NCT02178436

Brief Summary

This partially randomized phase Ib/II trial studies the side effects and best dose of selinexor when given together with gemcitabine and nab-paclitaxel, and to see how well they work in treating patients with pancreatic cancer that has spread to other parts of the body (metastatic). Drugs used in chemotherapy, such as selinexor, gemcitabine and nab-paclitaxel, work in different ways to stop the growth of tumor cells, either by killing the cells, by stopping them from dividing, or by stopping them from spreading.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
15

participants targeted

Target at below P25 for phase_1

Timeline
Completed

Started Oct 2014

Longer than P75 for phase_1

Geographic Reach
1 country

2 active sites

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

June 23, 2014

Completed
7 days until next milestone

First Posted

Study publicly available on registry

June 30, 2014

Completed
4 months until next milestone

Study Start

First participant enrolled

October 31, 2014

Completed
7.1 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

November 27, 2021

Completed
1.4 years until next milestone

Study Completion

Last participant's last visit for all outcomes

April 5, 2023

Completed
7 months until next milestone

Results Posted

Study results publicly available

November 7, 2023

Completed
Last Updated

November 7, 2023

Status Verified

November 1, 2023

Enrollment Period

7.1 years

First QC Date

June 23, 2014

Results QC Date

September 13, 2023

Last Update Submit

November 5, 2023

Conditions

Outcome Measures

Primary Outcomes (3)

  • Maximum Tolerated Dose (MTD) of Selinexor, Gemcitabine Hydrochloride, and Paclitaxel Albumin-stabilized Nanoparticle Formulation Combination (Phase Ib)

    MTD is defined as the lowest dose for which less than a third of patients experience a dose limiting toxicity graded according to National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE) version 4.03.

    28 days

  • Proportion of Patients With a Toxic Event, Graded According to NCI CTCAE Version 4.03

    The reported output is the proportion of patients that had a toxic event along with the associated 90% Wilson's confidence interval.

    Up to 2 years

  • Overall Survival (Phase II)

    Estimated on an intention-to-treat basis (using all registered patients), and on a response-evaluable basis (using all patients who completed at least one 4-week treatment cycle) using the Kaplan-Meier method.

    Up to 7 months post treatment initiation

Secondary Outcomes (3)

  • Effects the Study Drug Combination Has on Participants

    Day 1 of course 1 (before selinexor administration, 1, 2, 4 and 8 hours after selinexor administration) and days 2, 3 and 8

  • Proportion of Patients With a Response

    Up to 2 years

  • Progression Free Survival (Phase II)

    Up to 2 years

Other Outcomes (1)

  • Change in Gene Expression (Including Forkhead Box Protein O, I-kappaB, Cyclin-dependent Kinase Inhibitor 1B, Par4 and Phosphorylated Signal Transducer and Activator of Transcription 3) (Phase II)

    Baseline to up to 2 years

Study Arms (3)

Group I: Phase Ib (gemcitabine, nab-paclitaxel, selinexor)

EXPERIMENTAL

Patients receive gemcitabine hydrochloride IV, nab-paclitaxel IV, and selinexor PO on days 1, 8, and 15. Cycles repeat every 4 weeks in the absence of disease progression or unacceptable toxicity.

Drug: gemcitabine hydrochlorideDrug: SelinexorOther: Pharmacological StudyOther: Laboratory Biomarker AnalysisDrug: Nab paclitaxel

Group II: Phase II Group I (gemcitabine, selinexor)

EXPERIMENTAL

Patients receive gemcitabine hydrochloride IV on days 1, 8, and 15. Patients also receive selinexor PO on days 3, 8, and 15 of cycle 1 and on days 1, 8, and 15 for the subsequent cycles. Cycles repeat every 4 weeks in the absence of disease progression or unacceptable toxicity

Drug: gemcitabine hydrochlorideDrug: SelinexorOther: Pharmacological StudyOther: Laboratory Biomarker Analysis

GroupIII: Phase II Group II (gemcitabine, selinexor)

EXPERIMENTAL

Patients receive gemcitabine hydrochloride IV and selinexor PO on days 1, 8, and 15. Cycles repeat every 4 weeks in the absence of disease progression or unacceptable toxicity.

