Relapsed/Refractory Diffuse Large B-cell LymphomaPhase 2/3NCT04442022
A Study of Rituximab-Gemcitabine-Dexamethasone-Platinum (R-GDP) With or Without Selinexor in Patients With Relapsed/Refractory Diffuse Large B-cell Lymphoma
A Phase 2/3 study testing Selinexor (combination therapy), Rituximab (combination therapy) and Gemcitabine (combination therapy) in people with Relapsed/Refractory Diffuse Large B-cell Lymphoma, run by Karyopharm Therapeutics Inc at 38 sites in 6 countries.
Trial summary
The purpose of this Phase 2/3 study is to evaluate efficacy and safety of the combination of selinexor and R-GDP (SR-GDP) in patients with RR DLBCL who are not intended to receive hematopoetic stem cell transplantation (HSCT) or chimeric antigen receptor T cell (CAR-T) therapy. Read more about this study
- Who is it for?
- Ages 18 years and older
- Conditions the study is for
- Relapsed/Refractory Diffuse Large B-cell Lymphoma
- What is being tested?
- Selinexor (combination therapy), Rituximab (combination therapy) and Gemcitabine (combination therapy)
- Type of treatment
- Pill or oral medicine, Injection or infusion
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 501 participants
- Where
- 38 sitesin 6 countries
- Study dates
- 3 Sep 2020to Dec 2026
- Phase
- Phase 2/3
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Have pathologically confirmed de novo DLBCL or DLBCL transformed from previously diagnosed indolent lymphoma (e.g., follicular lymphoma). Patient with high-grade lymphoma with c-MYC, Bcl2 and/or Bcl6 rearrangements are eligible (only for Phase 2). (Documentation to be provided).
- Have received at least 1 but no more than 3 prior lines of systemic therapy for the treatment of DLBCL with relapsed or refractory disease following their most recent regimen.
- Salvage chemoimmunotherapy followed by stem cell transplantation will be considered as 1 line of systemic therapy.
- Maintenance therapy will not be counted as a separate line of systemic therapy.
- Radiation with curative intent for localized DLBCL will not be counted as 1 line of systemic therapy.
- Positron emission tomography (PET) positive measurable disease with at least 1 node having the longest diameter (LDi) greater than (>) 1.5 centimeter (cm) or 1 extranodal lesion with LDi >1 cm (per the Lugano Criteria 2014). The Deauville 5-point scale (D5PS) score assessed on the FDG PET/CT should be between 3 to 5.
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- Not intended for HSCT or CAR-T cell therapy based on objective clinical criteria determined by the treating physician. Patients who cannot receive HSCT due to active disease are allowed on study (up to approximately 15 percent [%] of patients enrolled in each Phase). Documentation on lack of intention to proceed to receive HSCT or CAR-T therapy must be provided by the treating physician.
- Adequate bone marrow function at screening, defined as:
- Absolute neutrophil count (ANC) ≥1*10^9 per liter (/L).
- Platelet count ≥100*10^9/L (without platelet transfusion less than [<] 14 days prior to Cycle 1 Day 1 [C1D1]).
- Hemoglobin ≥8.5 gram per deciliter (g/dL) (without red blood cell transfusion <14 days prior to C1D1).
- Circulating lymphocytes less than or equal to (≤) 50*10^9/L.
- Adequate liver and kidney function, defined as:
- Aspartate transaminase (AST) or alanine transaminase (ALT) ≤2.5*upper limit of normal (ULN), or ≤5*ULN in cases with known lymphoma involvement in the liver.
- Serum total bilirubin ≤2*ULN, or ≤5*ULN if due to Gilbert syndrome or in cases with known lymphoma involvement in the liver.
- Calculated creatinine clearance (CrCl) ≥30 milliliter per minute (mL/min) based on Cockcroft-Gault formula.
- Eastern Cooperative Oncology Group (ECOG) performance status of ≤2.
- An estimated life expectancy of >3 months at Screening.
- Patients with primary refractory DLBCL defined as no response or relapse within 6 months after ending first-line treatment, will be allowed in the study.
- Agree to highly effective contraception during the duration of the study with contraception use continuing for 12 months after the last dose of study treatment
- Female patients of childbearing potential must have a negative serum pregnancy test at Screening and agree to use highly effective methods of contraception throughout the study and for 12 months following the last dose of study treatment (except patients with Non-Childbearing potential: Age >50 years and naturally amenorrhoeic for >1 year, or previous bilateral salpingo-oophorectomy, or hysterectomy).
- Male patients who are sexually active must use highly effective methods of contraception throughout the study and for 12 months following the last dose of study treatment. Male patients must agree not to donate sperm during the study treatment period and for 12 months following the last dose of study treatment.
