (4.17%)
    2 / 14 (14.29%)
    3 / 30 (10.00%)
         occurrences all number
    3
    1
    2
    3
    Malaise
         subjects affected / exposed
    1 / 8 (12.50%)
    1 / 24 (4.17%)
    3 / 14 (21.43%)
    3 / 30 (10.00%)
         occurrences all number
    1
    1
    3
    3
    Face oedema
         subjects affected / exposed
    0 / 8 (0.00%)
    2 / 24 (8.33%)
    2 / 14 (14.29%)
    0 / 30 (0.00%)
         occurrences all number
    0
    2
    2
    0
    Non-cardiac chest pain
         subjects affected / exposed
    0 / 8 (0.00%)
    0 / 24 (0.00%)
    1 / 14 (7.14%)
    1 / 30 (3.33%)
         occurrences all number
    0
    0
    1
    1
    Pyrexia
         subjects affected / exposed
    1 / 8 (12.50%)
    0 / 24 (0.00%)
    1 / 14 (7.14%)
    0 / 30 (0.00%)
         occurrences all number
    1
    0
    1
    0
    Reproductive system and breast disorders
    Erectile dysfunction
         subjects affected / exposed
    0 / 8 (0.00%)
    0 / 24 (0.00%)
    0 / 14 (0.00%)
    2 / 30 (6.67%)
         occurrences all number
    0
    0
    0
    2
    Respiratory, thoracic and mediastinal disorders
    Cough
         subjects affected / exposed
    1 / 8 (12.50%)
    3 / 24 (12.50%)
    1 / 14 (7.14%)
    4 / 30 (13.33%)
         occurrences all number
    1
    3
    1
    4
    Dyspnoea
         subjects affected / exposed
    1 / 8 (12.50%)
    1 / 24 (4.17%)
    4 / 14 (28.57%)
    2 / 30 (6.67%)
         occurrences all number
    1
    1
    4
    2
    Oropharyngeal pain
         subjects affected / exposed
    2 / 8 (25.00%)
    1 / 24 (4.17%)
    0 / 14 (0.00%)
    2 / 30 (6.67%)
         occurrences all number
    2
    1
    0
    2
    Epistaxis
         subjects affected / exposed
    0 / 8 (0.00%)
    3 / 24 (12.50%)
    0 / 14 (0.00%)
    0 / 30 (0.00%)
         occurrences all number
    0
    3
    0
    0
    Nasal congestion
         subjects affected / exposed
    1 / 8 (12.50%)
    2 / 24 (8.33%)
    0 / 14 (0.00%)
    0 / 30 (0.00%)
         occurrences all number
    1
    2
    0
    0
    Rhinitis allergic
         subjects affected / exposed
    0 / 8 (0.00%)
    0 / 24 (0.00%)
    0 / 14 (0.00%)
    2 / 30 (6.67%)
         occurrences all number
    0
    0
    0
    2
    Apnoea
         subjects affected / exposed
    0 / 8 (0.00%)
    0 / 24 (0.00%)
    1 / 14 (7.14%)
    0 / 30 (0.00%)
         occurrences all number
    0
    0
    1
    0
    Pulmonary embolism
         subjects affected / exposed
    0 / 8 (0.00%)
    0 / 24 (0.00%)
    1 / 14 (7.14%)
    0 / 30 (0.00%)
         occurrences all number
    0
    0
    1
    0
    Psychiatric disorders
    Confusional state
         subjects affected / exposed
    2 / 8 (25.00%)
    4 / 24 (16.67%)
    1 / 14 (7.14%)
    5 / 30 (16.67%)
         occurrences all number
    2
    4
    1
    5
    Depression
         subjects affected / exposed
    1 / 8 (12.50%)
    1 / 24 (4.17%)
    2 / 14 (14.29%)
    1 / 30 (3.33%)
         occurrences all number
    1
    1
    2
    1
    Insomnia
         subjects affected / exposed
    0 / 8 (0.00%)
    4 / 24 (16.67%)
    1 / 14 (7.14%)
    0 / 30 (0.00%)
         occurrences all number
    0
    4
    1
    0
    Anxiety
         subjects affected / exposed
    1 / 8 (12.50%)
    1 / 24 (4.17%)
    0 / 14 (0.00%)
