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Multiple MyelomaPhase 1/2NCT05422027

Selinexor Plus VRd in High Risk Newly Diagnosed Multiple Myeloma

A Phase 1/2 study testing Selinexor, Bortezomib and Lenalidomide in people with Multiple Myeloma, run by Xia Zhongjun at 4 sites in China.

Unknown status

Status not confirmed. The sponsor has not verified this record for over two years, so it may be out of date.

Official record
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Trial summary

This is a single-arm and open-label study to explore XVRd (ATG-010, Bortezomib, Lenalidomide and Dexamethasone) regimen in high-risk newly diagnosed multiple myeloma.The primary objective of the dose escalation study is to determine the safety, tolerability, and recommended phase II dose (RP2D) of selinexor; Then dose… Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Multiple Myeloma
What is being tested?
Selinexor, Bortezomib and Lenalidomide
Could I receive a placebo?
No, everyone receives an active treatment
How many people
42 participants
Where
4 sitesChina
Study dates
25 Jul 2022to 31 Dec 2025
Phase
Phase 1/2
Are there results?
None posted in the registry

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

  • Patients must meet all of the following inclusion criteria to be eligible to enroll in this study:
  • Willing and able to written informed consent (ICF) .
  • Age ≥ 18 years.
  • Newly diagnosed multiple myeloma as defined by IMWG(Rajkumar, Dimopoulos et al. 2014) , measurable disease as defined IMWG 2016 criteria(Table 5) (Kumar, Paiva et al.2016), and meet at least one of the following criteria:
  • Serum M-protein (SPEP) ≥ 5 g/L, If the MM type is IgA/IgD, that can be substituted by IgA/IgD quantitative level.
  • 24 hours-Urinary M-protein excretion ≥ 0.2 g (200 mg)
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  • Serum FLC ≥ 100 mg/L with abnormal FLC ratio ( FLC Normal ratio:0.26 to 1.65)
  • According to mSMART 3.0 definition for high risk multiple myeloma:
  • High Risk genetic Abnormalities t(4;14) , t(14;16) , t(14;20) , Del 17p, p53 mutation, Gain 1q
  • R-ISS Stage 3
  • High Plasma Cell S-phase
  • GEP: High risk signature
  • Eastern Cooperative Oncology Group (ECOG) Performance Status of 0, 1, or 2. ECOG PS 3 allowed, if caused by myeloma.
  • Patients must have received no prior chemotherapy for multiple myeloma. Patients must have received no prior radiotherapy to a large area of the pelvis (more than half of the pelvis). Patients must have received no prior steroid treatment for myeloma with the exception of a maximum of 14 days of treatment for symptom control.
  • Adequate hepatic function: total bilirubin < 1.5× upper limit of normal (ULN) (for patients with Gilbert's syndrome, a total bilirubin of < 3× ULN is required), AST < 2× ULN, and ALT < 2× ULN.
  • Adequate renal function: estimated creatinine clearance ≥ 30 mL/min (calculated using the formula of Cockroft-Gault).
  • Adequate hematopoietic function within 7 days prior to C1D1 and met the following criteria: White blood cell (WBC) count ≥1.5×109/L, Absolute neutrophil count (ANC)≥1.0×109/L, Hemoglobin (HB) ≥85g/L and Platelet count (PLT) ≥75×109/L (patients whom <50% of bone marrow nucleated cells are plasma cells) or PLT ≥ 50×109/L (patients whom ≥ 50% of bone marrow nucleated cells are plasma cells).
  • Patients could not receive hematopoietic growth factor treatment within 2 weeks prior to screening, These growth factors include Erythropoietin (EPO), granulocyte colony-stimulating factor (G-CSF), Granulocyte macrophages-colony stimulating factor (GM-CSF), Platelet agonist, etc (Eltrombopag, Thrombopoietin (TPO), Interleukin-11).
  • Patients receive transfusions of blood products:
  • At least 2 weeks elapsed between the screening hemoglobin assessment and the last red blood cell infusion,
  • And at least 1 week elapsed between the screening platelet assessment and the last platelet infusion.
  • Patients must be able to take prophylactic anticoagulant therapy as recommended by the study.
  • Female patients of childbearing potential must meet below two criteria:
  • must agree to use effective contraception methods since signature in ICF, throughout the study and for 3 months following the last dose of study treatment.
  • must have a negative serum pregnancy test at screening. Note: A woman is considered of childbearing potential following menarche and until becoming postmenopausal (defined as no menstrual period for a minimum of 12 months) or permanently sterile (having undergone a hysterectomy, bilateral salpingectomy or bilateral oophorectomy). A woman who is taking oral contraceptive or using intrauterine device is considered of childbearing potential.
  • Male patients (including those who have received vasectomy) must use a condom if sexually active with a female of child-bearing potential throughout the study and for 3 months following the last dose of study treatment.