Who cannot join
- DLBCL with mucosa-associated lymphoid tissue (MALT) lymphoma, composite lymphoma (Hodgkin's lymphoma + non-Hodgkin's lymphoma [NHL]), DLBCL transformed from diseases other than indolent NHL; primary mediastinal (thymic) large B-cell lymphoma (PMBL); T-cell rich large B-cell lymphoma.
- Previous treatment with selinexor or other XPO1 inhibitors.
- Contraindication to any drug contained in the combination therapy regimen (SR-GDP).
- Known active central nervous system or meningeal involvement by DLBCL at time of Screening.
- Use of any standard or experimental anti-DLBCL therapy (including nonpalliative radiation, chemotherapy, immunotherapy, radio-immunotherapy, or any other anticancer therapy) <21 days prior to C1D1 (prednisone <30 mg or equivalent is permitted; palliative radiation is permitted only if on non-target lesions).
- Any AE, by C1D1, which has not recovered to Grade ≤1 (Common Terminology Criteria for Adverse Events [CTCAE], v.5.0), or returned to baseline, related to the previous DLBCL therapy, except hematological abnormalities (as specified in the inclusion criteria) and alopecia.
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- Major surgery <14 days of Cycle 1 Day 1.
- Hematopoietic stem cell transplantation/CAR-T therapy as follows:
- Autologous stem cell transplant (SCT) <100 days or allogeneic-SCT <180 days prior to C1D1
- Active graft-versus-host disease (GVHD) after allogeneic SCT (or cannot discontinue GVHD treatment or prophylaxis)
- CAR-T cell infusion <90 days prior to Cycle 1
- Neuropathy Grade ≥2 (CTCAE, v.5.0).
- Any life-threatening illness, medical condition, or organ system dysfunction which, in the Investigator's opinion, could compromise the patient's safety, or being compliant with the study procedures.
- Uncontrolled (i.e., clinically unstable) infection requiring parenteral antibiotics, antivirals, or antifungals within 7 days prior to first dose of study treatment; however, prophylactic use of these agents is acceptable (including parenteral).
- Patient with active hepatitis B virus (HBV), hepatitis C virus (HCV), or human immunodeficiency virus (HIV) infections:
- Patient with active HBV are allowed if antiviral therapy for hepatitis B has been given for >8 weeks and viral load is <100 International units (IU)/mL prior to first dose of study treatment.
- Patients with known history of HCV or found to be HCV antibody positive on screening, are allowed if there is documentation of negative viral load per institutional standard.
- Patients with HIV are allowed if they have a negative viral load per institutional standard, and no history of acquired immune deficiency syndrome (AIDS)-defining opportunistic infections in the last year.
- Inability to swallow tablets, malabsorption syndrome, or any other gastrointestinal (GI) disease or dysfunction that could interfere with absorption of study treatment.
- Breastfeeding or pregnant women.
- Inability or unwillingness to sign an informed consent form (ICF).
- In the opinion of the Investigator, patient who are significantly below their ideal body weight.
- Patients who received a live attenuated vaccine within prior 28 days of the first dose of study treatment.
Trial locations and contacts
38 sites in 6 countries.
38 sites in 6 countries
United States8 sites
University of Maryland Greenebaum Comprehensive Cancer Center
Baltimore, Maryland, 21201
The Oncology Institute (TOI) Clinical Research
Cerritos, California, 90703
Ironwood Physicians P.C. dba Ironwood Cancer and Research Centers
Chandler, Arizona, 85224
Norton Cancer Institute, St. Matthews
Louisville, Kentucky, 40207
Stony Brook
Stony Brook, New York, 11794
Arizona Oncology Associates
Tucson, Arizona, 85711
Texas Oncology - Tyler
Tyler, Texas, 75702
The University of Texas Health Science Center at Tyler DBA UT Health East Texas HOPE Cancer Center
Tyler, Texas, 75702
Italy8 sites
AOU Ospedali Riuniti-Università Politecnica delle Marche Clinica di Ematologia
Ancona, Ancona, 60020
UOC Ematologia ad Indirizzo Oncologico, AORN "Sant'Anna e San Sebastiano"
Caserta, Caserta, 81100
National Cancer Institute
Naples, Napoli, 1-80131
AOU Maggiore della Carità SCDU Ematologia
Novara, Novara, 28100
Azienda Ospedaliera Ospedali Riuniti Villa Sofia Cervello
Palermo, Sicily, 90146
