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MyelofibrosisPhase 2NCT07447817

Selinexor and Pacritinib in JAK Inhibitor-naïve MF Patients With Cytopenias

A Phase 2 study testing Pacritinib and Selinexor in people with Myelofibrosis and Post-polycythemia Vera Myelofibrosis, run by John Mascarenhas at 3 sites in United States.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
Search all trials

Trial summary

This is a phase II, multicenter, open-label trial evaluating the safety and efficacy of pacritinib and selinexor in JAK inhibitor naïve patients with anemia and thrombocytopenia. Read more about this study

Who is it for?
Ages 18 years and older
What is being tested?
Pacritinib and Selinexor
Type of treatment
Pill or oral medicine
Could I receive a placebo?
No, everyone receives an active treatment
How many people
26 participants
Where
3 sitesUnited States
Study dates
23 Oct 2026to 24 May 2030
Phase
Phase 2
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

  • Adults ≥ 18 years of age capable of providing informed consent
  • Pathologically confirmed diagnosis of PMF, post-ET MF, or post-PV MF as per the World Health Organization (WHO) diagnostic criteria - Intermediate-1, Intermediate-2, or High-Risk disease by the Dynamic International Prognostic Scoring System (DIPSS)
  • Eastern Cooperative Oncology Group (ECOG) performance status ≤ 2
  • Baseline splenomegaly ≥ 5cm palpable below the left costal margin and in the midclavicular line OR ≥ 450cc by imaging (i.e. ultrasound, CT, MRI)
  • Baseline anemia, defined by hemoglobin < 10 g/dL within 28 days prior to Cycle 1 Day 1
  • Baseline thrombocytopenia, defined by platelet count 50-150 x 109/L without platelet transfusions within 28 days prior to Cycle 1 Day 1
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  • Adequate organ function as demonstrated by the following within 28 days prior to Cycle 1 Day 1:
  • ALT (SGPT) and/or AST (SGOT) ≤ 3x the upper limit of normal (ULN), or ≤ 4 x ULN if, upon judgment of the treating physician, it is believed to be due to MF-related extramedullary hematopoiesis (EMH);
  • Direct bilirubin ≤ 1.5 x ULN; or ≤ 2x ULN if, upon judgment of the treating physician, it is believed to be due to MF-related extramedullary hematopoiesis (EMH) or documented Gilbert's syndrome;
  • Creatinine clearance ≥ 30 mL/min;
  • Prothrombin time (PT) and activated partial thromboplastin time (aPTT) ≤ 1.5 × ULN (Exceptions to coagulation parameters may be considered for patients who are taking concomitant anticoagulation medications or have a documented anti-phospholipid antibody, after discussion with Study Chair approval)
  • Bone marrow and/or peripheral blood blast count < 5%; and
  • Absolute neutrophil count (ANC) ≥ 1500 mm3 without need for growth factors within 7 days prior to Cycle 1 Day 1.
  • Recovery to ≤ Grade 1 or baseline of any toxicities due to prior systemic treatments, excluding alopecia
  • Life expectancy of at least six months
  • Patients with active hepatitis B virus are eligible if antiviral therapy for hepatitis B has been given for >8 weeks and the viral load is <100 IU/mL.
  • Patients with history of hepatitis C virus (HCV) are eligible if they have received adequate curative anti-HCV treatment and HCV viral load is below the limit of quantification.
  • Patients with history of human immunodeficiency virus are eligible if they have cluster of differentiation (CD)4+ T-cell counts ≥350 cells/μL, negative viral load, and no history of acquired immunodeficiency syndrome (AIDS)-defining opportunistic infections in the last year and should be on established antiretroviral therapy for at least 4 weeks.
  • Women of childbearing potential (WOCBP) and men must agree to use adequate contraception prior to study entry, for the duration of study participation, and for 90 days following completion of therapy. Men must agree to use a condom and not father a child or donate sperm for the duration of the study and for 90 days after the last dose of study therapy
  • Able to adhere to the study visit schedule and all protocol requirements