    1 / 30 (3.33%)
         occurrences all number
    1
    1
    0
    1
    Abnormal behaviour
         subjects affected / exposed
    0 / 8 (0.00%)
    0 / 24 (0.00%)
    2 / 14 (14.29%)
    0 / 30 (0.00%)
         occurrences all number
    0
    0
    2
    0
    Mood altered
         subjects affected / exposed
    0 / 8 (0.00%)
    1 / 24 (4.17%)
    1 / 14 (7.14%)
    0 / 30 (0.00%)
         occurrences all number
    0
    1
    1
    0
    Personality change
         subjects affected / exposed
    0 / 8 (0.00%)
    0 / 24 (0.00%)
    0 / 14 (0.00%)
    2 / 30 (6.67%)
         occurrences all number
    0
    0
    0
    2
    Investigations
    Weight decreased
         subjects affected / exposed
    1 / 8 (12.50%)
    5 / 24 (20.83%)
    6 / 14 (42.86%)
    2 / 30 (6.67%)
         occurrences all number
    1
    5
    6
    2
    Alanine aminotransferase increased
         subjects affected / exposed
    2 / 8 (25.00%)
    1 / 24 (4.17%)
    0 / 14 (0.00%)
    5 / 30 (16.67%)
         occurrences all number
    2
    1
    0
    5
    Aspartate aminotransferase increased
         subjects affected / exposed
    1 / 8 (12.50%)
    1 / 24 (4.17%)
    0 / 14 (0.00%)
    3 / 30 (10.00%)
         occurrences all number
    1
    1
    0
    3
    Blood alkaline phosphatase increased
         subjects affected / exposed
    0 / 8 (0.00%)
    0 / 24 (0.00%)
    0 / 14 (0.00%)
    3 / 30 (10.00%)
         occurrences all number
    0
    0
    0
    3
    Injury, poisoning and procedural complications
    Fall
         subjects affected / exposed
    1 / 8 (12.50%)
    1 / 24 (4.17%)
    1 / 14 (7.14%)
    5 / 30 (16.67%)
         occurrences all number
    1
    1
    1
    5
    Contusion
         subjects affected / exposed
    0 / 8 (0.00%)
    0 / 24 (0.00%)
    1 / 14 (7.14%)
    1 / 30 (3.33%)
         occurrences all number
    0
    0
    1
    1
    Incision site pain
         subjects affected / exposed
    1 / 8 (12.50%)
    0 / 24 (0.00%)
    1 / 14 (7.14%)
    0 / 30 (0.00%)
         occurrences all number
    1
    0
    1
    0
    Spinal compression fracture
         subjects affected / exposed
    0 / 8 (0.00%)
    0 / 24 (0.00%)
    1 / 14 (7.14%)
    0 / 30 (0.00%)
         occurrences all number
    0
    0
    1
    0
    Wound dehiscence
         subjects affected / exposed
    1 / 8 (12.50%)
    0 / 24 (0.00%)
    0 / 14 (0.00%)
    0 / 30 (0.00%)
         occurrences all number
    1
    0
    0
    0
    Cardiac disorders
    Tachycardia
         subjects affected / exposed
    1 / 8 (12.50%)
    0 / 24 (0.00%)
    0 / 14 (0.00%)
    0 / 30 (0.00%)
         occurrences all number
    1
    0
    0
    0
    Nervous system disorders
    Dysgeusia
         subjects affected / exposed
    1 / 8 (12.50%)
    10 / 24 (41.67%)
    6 / 14 (42.86%)
    4 / 30 (13.33%)
         occurrences all number
    1
    10
    6
    4
    Headache
         subjects affected / exposed
    4 / 8 (50.00%)
    5 / 24 (20.83%)
    6 / 14 (42.86%)
    5 / 30 (16.67%)
         occurrences all number
    4
    5
    6
    5
    Dizziness
         subjects affected / exposed
    3 / 8 (37.50%)
    6 / 24 (25.00%)
    4 / 14 (28.57%)
    2 / 30 (6.67%)
         occurrences all number
    3
    6
    4
    2
    Memory impairment
         subjects affected / exposed