DIP. Oncologia- Ematologia, UOSD Centro Diagnosie TerapiaDei Linfomi
Pescara, Pescara, 65124
Fondatione Policlinico Universitario A. Gemelli
Rome, Rome, 00168
AOU City of Health and Science of Turin
Turin, Torino, 10126
Poland7 sites
Szpitale pomorskie gdynia dept of haematology
Gdynia, Pomeranian Voivodeship, 81-519
Pratia Onkologia Katowice
Katowice, Silesian Voivodeship, 40-523
Pratia MCM Krakow
Krakow, Lesser, 30-510
CM Pratia Poznań
Skorzewo, Wielkopolska, 60819
Institute of Hematology and Transfusion Medicine
Warsaw, 00-791
Department of Lymphoid Malignancies, Maria Sklodowska-Curie National Research Institute of Oncology
Warsaw, 02-781
Klinika Hematologii, Nowotworów Krwi i Transplantacji Szpiku Uniwersytecki Szpital Kliniczny im. Jana Mikulicza - Radeckiego we Wrocławiu
Wroclaw, Radeckiego, 50-367
China6 sites
Huaxi Hospital Sichuan University
Chengdu, Sichuan, 610044
The first affiliated Hospital, Zhejiang University
Hangzhou, Zhejiang, 310003
Ruijin Hospital Affiliated to The Shanghai Jiao Tong University Medical School
Huangpu, Shanghai Municipality, 200025
Jiangsu Province Hospital
Nanjing, Jiangsu, 210029
The First Affiliated Hospital of Soochow University
Suzhou, Jiangsu, 215006
Zhongshan Hospital Fudan University
Xuhui, Shanghai Municipality, 200032
Spain5 sites
Institut català d'oncologia-hospital germans trias i pujol
Badalona, Barcelona, 08916
Hospital Vall Hebron
Barcelona, Barcelona, 08035
Institut Catala D'oncolocia
Barcelona, Barcelona, 09809
Hospital Universitario La Paz
Madrid, Madrid, 28046
Hospital Virgen del Rocío
Seville, Seville, 41013
Israel4 sites
Assuta Ashdod Medical Center
Ashdod, 7747629
Soroka Medical Center
Beersheba, 8457108
Rabin Medical Center
Petah Tikva, 4941492
Assuta Medical Center - Ramat Hachayal
Tel Aviv, 6423906
About this study
Official title: A Phase 2/3, Multicenter Randomized Study of Rituximab-Gemcitabine-Dexamethasone-Platinum (R-GDP) With or Without Selinexor in Patients With Relapsed/Refractory Diffuse Large B-cell Lymphoma (RR DLBCL)
The purpose of this Phase 2/3 study is to evaluate efficacy and safety of the combination of selinexor and R-GDP (SR-GDP) in patients with RR DLBCL who are not intended to receive hematopoetic stem cell transplantation (HSCT) or chimeric antigen receptor T cell (CAR-T) therapy. This study consists of 3 arms each in Phase 2 and 3. Phase 2 portion of the study will assess the two doses of selinexor (40 milligram [mg] or 60 mg) in combination with R-GDP, for up to 6 cycles (21-day per cycle), followed by 60 mg selinexor single agent continuous therapy for those who have reached a partial or complete response. Phase 3 portion of the study will evaluate the selected dose of SR-GDP (identified in Phase 2) versus standard R-GDP + matching placebo, for up to 6 cycles (21-day per cycle), followed by placebo or 60 mg selinexor single agent continuous therapy for those who have reached partial or complete response.
- Being tested
- Selinexor (combination therapy), Placebo matching for Selinexor (combination therapy), Rituximab (combination therapy), Gemcitabine (combination therapy), Dexamethasone (combination therapy)
- Keywords
- Relapsed/Refractory DLBCL, Rituximab-Gemcitabine-Dexamethasone-Platinum (R-GDP), Selinexor, Karyopharm, KCP-330, XPOVIO, DLBCL, XPORT-DLBCL-030, R-GDP
- Medical subject headings
- Lymphoma, Large B-Cell, Diffuse, Recurrence
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Selinexor (combination therapy)Drug
Dose: 40 mg on Days 1 and 8 of each 21-day cycle for up to 6 cycles; Route of administration: oral
Selinexor (combination therapy)Drug
Dose: 60 mg on Days 1 and 8 of each 21-day cycle for up to 6 cycles; Route of administration: oral
Selinexor (combination therapy)Drug
Dose: Selected dose of selinexor (from Phase 2) on Days 1 and 8 of each 21-day cycle for up to 6 cycles; Route of administration: oral
Placebo matching for Selinexor (combination therapy)Drug
Dose: Placebo matching for selected dose of selinexor (from Phase 2) on Days 1 and 8 of each 21-day cycle for up to 6 cycles; Route of administration: oral
Rituximab (combination therapy)Drug
Dose: 375 milligram per meter square (mg/m^2) on Day 1; Route of administration: intravenous (IV)
Rituximab (combination therapy)Drug
Dose: 375 mg/m^2 on Day 1; Route of administration: IV