Who cannot join

  • Prior treatment with Janus kinase (JAK) inhibitors
  • Prior treatment with selinexor or other Exportin 1 (XPO1) inhibitors
  • Treatment with any MF-directed therapy (including investigational therapies and excluding hydroxyurea) within 2 weeks or 5.5 half-lives, whichever is shorter, of Cycle 1 Day 1
  • Completed hematopoietic cell transplant (HCT)
  • Prior splenectomy, splenic irradiation, or splenic artery embolization within 6 months of Cycle 1 Day 1
  • Impairment of gastrointestinal (GI) function or GI disease that could significantly alter the absorption of pacritinib or selinexor, including any unresolved nausea, vomiting, or diarrhea > National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE) v6.0 Grade 1
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  • Uncontrolled or currently progressing ocular toxicities
  • Moderate or severe cardiovascular disease meeting one or both of the below criteria:
  • Presence of cardiac disease, including a myocardial infarction within 6 months prior to study entry, unstable angina pectoris, New York Heart Association Class III/IV congestive heart failure, or uncontrolled hypertension
  • Documented major electrocardiogram (ECG) abnormalities (not responding to medical treatments)
  • Grade 2 or greater bleeding event within the past 6 months
  • QT corrected by the Fridericia method (QTcF) prolongation > 480 ms or other factors that increase the risk for QT interval prolongation (eg, hypokalemia [defined as serum potassium < 3.0 mEq/L that is persistent and refractory to correction], or history of long QT interval syndrome)
  • Recipient of organ transplant
  • History of major surgery or any planned surgical procedures within 28 days prior to Cycle 1 Day 1
  • Other malignancy within the last three years, other than curatively treated basal cell or squamous cell skin cancer, carcinoma in situ of the cervix, organ-confined or treated non-metastatic prostate cancer with normal prostate-specific antigen, in situ breast carcinoma after complete surgical resection, or superficial/non-invasive transitional cell bladder carcinoma.
  • Presence of active serious infection
  • Use of any prohibited medications (5.8) within two weeks or five half-lives, whichever is longer, prior to Cycle 1 Day 1
  • Women who are pregnant or lactating
  • Any serious, unstable medical or psychiatric condition that would prevent (as judged by the Investigator) the subject from signing the informed consent form (ICF) or any condition, including the presence of laboratory abnormalities, which places the subject at unacceptable risk if they were to participate in the study or confounds the ability to interpret data from the study
  • Is or has an immediate family member (e.g., spouse, parent/legal guardian, sibling, or child) who is investigational site or sponsor staff directly involved with this trial, unless prospective IRB approval (by chair or designee) is given allowing exception to this criterion for a specific subject

Trial locations and contacts

3 sites in 1 country. Contact the study team or a site near you to ask about taking part.

United States3 sites, 3 recruiting
  • Icahn School of Medicine at Mount Sinai

    New York, New York, 10029

    John Mascarenhas

    Recruiting
  • The University of Kansas Cancer Center-Westwood

    Westwood, Kansas, 66205

    Abdulraheem Yacoub

    Not yet recruiting
  • Wake Forest Baptist Health Comprehensive Cancer Center

    Winston-Salem, North Carolina, 27157

    Ruben Mesa

    Not yet recruiting

Other trials in United States

About this study

Official title: Investigator-Initiated, Open-Label, Phase II Trial of Selinexor in Combination With Pacritinib in Patients With Myelofibrosis Who Are JAK Inhibitor-Naïve and Have Cytopenias (ILLUMINATE)

This is a phase II, multicenter, open-label trial evaluating the safety and efficacy of pacritinib and selinexor in JAK inhibitor naïve patients with anemia and thrombocytopenia.

Read the detailed description

This Phase II, multicenter, open-label will evaluate the safety and efficacy of pacritinib and selinexor in JAK inhibitor naïve patients with anemia and thrombocytopenia. Participants will receive pacritinib monotherapy for 1 cycle (4 weeks) and will be assessed for qualification to proceed to combination therapy at Cycle 2 Day 1. Participants who qualify for combination therapy will receiving pacritinib and selinexor for the remaining cycles. Participants who do not qualify at Cycle 2 Day 1 will have weekly assessments and count checks. If they meet criteria for combination therapy at any point, selinexor will be added onto pacritinib. Participants who do not qualify for combination therapy by Cycle 4 Day 1 will complete 6 cycles of pacritinib monotherapy, complete primary endpoint assessments after 24 weeks, and discontinue study participation. Participants receiving combination therapy must demonstrate clinical benefit at Cycle 7 Day 1 (24 weeks) to continue receiving therapy until loss of response, disease progression, unacceptable toxicity, participant/physician withdrawal, or the study is terminated.

Being tested
Pacritinib, Selinexor
Keywords
Myelofibrosis, Anemia, Thrombocytopenia, Pacritinib, Selinexor
Medical subject headings
Primary Myelofibrosis, Anemia, Thrombocytopenia

What participants receive

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

  • PacritinibDrug

    Also called VONJO

    Pacritinib 200mg twice a day (BID) by mouth (PO)

  • SelinexorDrug

    Also called KPT-330; XPOVIO

    Selinexor 60mg once weekly (QW) by mouth (PO)

Study groups in NCT07447817
Study groupRoleWhat they receive
Pacritinib/SelinexorExperimentalStudy participants will receive pacritinib monotherapy (200mg BID orally) for the first cycle (28 days). If they qualify to add on selinexor at any point from Cycle 2 Day 1 to Cycle 4 Day 1, participants will have selinexor (60mg QW orally) added onto their pacritinib regimen.
Receives: Drug: Pacritinib; Drug: Selinexor