    1 / 8 (12.50%)
    2 / 24 (8.33%)
    2 / 14 (14.29%)
    2 / 30 (6.67%)
         occurrences all number
    1
    2
    2
    2
    Aphasia
         subjects affected / exposed
    1 / 8 (12.50%)
    2 / 24 (8.33%)
    0 / 14 (0.00%)
    2 / 30 (6.67%)
         occurrences all number
    1
    2
    0
    2
    Balance disorder
         subjects affected / exposed
    1 / 8 (12.50%)
    1 / 24 (4.17%)
    2 / 14 (14.29%)
    1 / 30 (3.33%)
         occurrences all number
    1
    1
    2
    1
    Dysarthria
         subjects affected / exposed
    0 / 8 (0.00%)
    4 / 24 (16.67%)
    0 / 14 (0.00%)
    1 / 30 (3.33%)
         occurrences all number
    0
    4
    0
    1
    Seizure
         subjects affected / exposed
    2 / 8 (25.00%)
    1 / 24 (4.17%)
    0 / 14 (0.00%)
    2 / 30 (6.67%)
         occurrences all number
    2
    1
    0
    2
    Haemorrhage intracranial
         subjects affected / exposed
    2 / 8 (25.00%)
    0 / 24 (0.00%)
    0 / 14 (0.00%)
    2 / 30 (6.67%)
         occurrences all number
    2
    0
    0
    2
    Hemiparesis
         subjects affected / exposed
    1 / 8 (12.50%)
    2 / 24 (8.33%)
    0 / 14 (0.00%)
    1 / 30 (3.33%)
         occurrences all number
    1
    2
    0
    1
    Neuropathy peripheral
         subjects affected / exposed
    1 / 8 (12.50%)
    3 / 24 (12.50%)
    0 / 14 (0.00%)
    0 / 30 (0.00%)
         occurrences all number
    1
    3
    0
    0
    Tremor
         subjects affected / exposed
    0 / 8 (0.00%)
    2 / 24 (8.33%)
    0 / 14 (0.00%)
    2 / 30 (6.67%)
         occurrences all number
    0
    2
    0
    2
    Coordination abnormal
         subjects affected / exposed
    0 / 8 (0.00%)
    2 / 24 (8.33%)
    0 / 14 (0.00%)
    0 / 30 (0.00%)
         occurrences all number
    0
    2
    0
    0
    Depressed level of consciousness
         subjects affected / exposed
    1 / 8 (12.50%)
    0 / 24 (0.00%)
    0 / 14 (0.00%)
    1 / 30 (3.33%)
         occurrences all number
    1
    0
    0
    1
    Disturbance in attention
         subjects affected / exposed
    0 / 8 (0.00%)
    2 / 24 (8.33%)
    0 / 14 (0.00%)
    0 / 30 (0.00%)
         occurrences all number
    0
    2
    0
    0
    Hemianopia homonymous
         subjects affected / exposed
    0 / 8 (0.00%)
    0 / 24 (0.00%)
    1 / 14 (7.14%)
    1 / 30 (3.33%)
         occurrences all number
    0
    0
    1
    1
    IIIrd nerve disorder
         subjects affected / exposed
    1 / 8 (12.50%)
    1 / 24 (4.17%)
    0 / 14 (0.00%)
    0 / 30 (0.00%)
         occurrences all number
    1
    1
    0
    0
    Lethargy
         subjects affected / exposed
    0 / 8 (0.00%)
    0 / 24 (0.00%)
    1 / 14 (7.14%)
    1 / 30 (3.33%)
         occurrences all number
    0
    0
    1
    1
    Motor dysfunction
         subjects affected / exposed
    0 / 8 (0.00%)
    2 / 24 (8.33%)
    0 / 14 (0.00%)
    0 / 30 (0.00%)
         occurrences all number
    0
    2
    0
    0
    Paraesthesia
         subjects affected / exposed
    0 / 8 (0.00%)
    0 / 24 (0.00%)
    0 / 14 (0.00%)
    2 / 30 (6.67%)
         occurrences all number
    0
    0
    0
    2
    Syncope
         subjects affected / exposed
    0 / 8 (0.00%)
    0 / 24 (0.00%)
    1 / 14 (7.14%)
    1 / 30 (3.33%)
         occurrences all number