Gemcitabine (combination therapy)Drug
Dose: 1000 mg/m^2 on Days 1 and 8; Route of administration: IV
Dexamethasone (combination therapy)Drug
Dose: 40 mg (20 mg if patient is more than 70 years old) on Days 1, 2, 3, and 4; Route of administration: oral or IV
Cisplatin (combination therapy)Drug
Dose: 75 mg/m^2 on Day 1; Route of administration: IV
Selinexor (continuous therapy)Drug
Dose: 60 mg QW for each 28-day cycle until PD; Route of administration: oral
Placebo matching for Selinexor (continuous therapy)Drug
Dose: Placebo matching for 60 mg selinexor QW for each 28-day cycle until PD; Route of administration: oral
| Study group | Role | What they receive |
|---|---|---|
| Phase 2: Selinexor 40 mg + R-GDP | Experimental | Patients with RR DLBCL will receive combination therapy of selinexor 40 mg orally at Day 1 and Day 8 of each 21-day cycle for up to 6 cycles in combination with R-GDP followed by single-agent continuous therapy with selinexor 60 mg orally once weekly (QW) for each 28-day cycle until progressive disease (PD) or unacceptable toxicity. Receives: Drug: Selinexor (combination therapy); Drug: Rituximab (combination therapy); Drug: Gemcitabine (combination therapy); Drug: Dexamethasone (combination therapy); Drug: Cisplatin (combination therapy); Drug: Selinexor (continuous therapy) |
| Phase 2: Selinexor 60 mg + R-GDP | Experimental | Patients with RR DLBCL will receive combination therapy of selinexor 60 mg orally at Day 1 and Day 8 of each 21-day cycle for up to 6 cycles in combination with R-GDP followed by single-agent continuous therapy with selinexor 60 mg orally QW for each 28-day cycle until PD or unacceptable toxicity. Receives: Drug: Selinexor (combination therapy); Drug: Rituximab (combination therapy); Drug: Gemcitabine (combination therapy); Drug: Dexamethasone (combination therapy); Drug: Cisplatin (combination therapy); Drug: Selinexor (continuous therapy) |
| Phase 2: R-GDP | Active comparator | Patients with RR DLBCL will receive R-GDP on specified days (Days 1, 2, 3, 4, and 8) for each 21-day cycle for up to 6 cycles. Receives: Drug: Rituximab (combination therapy); Drug: Gemcitabine (combination therapy); Drug: Dexamethasone (combination therapy); Drug: Cisplatin (combination therapy) |
| Phase 3: Selinexor (Selected Dose) + R-GDP followed by Selinexor 60 mg | Experimental | Patients with RR DLBCL will receive combination therapy of selinexor (selected dose from Phase 2) at Day 1 and Day 8 of each 21-day cycle for up to 6 cycles in combination with R-GDP followed by selinexor 60 mg orally QW for each 28-day cycle until PD or unacceptable toxicity. Receives: Drug: Selinexor (combination therapy); Drug: Rituximab (combination therapy); Drug: Gemcitabine (combination therapy); Drug: Dexamethasone (combination therapy); Drug: Cisplatin (combination therapy); Drug: Selinexor (continuous therapy) |
| Phase 3: Selinexor (Selected Dose) + R-GDP followed by Placebo | Experimental | Patients with RR DLBCL will receive combination therapy of selinexor (selected dose from Phase 2) at Day 1 and Day 8 of each 21-day cycle for up to 6 cycles in combination with R-GDP followed by matching placebo for selinexor orally QW for each 28-day cycle until PD or unacceptable toxicity. Receives: Drug: Selinexor (combination therapy); Drug: Rituximab (combination therapy); Drug: Gemcitabine (combination therapy); Drug: Dexamethasone (combination therapy); Drug: Cisplatin (combination therapy); Drug: Placebo matching for Selinexor (continuous therapy) |
| Phase 3: Placebo + R-GDP followed by Placebo | Placebo comparator | Patients with RR DLBCL will receive combination therapy of placebo matching for selinexor (selected dose from Phase 2) at Day 1 and Day 8 of each 21-day cycle for up to 6 cycles in combination with R-GDP followed by matching placebo for selinexor orally QW for each 28-day cycle until PD or unacceptable toxicity. Receives: Drug: Placebo matching for Selinexor (combination therapy); Drug: Rituximab (combination therapy); Drug: Gemcitabine (combination therapy); Drug: Dexamethasone (combination therapy); Drug: Cisplatin (combination therapy); Drug: Placebo matching for Selinexor (continuous therapy) |
What is being measured
The primary outcome is the main question the study is designed to answer.