Drug: gemcitabine hydrochlorideDrug: SelinexorOther: Pharmacological StudyOther: Laboratory Biomarker Analysis

Interventions

Given IV

Also known as: dFdC, difluorodeoxycytidine hydrochloride, Gemcitabine HCI, Gemzar
Group I: Phase Ib (gemcitabine, nab-paclitaxel, selinexor)Group II: Phase II Group I (gemcitabine, selinexor)GroupIII: Phase II Group II (gemcitabine, selinexor)

Given IV

Also known as: KPT-330, Xpovio, CRM1 nuclear export inhibitor KPT-330, selective inhibitor of nuclear export KPT-330, SINE KPT-330
Group I: Phase Ib (gemcitabine, nab-paclitaxel, selinexor)Group II: Phase II Group I (gemcitabine, selinexor)GroupIII: Phase II Group II (gemcitabine, selinexor)

Correlative studies

Group I: Phase Ib (gemcitabine, nab-paclitaxel, selinexor)Group II: Phase II Group I (gemcitabine, selinexor)GroupIII: Phase II Group II (gemcitabine, selinexor)

Correlative studies

Group I: Phase Ib (gemcitabine, nab-paclitaxel, selinexor)Group II: Phase II Group I (gemcitabine, selinexor)GroupIII: Phase II Group II (gemcitabine, selinexor)

Given IV

Also known as: ABI 007, Abraxane, Protein-bound Paclitaxel, Nanoparticle Paclitaxel,
Group I: Phase Ib (gemcitabine, nab-paclitaxel, selinexor)

Eligibility Criteria

Age19 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Written informed consent in accordance with federal, local, and institutional guidelines
  • Patients with metastatic pancreatic adenocarcinoma not treated with chemotherapy for metastatic disease
  • Eastern Cooperative Oncology Group (ECOG) performance status of 0-1
  • Absolute neutrophil count (ANC) \>= 1500/mm\^3
  • Platelet count \>= 100,000/mm\^3
  • Bilirubin \< 2 times the upper limit of normal (ULN) (except patients with Gilbert's syndrome who must have a total bilirubin of \< 3 times ULN)
  • Alanine aminotransferase (ALT) \< 2.5 times ULN
  • Serum creatinine =\< 1.5 mg/dL
  • Serum albumin \>= 3.0 g/dL
  • Female patients of child-bearing potential must agree to use dual methods of contraception and have a negative serum pregnancy test at screening, and male patients must use an effective barrier method of contraception if sexually active with a female of child-bearing potential; acceptable methods of contraception are condoms with contraceptive foam, oral, implantable or injectable contraceptives, contraceptive patch, intrauterine device, diaphragm with spermicidal gel, or a sexual partner who is surgically sterilized or post-menopausal; for both male and female patients, effective methods of contraception must be used throughout the study and for three months following the last dose
  • Patients with history of previously treated malignancies who have no evidence of disease for last five years are allowed to participate

You may not qualify if:

  • Patients who are pregnant or lactating
  • Radiation, chemotherapy, or immunotherapy or any other anticancer therapy =\< 3 weeks prior to cycle 1 day 1; mitomycin C or radio-immunotherapy 6 weeks prior to cycle 1 day 1
  • Major surgery within four weeks before cycle 1 day 1
  • Unstable cardiovascular function:
  • Symptomatic ischemia, or
  • Uncontrolled clinically significant conduction abnormalities (e.g.: ventricular tachycardia on antiarrhythmics are excluded and 1st degree atrioventricular \[AV\] block or asymptomatic left anterior fascicular block \[LAFB\]/right bundle branch block \[RBBB\] will not be excluded), or
  • Congestive heart failure (CHF) of New York Heart Association (NYHA) class \>= 3, or
  • Myocardial infarction (MI) within 3 months of cycle 1 day 1 dose
  • Uncontrolled active infection requiring parenteral antibiotics, antivirals, or antifungals within one week prior to first dose
  • Known to be HIV seropositive who are on anti-HIV drugs because of the unknown interactions between these drugs and the study agents
  • Known active hepatitis A, B, or C infection; or known to be positive for hepatitis C virus (HCV) ribonucleic acid (RNA) or HBsAg (hepatitis B virus \[HBV\] surface antigen)
  • Patients with active central nervous system (CNS) malignancy; asymptomatic small lesions are not considered active; treated lesions may be considered inactive if they are stable for at least 3 months
  • Patients with significantly diseased or obstructed gastrointestinal tract or uncontrolled vomiting or diarrhea
  • Grade \>= 2 peripheral neuropathy within 14 days prior to cycle 1 day 1
  • History of seizures, movement disorders or cerebrovascular accident within the past 5 years prior to cycle 1 day 1
  • +5 more criteria

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (2)

Barbara Ann Karmanos Cancer Institute

Detroit, Michigan, 48201, United States

Location

Stony Brook University Cancer Center

Stony Brook, New York, 11794, United States

Location

Related Publications (1)

  • Azmi AS, Khan HY, Muqbil I, Aboukameel A, Neggers JE, Daelemans D, Mahipal A, Dyson G, Kamgar M, Al-Hallak MN, Tesfaye A, Kim S, Shidham V, M Mohammad R, Philip PA. Preclinical Assessment with Clinical Validation of Selinexor with Gemcitabine and Nab-Paclitaxel for the Treatment of Pancreatic Ductal Adenocarcinoma. Clin Cancer Res. 2020 Mar 15;26(6):1338-1348. doi: 10.1158/1078-0432.CCR-19-1728. Epub 2019 Dec 12.

MeSH Terms

Conditions

Pancreatic Neoplasms

Interventions

GemcitabineselinexorTaxesAlbumin-Bound Paclitaxel

Condition Hierarchy (Ancestors)

Digestive System NeoplasmsNeoplasms by SiteNeoplasmsEndocrine Gland NeoplasmsDigestive System DiseasesPancreatic DiseasesEndocrine System Diseases

Intervention Hierarchy (Ancestors)

Heterocyclic CompoundsDeoxycytidineCytidinePyrimidine NucleosidesPyrimidinesHeterocyclic Compounds, 1-RingEconomicsHealth Care Economics and OrganizationsPaclitaxelTaxoidsCyclodecanesCycloparaffinsHydrocarbons, AlicyclicHydrocarbons, CyclicHydrocarbonsOrganic ChemicalsDiterpenesTerpenesAlbuminsProteinsAmino Acids, Peptides, and Proteins

Results Point of Contact

Title
Mohammed Najeeb Al Hallak M.D.
Organization
Karmanos Cancer Institute

Study Officials

  • Mohammed N Al Hallak, M.D.

    Barbara Ann Karmanos Cancer Institute

    PRINCIPAL INVESTIGATOR

Publication Agreements

PI is Sponsor Employee
Yes

Study Design

Study Type
interventional
Phase
phase 1
Allocation
RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
PARALLEL
Model Details: Phase I is completed, due to Dose Limiting Toxicities (DLT).
Sponsor Type
OTHER
Responsible Party
SPONSOR INVESTIGATOR
PI Title
Principal Investigator

Study Record Dates

First Submitted

June 23, 2014

First Posted

June 30, 2014

Study Start

October 31, 2014

Primary Completion

November 27, 2021

Study Completion

April 5, 2023

Last Updated

November 7, 2023

Results First Posted

November 7, 2023

Record last verified: 2023-11

Locations