What is being measured

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

  1. Change in spleen volume

    Evaluate clinical efficacy of pacritinib and selinexor in myelofibrosis patients who are JAK inhibitor-naïve and have anemia and thrombocytopenia by assessing spleen volume reduction (SVR) of 35% or greater compared to baseline as measured by imaging (MRI/CT)

    Measured: Baseline and 24 weeks

Secondary outcomes (10)
  1. Spleen response rate

    Spleen response rate (by palpation) after 6 and 12 cycles; spleen response is defined as baseline splenomegaly palpable at 5-10cm that becomes not palpable, or baseline splenomegaly of >10cm that decreases by ≥ 50%, as measured by palpation

    Measured: At 24 weeks and 48 weeks

  2. Change in the Myelofibrosis-Symptom Assessment Form Total Symptom Score (MF-SAF TSS)

    Evaluate change in patient reported outcomes of treatment

    Change in MF-SAF TSS from baseline after 6 and 12 cycles; symptom response will be determined in participants with baseline MF-SAF TSS ≥ 10.

    The MF-SAF TSS comprises 7 items measuring MF-related symptoms. Each item is scored on a scale ranging from 0 (absent) to 10 (worst imaginable) and the items are summed for a total score.

    The Mf-SAF TSS is the summation of all the individual scores (0-70 scale). Symptoms response requires ≥50% reduction in the MPN-SAF TSS and will be evaluable only in patients with a baseline TSS >= 10.

    Measured: At 24 weeks and 48 weeks

  3. Change in Patient Global Impression of Change (PGIC)

    Patient Global Impression of Change (PGIC) response after 6 and 12 cycles; PGIC response is defined as "minimally improved" or better

    The Patient Global Impression of Change (PGIC) will be used to assess self-reported belief about the efficacy of treatment. PGIC is a 7-point scale depicting a patient's rating of overall improvement. Patients rate their change as "very much improved", "much improved", "minimally improved", "no change", "minimally worse", "much worse", or "very much worse.

    Total scale from 1-7, with higher score indicating poorer health outcomes.

    Measured: At 24 weeks and 48 weeks

  4. Anemia response

    Anemia response after 6 and 12 cycles; anemia response is determined according to revised 2024 International Working Group-European LeukemiaNet (IWG-ELN) criteria and includes major response rate and minor response rate for transfusion-dependent anemia.

    Major response: No transfusions for 12 weeks alongside a 12-week average hemoglobin increase of 150g/L

    Minor response: A 50% or more reduction in transfusions and failure to meet major response thresholds.

    Measured: At 24 weeks and 48 weeks

  5. Change in hemoglobin level

    Hemoglobin is the protein molecule in red blood cells that carries oxygen from the lungs to the body's tissues and returns carbon dioxide from the tissues back to the lungs.

    Measured: Continuously across all cycles of treatment, up to 48 weeks

  6. Change in platelet count

    Platelets are part of the blood cells. Platelets are a part of the blood clotting system and help in preventing bleeding.

    Measured: Continuously across all cycles of treatment, up to 48 weeks

  7. Progression-free survival

    Progression-free survival (PFS) is defined as time from first treatment to disease progression by IWG-ELN criteria

    Measured: At time of disease progression or at 48 weeks, whichever occurs first

  8. Overall survival

    Overall survival (OS) is defined as time from first treatment to death due to any cause or censored at last follow-up

    Measured: At time of death or censored at last follow-up, at 48 weeks

  9. Number of participants achieving RBC transfusion independence)

    The number of participants achieving transfusion independence will be divided by the number of participants who were transfusion-dependent at baseline

    Measured: at 24 weeks and at 48 weeks

  10. Number of participants achieving platelet transfusion independence

    The number of participants achieving transfusion independence will be divided by the number of participants who were transfusion-dependent at baseline

    Measured: at 24 weeks and at 48 weeks

Timeline

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

  1. First posted4 Mar 2026
  2. Study start23 Oct 2026 (estimated)
  3. Primary completion24 May 2030 (estimated)
  4. Study completion24 May 2030 (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 2
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
26 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07447817
Sponsor's protocol ID
STUDY-26-00174
Other IDs
5P01CA108671, MPN-RC 126
Status last verified
Oct 2026
First submitted
25 Feb 2026
Last updated
27 Oct 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No: The completed dataset is the sole property of the Sponsor-Investigator's institution and should not be exported to third parties, except for authorized representatives of appropriate Health/Regulatory Authorities, without permission from the Sponsor-investigator and their institution.

Questions about this trial

What is this clinical trial studying?

A Phase 2 study testing Pacritinib and Selinexor in people with Myelofibrosis and Post-polycythemia Vera Myelofibrosis, run by John Mascarenhas at 3 sites in United States.

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 20 inclusion and 20 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: looking for participants now, as of the sponsor's last update on 27 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 3 sites in United States. 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 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.

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?

Contact Gillian Sanchez ((917) 581-1774, gillian.sanchez@mssm.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in spleen volume (time frame: Baseline and 24 weeks). 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 27 Oct 2026.

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