Phase 2: Overall Response Rate (ORR): Based on Lugano Criteria 2014
Measured: From date of initial randomization to the date of disease progression or initiating a new DLBCL treatment (maximum of 5 years from randomization)
Phase 3: Progression-free Survival (PFS): Based on Lugano Criteria 2014
Measured: From date of initial randomization to the date of disease progression or death (maximum of 5 years from randomization)
Secondary outcomes (13)
Phase 2: Progression-free Survival: Based on Lugano Criteria 2014
Measured: From date of initial randomization to the date of disease progression or death (maximum of 5 years from randomization)
Phase 2: Overall Survival (OS)
Measured: From date of initial randomization until death (maximum of 5 years from randomization)
Phase 3: Overall Response Rate: Based on Lugano Criteria 2014
Measured: From date of initial randomization to the date of disease progression or initiating a new DLBCL treatment (maximum of 5 years from randomization)
Phase 3: Overall Survival
Measured: From date of initial randomization until death (maximum of 5 years from randomization)
Phase 2: Overall Response Rate at the End of Combination Therapy (ORR-EoC): Based on Lugano Criteria 2014
Measured: From C1D1 (Cycles 1 up to 6; 21 days per cycle) up to 28 days after EoC therapy
Phase 2: Overall Response Rate at the End of Combination Therapy: Based on Modified Lugano Criteria
Measured: From C1D1 (Cycles 1 up to 6; 21 days per cycle) up to 28 days after EoC therapy
Phase 2: Duration of Response (DOR): Based on Lugano Criteria 2014
Measured: From time of first response until disease progression or death (maximum of 5 years from randomization)
Phase 2: Number of Patients with Adverse Events (AEs)
Measured: Up to 30 days after last dose of study drug (maximum of 5 years from randomization)
Phase 3: Overall Response Rate at the End of Combination Therapy: Based on Lugano Criteria 2014
Measured: From C1D1 (Cycles 1 up to 6; 21 days per cycle) up to 28 days after EoC therapy
Phase 3: Overall Response Rate at the End of Combination Therapy: Based on Modified Lugano Criteria
Measured: From C1D1 (Cycles 1 up to 6; 21 days per cycle) up to 28 days after EoC therapy
Phase 3: Duration of Response: Based on Lugano Criteria 2014
Measured: From time of first response until disease progression or death (maximum of 5 years from randomization)
Phase 3: Progression-free Survival: Based on Modified Lugano Criteria
Measured: From date of initial randomization to the date of disease progression or death (maximum of 5 years from randomization)
Phase 3: Number of Patients with Adverse Events
Measured: Up to 30 days after last dose of study drug (maximum of 5 years from randomization)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted22 Jun 2020
- Study start3 Sep 2020
- Primary completionDec 2026 (estimated)
- Study completionDec 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Relapsed/Refractory Diffuse Large B-cell LymphomaStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 2/3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Sequential
- Masking
- Double blind
- Who is masked
- Participant, Investigator
- Enrolment
- 501 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Karyopharm Therapeutics Inc
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04442022
- Sponsor's protocol ID
- XPORT-DLBCL-030
- Other IDs
- 2020-000605-84
- Status last verified
- Sep 2026
- First submitted
- 10 Jun 2020
- Last updated
- 2 Oct 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
- Individual data sharing
- Undecided
Study at a glance
From the registry record, last updated by the sponsor on 2 Oct 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Phase 2/3, Multicenter Randomized Study of Rituximab-Gemcitabine-Dexamethasone-Platinum (R-GDP) With or Without Selinexor in Patients With Relapsed/Refractory Diffuse Large B-cell Lymphoma (RR DLBCL)
- ClinicalTrials.gov ID
- NCT04442022
- Acronym / sponsor ID
- XPORT-DLBCL-030
- Keywords
- Relapsed/Refractory DLBCL, Rituximab-Gemcitabine-Dexamethasone-Platinum (R-GDP), Selinexor, Karyopharm, KCP-330, XPOVIO, DLBCL, XPORT-DLBCL-030
- Phase
- Phase 2/3
- Study type
- Interventional
- Recruitment status
- Active, not recruiting
- Enrolment
- 501 participants (estimated)
- Lead sponsor
- Karyopharm Therapeutics IncIndustry (pharma, biotech, devices)
- Study start
- 3 Sep 2020 (actual)
- Primary completion
- Dec 2026 (estimated)
- Study completion
- Dec 2026 (estimated)
- First posted