Who cannot join

  • Patients who meet any of the following criteria will not be enrolled:
  • Plasma cell leukemia.
  • Documented active amyloidosis.
  • Involvement of the central nervous system(CNS) by Multiple myeloma.
  • Prior exposure to a SINE compound, including ATG-010.
  • Currently, whether or not the patient is on medication, > Grade 2 peripheral neuropathy or ≥ Grade ≥ 2 painful neuropathy at baseline.
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  • Known intolerance, hypersensitivity, or contraindication to glucocorticoids, bortezomib, lenalidomide, and Selinexor (ATG-010) .
  • Active, unstable cardiovascular function, as indicated by the presence of:
  • Symptomatic ischemia, or
  • Uncontrolled clinically significant conduction abnormalities (eg, patients with ventricular tachycardia on anti-arrhythmics are excluded; patients with first degree atrioventricular block or asymptomatic left anterior fascicular block/right bundle branch block will not be excluded), or
  • Congestive heart failure of New York Heart Association Class ≥3 or known left ventricular ejection fraction <40%, or
  • Myocardial infarction within 6 months prior to C1D1.
  • Known positive serology for HIV or HIV seropositivity.
  • Known active hepatitis A, B, or C infection; eg. positive for HCV RNA or HBV-DNA.
  • Women who are pregnant or nursing.
  • Life expectancy of less than 6 months.
  • Any active gastrointestinal dysfunction interfering with the patient's ability to swallow tablets, or any active gastrointestinal dysfunction that could interfere with absorption of study treatment.
  • Any active, serious psychiatric, medical, or other conditions/situations that, in the opinion of the Investigator, could interfere with treatment, compliance, or the ability to give informed consent.
  • Contraindication to any of the required concomitant drugs or supportive treatments.
  • Has any concurrent diseases or complications that is likely to interfere with the study procedures.
  • Patients unwilling or unable to comply with the protocol.

Trial locations and contacts

4 sites in 1 country.

Zhongjun Xia, Ph.D contact

+86-020-87342438

xiazhj@sysucc.org.cn

China4 sites, 4 recruiting
  • Guangdong Provincial Peoples Hospital

    Guangzhou, Guangdong, 510000

    Liye Zhong, Ph.D

    Not yet recruiting
  • Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China,

    Guangzhou, Guangdong, 510060

    Zhong-jun Xia, Ph.D, +86 020-87342439, xiazhj@sysucc.org.cn

    Zhong-jun Xia, M.D.

    Recruiting
  • Sun Yat-sen Memorial Hospital, Sun Yat-sen University

    Guangzhou, Guangdong, 510120

    Xiuju Wang, Ph.D

    Xiuju Wang, Ph.D

    Not yet recruiting
  • Nanfang Hospital

    Guangzhou, Guangdong, 510515

    Yongqiang Wei, PhD

    Yongqiang Wei, PhD

    Not yet recruiting

Other trials in China

About this study

Official title: Selinexor(ATG-010) Plus Bortezomib, Lenalidomide and Dexamethasone (XVRd) in High Risk Newly Diagnosed Multiple Myeloma

This is a single-arm and open-label study to explore XVRd (ATG-010, Bortezomib, Lenalidomide and Dexamethasone) regimen in high-risk newly diagnosed multiple myeloma.The primary objective of the dose escalation study is to determine the safety, tolerability, and recommended phase II dose (RP2D) of selinexor; Then dose expansion at the RP2D level based on dose escalation phase will be conducted to evaluate the efficacy, safety and tolerability.The enrollment period for this study is expected to be approximately 12 months.

The study will end when all patients have completed 12 cycles treatment/follow-up since the initiation of the study drug, or the last patient has expired, has been lost to follow-up, or has withdrawn consent, whichever occurs first.

Read the detailed description

This is a single-arm and open-label study to explore XVRd (ATG-010, Bortezomib, Lenalidomide and Dexamethasone) regimen in high-risk newly diagnosed multiple myeloma. Approximately 3-42 patients will be enrolled in the study. In dose escalation phase, patients with high-risk NDMM will be treated with VRd standard regimen (bortezomib 1.3mg/m2 SC on day1,4,8,11, lenalidomide 25 mg on day 1-14 and dexamethasone 40mg on day 1,8,15 in a 21-day cycle) plus escalating doses of selinexor 40 mg or 60 mg on days 1, 8, and 15 of each cycle in a 3+3 design. The primary objective of the dose escalation study is to determine the safety, tolerability,and recommended phase II dose (RP2D) of selinexor; Then dose expansion at the RP2D level based on dose escalation phase will be conducted to evaluate the efficacy, safety and tolerability. All of the patients will receive 12 cycles of XVRd , and subjects can choose maintenance treatment with XR after 12 cycles of XVRd.The primary objective of the dose escalation study is to determine the safety, tolerability, and recommended phase II dose (RP2D) of selinexor; Then dose expansion at the RP2D level based on dose escalation phase will be conducted to evaluate the efficacy, safety and tolerability.

The enrollment period for this study is expected to be approximately 12 months. The study will end when all patients have completed 12 cycles treatment/follow-up since the initiation of the study drug, or the last patient has expired, has been lost to follow-up, or has withdrawn consent, whichever occurs first.