    0
    0
    1
    1
    Taste disorder
         subjects affected / exposed
    0 / 8 (0.00%)
    0 / 24 (0.00%)
    0 / 14 (0.00%)
    2 / 30 (6.67%)
         occurrences all number
    0
    0
    0
    2
    Visual field defect
         subjects affected / exposed
    0 / 8 (0.00%)
    1 / 24 (4.17%)
    1 / 14 (7.14%)
    0 / 30 (0.00%)
         occurrences all number
    0
    1
    1
    0
    Ataxia
         subjects affected / exposed
    0 / 8 (0.00%)
    0 / 24 (0.00%)
    1 / 14 (7.14%)
    0 / 30 (0.00%)
         occurrences all number
    0
    0
    1
    0
    Cerebrospinal fluid leakage
         subjects affected / exposed
    1 / 8 (12.50%)
    0 / 24 (0.00%)
    0 / 14 (0.00%)
    0 / 30 (0.00%)
         occurrences all number
    1
    0
    0
    0
    Intracranial pressure increased
         subjects affected / exposed
    1 / 8 (12.50%)
    0 / 24 (0.00%)
    0 / 14 (0.00%)
    0 / 30 (0.00%)
         occurrences all number
    1
    0
    0
    0
    Somnolence
         subjects affected / exposed
    0 / 8 (0.00%)
    0 / 24 (0.00%)
    1 / 14 (7.14%)
    0 / 30 (0.00%)
         occurrences all number
    0
    0
    1
    0
    Upper motor neurone lesion
         subjects affected / exposed
    0 / 8 (0.00%)
    0 / 24 (0.00%)
    1 / 14 (7.14%)
    0 / 30 (0.00%)
         occurrences all number
    0
    0
    1
    0
    Blood and lymphatic system disorders
    Thrombocytopenia
         subjects affected / exposed
    6 / 8 (75.00%)
    16 / 24 (66.67%)
    6 / 14 (42.86%)
    11 / 30 (36.67%)
         occurrences all number
    6
    16
    6
    11
    Leukopenia
         subjects affected / exposed
    0 / 8 (0.00%)
    7 / 24 (29.17%)
    1 / 14 (7.14%)
    14 / 30 (46.67%)
         occurrences all number
    0
    7
    1
    14
    Neutropenia
         subjects affected / exposed
    1 / 8 (12.50%)
    7 / 24 (29.17%)
    2 / 14 (14.29%)
    10 / 30 (33.33%)
         occurrences all number
    1
    7
    2
    10
    Anaemia
         subjects affected / exposed
    2 / 8 (25.00%)
    5 / 24 (20.83%)
    1 / 14 (7.14%)
    6 / 30 (20.00%)
         occurrences all number
    2
    5
    1
    6
    Lymphopenia
         subjects affected / exposed
    2 / 8 (25.00%)
    2 / 24 (8.33%)
    0 / 14 (0.00%)
    8 / 30 (26.67%)
         occurrences all number
    2
    2
    0
    8
    Ear and labyrinth disorders
    Tinnitus
         subjects affected / exposed
    0 / 8 (0.00%)
    2 / 24 (8.33%)
    0 / 14 (0.00%)
    1 / 30 (3.33%)
         occurrences all number
    0
    2
    0
    1
    Hypoacusis
         subjects affected / exposed
    0 / 8 (0.00%)
    0 / 24 (0.00%)
    0 / 14 (0.00%)
    2 / 30 (6.67%)
         occurrences all number
    0
    0
    0
    2
    Eye disorders
    Vision blurred
         subjects affected / exposed
    0 / 8 (0.00%)
    6 / 24 (25.00%)
    1 / 14 (7.14%)
    4 / 30 (13.33%)
         occurrences all number
    0
    6
    1
    4
    Dry eye
         subjects affected / exposed
    1 / 8 (12.50%)
    1 / 24 (4.17%)
    1 / 14 (7.14%)
    1 / 30 (3.33%)
         occurrences all number
    1
    1
    1
    1
    Cataract
         subjects affected / exposed
    0 / 8 (0.00%)
    0 / 24 (0.00%)
    0 / 14 (0.00%)
    3 / 30 (10.00%)
         occurrences all number
    0
    0
    0