- 22 Jun 2020 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The purpose of this Phase 2/3 study is to evaluate efficacy and safety of the combination of selinexor and R-GDP (SR-GDP) in patients with RR DLBCL who are not intended to receive hematopoetic stem cell transplantation (HSCT) or chimeric antigen receptor T cell (CAR-T) therapy. This study consists of 3 arms each in Phase 2 and 3. Phase 2 portion of the study will assess the two doses of selinexor (40 milligram [mg] or 60 mg) in combination with R-GDP, for up to 6 cycles (21-day per cycle), followed by 60 mg selinexor single agent continuous therapy for those who have reached a partial or complete response. Phase 3 portion of the study will evaluate the selected dose of SR-GDP (identified in Phase 2) versus standard R-GDP + matching placebo, for up to 6 cycles (21-day per cycle), followed by placebo or 60 mg selinexor single agent continuous therapy for those who have reached partial or complete response.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Sequential
- Masking
- Double blind (participant, investigator)
- Number of arms
- 6
| Arm | Type | Receives |
|---|---|---|
| Phase 2: Selinexor 40 mg + R-GDP | Experimental | Drug: Selinexor (combination therapy), Drug: Rituximab (combination therapy), Drug: Gemcitabine (combination therapy), Drug: Dexamethasone (combination therapy), Drug: Cisplatin (combination therapy), Drug: Selinexor (continuous therapy)Patients with RR DLBCL will receive combination therapy of selinexor 40 mg orally at Day 1 and Day 8 of each 21-day cycle for up to 6 cycles in combination with R-GDP followed by single-agent continuous therapy with selinexor 60 mg orally once weekly (QW) for each 28-day cycle until progressive disease (PD) or unacceptable toxicity. |
| Phase 2: Selinexor 60 mg + R-GDP | Experimental | Drug: Selinexor (combination therapy), Drug: Rituximab (combination therapy), Drug: Gemcitabine (combination therapy), Drug: Dexamethasone (combination therapy), Drug: Cisplatin (combination therapy), Drug: Selinexor (continuous therapy)Patients with RR DLBCL will receive combination therapy of selinexor 60 mg orally at Day 1 and Day 8 of each 21-day cycle for up to 6 cycles in combination with R-GDP followed by single-agent continuous therapy with selinexor 60 mg orally QW for each 28-day cycle until PD or unacceptable toxicity. |
| Phase 2: R-GDP | Active comparator | Drug: Rituximab (combination therapy), Drug: Gemcitabine (combination therapy), Drug: Dexamethasone (combination therapy), Drug: Cisplatin (combination therapy)Patients with RR DLBCL will receive R-GDP on specified days (Days 1, 2, 3, 4, and 8) for each 21-day cycle for up to 6 cycles. |
| Phase 3: Selinexor (Selected Dose) + R-GDP followed by Selinexor 60 mg | Experimental | Drug: Selinexor (combination therapy), Drug: Rituximab (combination therapy), Drug: Gemcitabine (combination therapy), Drug: Dexamethasone (combination therapy), Drug: Cisplatin (combination therapy), Drug: Selinexor (continuous therapy)Patients with RR DLBCL will receive combination therapy of selinexor (selected dose from Phase 2) at Day 1 and Day 8 of each 21-day cycle for up to 6 cycles in combination with R-GDP followed by selinexor 60 mg orally QW for each 28-day cycle until PD or unacceptable toxicity. |
| Phase 3: Selinexor (Selected Dose) + R-GDP followed by Placebo | Experimental | Drug: Selinexor (combination therapy), Drug: Rituximab (combination therapy), Drug: Gemcitabine (combination therapy), Drug: Dexamethasone (combination therapy), Drug: Cisplatin (combination therapy), Drug: Placebo matching for Selinexor (continuous therapy)Patients with RR DLBCL will receive combination therapy of selinexor (selected dose from Phase 2) at Day 1 and Day 8 of each 21-day cycle for up to 6 cycles in combination with R-GDP followed by matching placebo for selinexor orally QW for each 28-day cycle until PD or unacceptable toxicity. |
| Phase 3: Placebo + R-GDP followed by Placebo | Placebo comparator | Drug: Placebo matching for Selinexor (combination therapy), Drug: Rituximab (combination therapy), Drug: Gemcitabine (combination therapy), Drug: Dexamethasone (combination therapy), Drug: Cisplatin (combination therapy), Drug: Placebo matching for Selinexor (continuous therapy)Patients with RR DLBCL will receive combination therapy of placebo matching for selinexor (selected dose from Phase 2) at Day 1 and Day 8 of each 21-day cycle for up to 6 cycles in combination with R-GDP followed by matching placebo for selinexor orally QW for each 28-day cycle until PD or unacceptable toxicity. |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (22 listed)
- Have pathologically confirmed de novo DLBCL or DLBCL transformed from previously diagnosed indolent lymphoma (e.g., follicular lymphoma). Patient with high-grade lymphoma with c-MYC, Bcl2 and/or Bcl6 rearrangements are eligible (only for Phase 2). (Documentation to be provided).