Being tested
Selinexor, Bortezomib, Lenalidomide, Dexamethasone
Keywords
Selinexor, ATG-010, Newly Diagnosed, High Risk
Medical subject headings
Multiple Myeloma

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • SelinexorDrug

    Also called ATG-010, Xpovio

    Selinexor (ATG-010# is a first-in-class, oral selective exportin 1 (XPO1) inhibitor (1,2). Selinexor functions by binding with and inhibiting the nuclear export protein XPO1 (also called CRM1), leading to the accumulation of tumor suppressor proteins in the cell nucleus along with inhibition of translation of oncoprotein mRNAs.

    Selinexor dose escalation: 40, 60mg respectively on day 1,8,15 for 21 days cycles

  • BortezomibDrug

    Also called Velcade

    The investigators gave patients subcutaneous bortezomib 1.3mg/sqm on days 1, 8,15 of a 21- day cycle.

    standard bortezomib-lenalidomide-dexamethasone

  • LenalidomideDrug

    Also called Revlimid

    The investigators gave patients oral lenalidomide 25mg on days 1 to 14 of a 21-day cycle.

    standard bortezomib-lenalidomide-dexamethasone

  • DexamethasoneDrug

    Also called Dexamethasone Acetate

    The investigators gave patients oral dexamethasone 40mg on days 1, 8, 15 of a 21-day cycle.

    standard bortezomib-lenalidomide-dexamethasone

Study groups in NCT05422027
Study groupRoleWhat they receive
Selinexor-VRd(XVRd)Experimentalbortezomib SC 1.3mg/sqm on day 1,4,8,11, lenalidomide oral 25 mg on day 1-14, and dexamethasone 40mg on day 1,8,15 in a 21-day cycle; Selinexor dose escalation: 40,60mg respectively on day 1,8,15 for 21-days cycles. Then Selinexor will be given at the recommended dose level on phase II.
Receives: Drug: Selinexor; Drug: Bortezomib; Drug: Lenalidomide; Drug: Dexamethasone

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Dose Escalation: Maximum Tolerated Dose (MTD)

    The MTD will be determined by study definition as the highest dose level without significant safety and tolerability concern.

    Measured: Assessed from the date of first dose of study treatment to the first cycle ends (maximum 21days) ;

  2. Dose Escalation: Recommended Phase 2 Does (RP2D)

    The RP2D is defined as the dose level chosen by the sponsor (in consultation with the investigators) for the dose expansion arms, based on safety, tolerability, efficacy, PK, and PD data collected during the dose escalation portion of the study.

    Measured: Assessed from the date of first dose of study treatment to the first cycle ends (maximum 21days) ;

  3. Dose Expansion: MRD negative remission

    MRD negative remission (<10-5) as defined by IMWG consensus

    Measured: At any time up to 12 months after XVRD treatment

Secondary outcomes (7)
  1. complete response (CR)

    complete response (CR) and stringent complete response (sCR)

    Measured: Cycle 1 Day 1 (each cycle consists of maximum 21 days) until a VGPR, CR or PR (up to 12 cycles)

  2. Overall Survival (OS)

    Occurrence of death regardless of cause

    Measured: 12 months

  3. Progression-Free Survival (PFS)

    Duration from start of study treatment to PD or death (regardless of cause), whichever comes first

    Measured: 12 months

  4. Duration of Response (DOR)

    Duration from the first observation of at least PR to time of disease progression, or deaths due to disease progression, whichever occurs first

    Measured: 12 months

  5. Clinical Benefit Rate (CBR)

    Clinical Benefit Rate (CBR=ORR+Minor Response [MR])

    Measured: 12 months

  6. Disease Control Rate (DCR)

    Disease Control Rate (DCR=CBR+Stable Disease[SD; for a minimum of 12 weeks])

    Measured: 12 months

  7. Number of Participants with Adverse Events

    Number of Participants With Treatment-Emergent Adverse Events (TEAEs) and Treatment-Emergent Serious Adverse Events (TESAEs)

    Measured: From first dose of study drug administration to end of treatment (up to 12 months)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted16 Jun 2022
  2. Study start25 Jul 2022
  3. Primary completion30 Jun 2025 (estimated)
  4. Study completion31 Dec 2025 (estimated)

Resources

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 1/2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
42 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05422027
Sponsor's protocol ID
ATG-010-IIT-MM-005
Status last verified
Jun 2024
First submitted
13 Jun 2022
Last updated
17 Jun 2024
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
Yes: All IPD results are used for publication,and can be shared with other investigators and sponsors

Questions about this trial

What is this clinical trial studying?

A Phase 1/2 study testing Selinexor, Bortezomib and Lenalidomide in people with Multiple Myeloma, run by Xia Zhongjun at 4 sites in China.

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 26 inclusion and 21 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: status not confirmed, as of the sponsor's last update on 17 Jun 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 4 sites in China. 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. 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 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

Results are not available in the source record.

How can a doctor refer a patient or contact the research team?

Contact Zhongjun Xia, Ph.D (+86-020-87342438, xiazhj@sysucc.org.cn), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Dose Escalation: Maximum Tolerated Dose (MTD) (time frame: Assessed from the date of first dose of study treatment to the first cycle ends (maximum 21days) ;). The study lists 3 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 17 Jun 2024.

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