    3
    Eye pain
         subjects affected / exposed
    1 / 8 (12.50%)
    0 / 24 (0.00%)
    0 / 14 (0.00%)
    2 / 30 (6.67%)
         occurrences all number
    1
    0
    0
    2
    Periorbital oedema
         subjects affected / exposed
    1 / 8 (12.50%)
    1 / 24 (4.17%)
    0 / 14 (0.00%)
    1 / 30 (3.33%)
         occurrences all number
    1
    1
    0
    1
    Visual acuity reduced
         subjects affected / exposed
    0 / 8 (0.00%)
    3 / 24 (12.50%)
    0 / 14 (0.00%)
    0 / 30 (0.00%)
         occurrences all number
    0
    3
    0
    0
    Gastrointestinal disorders
    Nausea
         subjects affected / exposed
    6 / 8 (75.00%)
    12 / 24 (50.00%)
    9 / 14 (64.29%)
    21 / 30 (70.00%)
         occurrences all number
    6
    12
    9
    21
    Vomiting
         subjects affected / exposed
    1 / 8 (12.50%)
    9 / 24 (37.50%)
    5 / 14 (35.71%)
    13 / 30 (43.33%)
         occurrences all number
    1
    9
    5
    13
    Constipation
         subjects affected / exposed
    3 / 8 (37.50%)
    8 / 24 (33.33%)
    7 / 14 (50.00%)
    7 / 30 (23.33%)
         occurrences all number
    3
    8
    7
    7
    Diarrhoea
         subjects affected / exposed
    2 / 8 (25.00%)
    3 / 24 (12.50%)
    3 / 14 (21.43%)
    6 / 30 (20.00%)
         occurrences all number
    2
    3
    3
    6
    Dry mouth
         subjects affected / exposed
    1 / 8 (12.50%)
    3 / 24 (12.50%)
    2 / 14 (14.29%)
    1 / 30 (3.33%)
         occurrences all number
    1
    3
    2
    1
    Dyspepsia
         subjects affected / exposed
    0 / 8 (0.00%)
    2 / 24 (8.33%)
    1 / 14 (7.14%)
    2 / 30 (6.67%)
         occurrences all number
    0
    2
    1
    2
    Abdominal pain
         subjects affected / exposed
    0 / 8 (0.00%)
    0 / 24 (0.00%)
    1 / 14 (7.14%)
    3 / 30 (10.00%)
         occurrences all number
    0
    0
    1
    3
    Stomatitis
         subjects affected / exposed
    0 / 8 (0.00%)
    2 / 24 (8.33%)
    1 / 14 (7.14%)
    0 / 30 (0.00%)
         occurrences all number
    0
    2
    1
    0
    Toothache
         subjects affected / exposed
    0 / 8 (0.00%)
    0 / 24 (0.00%)
    1 / 14 (7.14%)
    1 / 30 (3.33%)
         occurrences all number
    0
    0
    1
    1
    Skin and subcutaneous tissue disorders
    Alopecia
         subjects affected / exposed
    0 / 8 (0.00%)
    2 / 24 (8.33%)
    0 / 14 (0.00%)
    4 / 30 (13.33%)
         occurrences all number
    0
    2
    0
    4
    Pruritus
         subjects affected / exposed
    2 / 8 (25.00%)
    1 / 24 (4.17%)
    0 / 14 (0.00%)
    2 / 30 (6.67%)
         occurrences all number
    2
    1
    0
    2
    Dry skin
         subjects affected / exposed
    1 / 8 (12.50%)
    0 / 24 (0.00%)
    1 / 14 (7.14%)
    1 / 30 (3.33%)
         occurrences all number
    1
    0
    1
    1
    Rash maculo-papular
         subjects affected / exposed
    0 / 8 (0.00%)
    0 / 24 (0.00%)
    1 / 14 (7.14%)
    2 / 30 (6.67%)
         occurrences all number
    0
    0
    1
    2
    Rash
         subjects affected / exposed
    1 / 8 (12.50%)
    1 / 24 (4.17%)
    0 / 14 (0.00%)
    0 / 30 (0.00%)
         occurrences all number
    1
    1
    0
    0
    Purpura
         subjects affected / exposed
    0 / 8 (0.00%)
    0 / 24 (0.00%)