- Have received at least 1 but no more than 3 prior lines of systemic therapy for the treatment of DLBCL with relapsed or refractory disease following their most recent regimen.
- Positron emission tomography (PET) positive measurable disease with at least 1 node having the longest diameter (LDi) greater than (>) 1.5 centimeter (cm) or 1 extranodal lesion with LDi >1 cm (per the Lugano Criteria 2014). The Deauville 5-point scale (D5PS) score assessed on the FDG PET/CT should be between 3 to 5.
- Not intended for HSCT or CAR-T cell therapy based on objective clinical criteria determined by the treating physician. Patients who cannot receive HSCT due to active disease are allowed on study (up to approximately 15 percent [%] of patients enrolled in each Phase). Documentation on lack of intention to proceed to receive HSCT or CAR-T therapy must be provided by the treating physician.
- Adequate bone marrow function at screening, defined as:
Key exclusion criteria (23 listed)
- DLBCL with mucosa-associated lymphoid tissue (MALT) lymphoma, composite lymphoma (Hodgkin's lymphoma + non-Hodgkin's lymphoma [NHL]), DLBCL transformed from diseases other than indolent NHL; primary mediastinal (thymic) large B-cell lymphoma (PMBL); T-cell rich large B-cell lymphoma.
- Previous treatment with selinexor or other XPO1 inhibitors.
- Contraindication to any drug contained in the combination therapy regimen (SR-GDP).
- Known active central nervous system or meningeal involvement by DLBCL at time of Screening.
- Use of any standard or experimental anti-DLBCL therapy (including nonpalliative radiation, chemotherapy, immunotherapy, radio-immunotherapy, or any other anticancer therapy) <21 days prior to C1D1 (prednisone <30 mg or equivalent is permitted; palliative radiation is permitted only if on non-target lesions).
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Selinexor (combination therapy)Dose: 40 mg on Days 1 and 8 of each 21-day cycle for up to 6 cycles; Route of administration: oral | Drug | Phase 2: Selinexor 40 mg + R-GDP |
| Selinexor (combination therapy)Dose: 60 mg on Days 1 and 8 of each 21-day cycle for up to 6 cycles; Route of administration: oral | Drug | Phase 2: Selinexor 60 mg + R-GDP |
| Selinexor (combination therapy)Dose: Selected dose of selinexor (from Phase 2) on Days 1 and 8 of each 21-day cycle for up to 6 cycles; Route of administration: oral | Drug | Phase 3: Selinexor (Selected Dose) + R-GDP followed by Placebo, Phase 3: Selinexor (Selected Dose) + R-GDP followed by Selinexor 60 mg |
| Placebo matching for Selinexor (combination therapy)Dose: Placebo matching for selected dose of selinexor (from Phase 2) on Days 1 and 8 of each 21-day cycle for up to 6 cycles; Route of administration: oral | Drug | Phase 3: Placebo + R-GDP followed by Placebo |
| Rituximab (combination therapy)Dose: 375 milligram per meter square (mg/m^2) on Day 1; Route of administration: intravenous (IV) | Drug | Phase 2: Selinexor 40 mg + R-GDP |
| Rituximab (combination therapy)Dose: 375 mg/m^2 on Day 1; Route of administration: IV | Drug | Phase 2: R-GDP, Phase 2: Selinexor 60 mg + R-GDP, Phase 3: Placebo + R-GDP followed by Placebo, Phase 3: Selinexor (Selected Dose) + R-GDP followed by Placebo, Phase 3: Selinexor (Selected Dose) + R-GDP followed by Selinexor 60 mg |
| Gemcitabine (combination therapy)Dose: 1000 mg/m^2 on Days 1 and 8; Route of administration: IV | Drug | Phase 2: R-GDP, Phase 2: Selinexor 40 mg + R-GDP, Phase 2: Selinexor 60 mg + R-GDP, Phase 3: Placebo + R-GDP followed by Placebo, Phase 3: Selinexor (Selected Dose) + R-GDP followed by Placebo, Phase 3: Selinexor (Selected Dose) + R-GDP followed by Selinexor 60 mg |
| Dexamethasone (combination therapy)Dose: 40 mg (20 mg if patient is more than 70 years old) on Days 1, 2, 3, and 4; Route of administration: oral or IV | Drug | Phase 2: R-GDP, Phase 2: Selinexor 40 mg + R-GDP, Phase 2: Selinexor 60 mg + R-GDP, Phase 3: Placebo + R-GDP followed by Placebo, Phase 3: Selinexor (Selected Dose) + R-GDP followed by Placebo, Phase 3: Selinexor (Selected Dose) + R-GDP followed by Selinexor 60 mg |
| Cisplatin (combination therapy)Dose: 75 mg/m^2 on Day 1; Route of administration: IV | Drug | Phase 2: R-GDP, Phase 2: Selinexor 40 mg + R-GDP, Phase 2: Selinexor 60 mg + R-GDP, Phase 3: Placebo + R-GDP followed by Placebo, Phase 3: Selinexor (Selected Dose) + R-GDP followed by Placebo, Phase 3: Selinexor (Selected Dose) + R-GDP followed by Selinexor 60 mg |
| Selinexor (continuous therapy)Dose: 60 mg QW for each 28-day cycle until PD; Route of administration: oral | Drug | Phase 2: Selinexor 40 mg + R-GDP, Phase 2: Selinexor 60 mg + R-GDP, Phase 3: Selinexor (Selected Dose) + R-GDP followed by Selinexor 60 mg |
| Placebo matching for Selinexor (continuous therapy)Dose: Placebo matching for 60 mg selinexor QW for each 28-day cycle until PD; Route of administration: oral | Drug | Phase 3: Placebo + R-GDP followed by Placebo, Phase 3: Selinexor (Selected Dose) + R-GDP followed by Placebo |
Primary outcome
Phase 2: Overall Response Rate (ORR): Based on Lugano Criteria 2014
Time frame: From date of initial randomization to the date of disease progression or initiating a new DLBCL treatment (maximum of 5 years from randomization)
Phase 3: Progression-free Survival (PFS): Based on Lugano Criteria 2014
Time frame: From date of initial randomization to the date of disease progression or death (maximum of 5 years from randomization)
13 secondary outcomes
Phase 2: Progression-free Survival: Based on Lugano Criteria 2014
Time frame: From date of initial randomization to the date of disease progression or death (maximum of 5 years from randomization)
Phase 2: Overall Survival (OS)
Time frame: From date of initial randomization until death (maximum of 5 years from randomization)
Phase 3: Overall Response Rate: Based on Lugano Criteria 2014
Time frame: From date of initial randomization to the date of disease progression or initiating a new DLBCL treatment (maximum of 5 years from randomization)
Phase 3: Overall Survival
Time frame: From date of initial randomization until death (maximum of 5 years from randomization)
Phase 2: Overall Response Rate at the End of Combination Therapy (ORR-EoC): Based on Lugano Criteria 2014
Time frame: From C1D1 (Cycles 1 up to 6; 21 days per cycle) up to 28 days after EoC therapy
Phase 2: Overall Response Rate at the End of Combination Therapy: Based on Modified Lugano Criteria
Time frame: From C1D1 (Cycles 1 up to 6; 21 days per cycle) up to 28 days after EoC therapy
Phase 2: Duration of Response (DOR): Based on Lugano Criteria 2014
Time frame: From time of first response until disease progression or death (maximum of 5 years from randomization)
Phase 2: Number of Patients with Adverse Events (AEs)
Time frame: Up to 30 days after last dose of study drug (maximum of 5 years from randomization)
Phase 3: Overall Response Rate at the End of Combination Therapy: Based on Lugano Criteria 2014
Time frame: From C1D1 (Cycles 1 up to 6; 21 days per cycle) up to 28 days after EoC therapy
Phase 3: Overall Response Rate at the End of Combination Therapy: Based on Modified Lugano Criteria
Time frame: From C1D1 (Cycles 1 up to 6; 21 days per cycle) up to 28 days after EoC therapy
Phase 3: Duration of Response: Based on Lugano Criteria 2014
Time frame: From time of first response until disease progression or death (maximum of 5 years from randomization)
Phase 3: Progression-free Survival: Based on Modified Lugano Criteria
Time frame: From date of initial randomization to the date of disease progression or death (maximum of 5 years from randomization)
Phase 3: Number of Patients with Adverse Events
Time frame: Up to 30 days after last dose of study drug (maximum of 5 years from randomization)
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 2 Oct 2026.
- Individual participant dataSharing planned: Undecided
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
38 sites in 6 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 2/3 study testing Selinexor (combination therapy), Rituximab (combination therapy) and Gemcitabine (combination therapy) in people with Relapsed/Refractory Diffuse Large B-cell Lymphoma, run by Karyopharm Therapeutics Inc at 38 sites in 6 countries.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 22 inclusion and 23 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: under way, not looking for participants, as of the sponsor's last update on 2 Oct 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 38 sites in United States, Italy, Poland, China, Spain and 1 more country. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this combined phase mean?
Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.
Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Phase 2: Overall Response Rate (ORR): Based on Lugano Criteria 2014 (time frame: From date of initial randomization to the date of disease progression or initiating a new DLBCL treatment (maximum of 5 years from randomization)). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 2 Oct 2026.