    1 / 14 (7.14%)
    0 / 30 (0.00%)
         occurrences all number
    0
    0
    1
    0
    Night Sweats
         subjects affected / exposed
    0 / 8 (0.00%)
    1 / 24 (4.17%)
    1 / 14 (7.14%)
    0 / 30 (0.00%)
         occurrences all number
    0
    1
    1
    0
    Renal and urinary disorders
    Urinary incontinence
         subjects affected / exposed
    1 / 8 (12.50%)
    3 / 24 (12.50%)
    2 / 14 (14.29%)
    3 / 30 (10.00%)
         occurrences all number
    1
    3
    2
    3
    Pollakiuria
         subjects affected / exposed
    0 / 8 (0.00%)
    2 / 24 (8.33%)
    1 / 14 (7.14%)
    1 / 30 (3.33%)
         occurrences all number
    0
    2
    1
    1
    Endocrine disorders
    Cushingoid
         subjects affected / exposed
    0 / 8 (0.00%)
    4 / 24 (16.67%)
    0 / 14 (0.00%)
    0 / 30 (0.00%)
         occurrences all number
    0
    4
    0
    0
    Inappropriate antidiuretic hormone secretion
         subjects affected / exposed
    1 / 8 (12.50%)
    0 / 24 (0.00%)
    0 / 14 (0.00%)
    0 / 30 (0.00%)
         occurrences all number
    1
    0
    0
    0
    Musculoskeletal and connective tissue disorders
    Muscular weakness
         subjects affected / exposed
    1 / 8 (12.50%)
    3 / 24 (12.50%)
    4 / 14 (28.57%)
    2 / 30 (6.67%)
         occurrences all number
    1
    3
    4
    2
    Back pain
         subjects affected / exposed
    1 / 8 (12.50%)
    0 / 24 (0.00%)
    2 / 14 (14.29%)
    2 / 30 (6.67%)
         occurrences all number
    1
    0
    2
    2
    Myalgia
         subjects affected / exposed
    0 / 8 (0.00%)
    0 / 24 (0.00%)
    1 / 14 (7.14%)
    1 / 30 (3.33%)
         occurrences all number
    0
    0
    1
    1
    Neck pain
         subjects affected / exposed
    0 / 8 (0.00%)
    0 / 24 (0.00%)
    1 / 14 (7.14%)
    1 / 30 (3.33%)
         occurrences all number
    0
    0
    1
    1
    Osteoporosis
         subjects affected / exposed
    0 / 8 (0.00%)
    0 / 24 (0.00%)
    1 / 14 (7.14%)
    0 / 30 (0.00%)
         occurrences all number
    0
    0
    1
    0
    Infections and infestations
    Nasopharyngitis
         subjects affected / exposed
    0 / 8 (0.00%)
    2 / 24 (8.33%)
    1 / 14 (7.14%)
    2 / 30 (6.67%)
         occurrences all number
    0
    2
    1
    2
    Urinary tract infection
         subjects affected / exposed
    1 / 8 (12.50%)
    0 / 24 (0.00%)
    1 / 14 (7.14%)
    3 / 30 (10.00%)
         occurrences all number
    1
    0
    1
    3
    Upper respiratory tract infection
         subjects affected / exposed
    1 / 8 (12.50%)
    1 / 24 (4.17%)
    0 / 14 (0.00%)
    1 / 30 (3.33%)
         occurrences all number
    1
    1
    0
    1
    Bronchitis
         subjects affected / exposed
    0 / 8 (0.00%)
    0 / 24 (0.00%)
    1 / 14 (7.14%)
    1 / 30 (3.33%)
         occurrences all number
    0
    0
    1
    1
    Cystitis
         subjects affected / exposed
    1 / 8 (12.50%)
    0 / 24 (0.00%)
    0 / 14 (0.00%)
    0 / 30 (0.00%)
         occurrences all number
    1
    0
    0
    0
    Influenza
         subjects affected / exposed
    0 / 8 (0.00%)
    0 / 24 (0.00%)
    1 / 14 (7.14%)
    0 / 30 (0.00%)
         occurrences all number
    0
    0
    1
    0
    Pneumonia
         subjects affected / exposed
    0 / 8 (0.00%)
    0 / 24 (0.00%)
    1 / 14 (7.14%)
    0 / 30 (0.00%)
         occurrences all number
    0
    0
    1
    0
    Metabolism and nutrition disorders
    Decreased appetite
         subjects affected / exposed
    3 / 8 (37.50%)
    12 / 24 (50.00%)
    10 / 14 (71.43%)
    8 / 30 (26.67%)
         occurrences all number
    3
    12
    10
    8
    Hyponatraemia
         subjects affected / exposed
    4 / 8 (50.00%)
    11 / 24 (45.83%)
    3 / 14 (21.43%)
    1 / 30 (3.33%)
         occurrences all number
    4
    11
    3
    1
    Hypophosphataemia
         subjects affected / exposed
    3 / 8 (37.50%)
    5 / 24 (20.83%)
    0 / 14 (0.00%)
    0 / 30 (0.00%)
         occurrences all number
    3
    5
    0
    0
    Hyperglycaemia
         subjects affected / exposed
    0 / 8 (0.00%)
    4 / 24 (16.67%)
    1 / 14 (7.14%)
    1 / 30 (3.33%)
         occurrences all number
    0
    4
    1
    1
    Dehydration
         subjects affected / exposed
    1 / 8 (12.50%)
    3 / 24 (12.50%)
    0 / 14 (0.00%)
    1 / 30 (3.33%)
         occurrences all number
    1
    3
    0
    1
    Hypokalaemia
         subjects affected / exposed
    1 / 8 (12.50%)
    2 / 24 (8.33%)
    2 / 14 (14.29%)
    0 / 30 (0.00%)
         occurrences all number
    1
    2
    2
    0
    Hyperkalaemia
         subjects affected / exposed
    0 / 8 (0.00%)
    3 / 24 (12.50%)
    0 / 14 (0.00%)
    1 / 30 (3.33%)
         occurrences all number
    0
    3
    0
    1
    Hyperlipasaemia
         subjects affected / exposed
    2 / 8 (25.00%)
    1 / 24 (4.17%)
    0 / 14 (0.00%)
    1 / 30 (3.33%)
         occurrences all number
    2
    1
    0
    1
    Hypercreatininaemia
         subjects affected / exposed
    1 / 8 (12.50%)
    0 / 24 (0.00%)
    1 / 14 (7.14%)
    0 / 30 (0.00%)
         occurrences all number
    1
    0
    1
    0
    Hyperamylasaemia
         subjects affected / exposed
    1 / 8 (12.50%)
    0 / 24 (0.00%)
    0 / 14 (0.00%)
    0 / 30 (0.00%)
         occurrences all number
    1
    0
    0
    0

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    15 Nov 2013
    Protocol Amendment 2: - Description of the use of new dosing and the tablet formulation planned for use in this study was added. Identified the initial starting dose for all subjects at 50 mg/m2 (35 mg/m2 as per original protocol) based on clinical experience. - Revised the dose modification criteria for thrombocytopenia (to hold the drug for ≥Grade 3 thrombocytopenia until resolved to ≤ Grade 1 and then resume at a lower dose; specified when to further dose reduce and when to discontinue for recurrent toxicity) and for renal toxicity based on NCI-CTCAE (Version 4.03) criteria for serum creatinine levels. - Expanded the inclusion criteria to allow enrollment of subjects with AST levels less than twice the upper limit of normal (< 2 x ULN). - Clarified that the 7 surgical subjects planned to be enrolled in Arm A will receive 3 doses instead of 2 to 3 doses prior to surgery. - Revised the selinexor administration time after brain surgery for subjects in Arm A based on data regarding previously observed thrombocytopenia in Phase I human experience. The initial protocol stated that selinexor would be administered post-operatively 1 to 5 weeks from the date of surgery.
    16 Jul 2014
    Protocol Amendment 3: - Expanded the number of subjects in Arm A from 7 to 20 subjects based on initial PK data from 5 subjects dosed 2 hours prior to surgery suggest that selinexor consistently reaches therapeutic concentrations (50-300 nM) within brain tumor lesions. Thus, further exploration was warranted. Enrollment method was updated as sequential enrollment into Groups 1-4 with 5 subjects per group. Following enrollment completion of Group 1 selinexor tumor exposure was to be evaluated and enrollment of each subsequent group to be initiated if selinexor tumor levels exceeds 25 nM levels. Subjects were to receive 3 doses of selinexor (BIW on Day 1 and 3, and between 2 and 48 hours prior to surgery on Day 8-10). - Expanded the overall number of subjects enrolled in the study from approximately 37 to approximately 50 subjects due to increase in number of subjects in Arm A. - Updated information related to the MTD to specify that escalating beyond 70 mg/m2 BIW was prohibited in any study.
    23 Mar 2015
    Protocol Amendment 4: - Changed to flat dosing: 60 mg BIW during Weeks 1-3 of each 4-week cycle (Arms A, B, C, E, and F) and 80 mg QIW (Arm D) based on the analysis of prolonged dosing results in KCP-330-002: a dose of 35 mg/m2 (~60 mg) BIW had acceptable efficacy and improved long-term tolerability and a dose of 50 mg/m2 (~85 mg) BIW was tolerated and cleared DLT evaluation. - Added Arms C and D (1:1 randomization) to compare the efficacy, tolerability and safety of selinexor (60 mg) administered BIW during Weeks 1-3 of each 4 week cycle (Arm C) with selinexor (80 mg) administered QIW (Arm D). - Added Arm E for subjects with malignant gliomas other than GBM and Arm F for subjects with GBM or anaplastic gliomas (AG) with bevacizumab-refractory recurrent disease with approximately 10 subjects in each new arm to evaluate preliminary evidence of efficacy of selinexor in these exploratory populations. - Updated the planned number of subjects from 50 to 115. - Revised inclusion criteria to include diagnoses for the new exploratory arms (Arms E and F): Arm E “Pathologically confirmed malignant gliomas other than GBM (WHO Grade 3 anaplastic astrocytomas, oligodendrogliomas, or oligo-astrocytomas), with radiographic evidence of recurrent disease after treatment with temozolomide and radiotherapy”, Arm F “Pathologically confirmed GBM (including all histologic variants) or AG with bevacizumab-refractory disease (defined as recurrence or progression of disease per RANO criteria during prior therapy with bevacizumab or other direct VEGF/VEGFR inhibitors) with radiographic evidence of recurrent disease after treatment with temozolomide and radiotherapy”. - Revised the dose adjustment guidelines for selinexor-related toxicities to include supportive treatment based on the event and the severity of the event. - Deleted PK blood draws for Arm B because enrollment in Arm B had been stopped and additional PK data were not needed.
    01 Jul 2015
    Protocol Amendment 5: - Expanded Arm E by 10 subjects (for a total of 20 subjects) due to the limited availability of treatment options for this subject population and updated total sample size from 115 to 125. - Revised the end of study definition to clarify that the study will continue after collection of data for the primary analysis (6mPFS). - Revised the mITT population (primary efficacy population) to include subjects who discontinued treatment prior to the first post-baseline assessment due to death, toxicity, or disease progression, to adopt a more conservative approach by including subjects who do not have at least 1 post-dosing efficacy evaluation due to death, toxicity, or disease progression. -Changed dosing frequency of selinexor from BIW during Weeks 1-3 of each 4-week cycle to BIW during Weeks 1-4 of each cycle for arms with BIW dosing. This was based on discussions with Investigators who indicated that some subjects could benefit from dosing during Week 4, especially if they were tolerating the drug well and did not require a dosing break to mitigate side effects.
    13 Nov 2015
    Protocol Amendment 6: - To eliminate Arms E and F (which were introduced in the last protocol amendment but did not yet contain enrolled subjects) as these arms are not going forward due to budgetary limitations. - To add an exclusion criterion requiring subjects not to have undergone major surgery within 4 weeks prior to Cycle 1 Day 1. - Revised the end of study definition (text in bold was added and strikethrough was deleted): The study will continue until the last subject in the study has died, has been off study treatment for 12 months has been lost to follow-up, or has withdrawn consent, whichever occurs first.

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    Study was terminated due to Sponsor decision (all except 1 subject were off-treatment and 2 subjects were in survival follow-up).
    For support, Contact us.
    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

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