Phase 2 study of the Exportin 1 inhibitor selinexor in patients with recurrent gynecological malignancies.


Journal

Gynecologic oncology
ISSN: 1095-6859
Titre abrégé: Gynecol Oncol
Pays: United States
ID NLM: 0365304

Informations de publication

Date de publication:
02 2020
Historique:
received: 14 07 2019
revised: 24 10 2019
accepted: 08 11 2019
pubmed: 12 12 2019
medline: 6 5 2020
entrez: 12 12 2019
Statut: ppublish

Résumé

Selinexor is an oral inhibitor of the nuclear export protein Exportin 1 (XPO1) with demonstrated antitumor activity in solid and hematological malignancies. We evaluated the efficacy and safety of selinexor in heavily pretreated, recurrent gynecological malignancies. In this phase 2 trial, patients received selinexor (35 or 50 mg/m 114 patients with ovarian (N = 66), endometrial (N = 23) or cervical (N = 25) cancer were enrolled. Median number of prior regimens for ovarian, endometrial and cervical cancer was 6 (1-11), 2 (1-5), and 3 (1-6) respectively. DCR was 30% (ovarian 30%; endometrial 35%; cervical 24%), which included confirmed PRs in 8%, 9%, and 4% of patients with ovarian, endometrial, and cervical cancer respectively. Median PFS and OS for patients with ovarian, endometrial and cervical cancer were 2.6, 2.8 and 1.4 months, and 7.3, 7.0, and 5.0 months, respectively. Common Grade 3/4 adverse events (AEs) were thrombocytopenia (17%), fatigue (14%), anemia (10%), nausea (9%) and hyponatremia (9%). Patients with ovarian cancer receiving 50 mg/m Selinexor demonstrated single-agent activity and disease control in patients with heavily pretreated ovarian and endometrial cancers. Side effects were a function of dose level and treatment frequency, similar to previous reports, reversible and mitigated with supportive care.

Sections du résumé

BACKGROUND
Selinexor is an oral inhibitor of the nuclear export protein Exportin 1 (XPO1) with demonstrated antitumor activity in solid and hematological malignancies. We evaluated the efficacy and safety of selinexor in heavily pretreated, recurrent gynecological malignancies.
METHODS
In this phase 2 trial, patients received selinexor (35 or 50 mg/m
RESULTS
114 patients with ovarian (N = 66), endometrial (N = 23) or cervical (N = 25) cancer were enrolled. Median number of prior regimens for ovarian, endometrial and cervical cancer was 6 (1-11), 2 (1-5), and 3 (1-6) respectively. DCR was 30% (ovarian 30%; endometrial 35%; cervical 24%), which included confirmed PRs in 8%, 9%, and 4% of patients with ovarian, endometrial, and cervical cancer respectively. Median PFS and OS for patients with ovarian, endometrial and cervical cancer were 2.6, 2.8 and 1.4 months, and 7.3, 7.0, and 5.0 months, respectively. Common Grade 3/4 adverse events (AEs) were thrombocytopenia (17%), fatigue (14%), anemia (10%), nausea (9%) and hyponatremia (9%). Patients with ovarian cancer receiving 50 mg/m
CONCLUSIONS
Selinexor demonstrated single-agent activity and disease control in patients with heavily pretreated ovarian and endometrial cancers. Side effects were a function of dose level and treatment frequency, similar to previous reports, reversible and mitigated with supportive care.

Identifiants

pubmed: 31822399
pii: S0090-8258(19)31663-4
doi: 10.1016/j.ygyno.2019.11.012
pii:
doi:

Substances chimiques

Hydrazines 0
Karyopherins 0
Receptors, Cytoplasmic and Nuclear 0
Triazoles 0
selinexor 31TZ62FO8F

Banques de données

ClinicalTrials.gov
['NCT02025985']

Types de publication

Clinical Trial, Phase II Journal Article Multicenter Study Randomized Controlled Trial Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

308-314

Informations de copyright

Copyright © 2019 Elsevier Inc. All rights reserved.

Auteurs

I B Vergote (IB)

Department of Obstetrics and Gynaecology, Division of Gynecologic Oncology, University Hospital Leuven, Leuven Cancer Institute, Leuven, Belgium, European Union. Electronic address: ignace.vergote@uzleuven.be.

B Lund (B)

Aalborg University Hospital, Aalborg, Denmark.

U Peen (U)

Herlev University Hospital, Herlev, Denmark.

Z Umajuridze (Z)

Department of Oncology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.

M Mau-Sorensen (M)

Department of Oncology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.

A Kranich (A)

GSO Hamburg, Germany.

E Van Nieuwenhuysen (E)

Department of Obstetrics and Gynaecology, Division of Gynecologic Oncology, University Hospital Leuven, Leuven Cancer Institute, Leuven, Belgium, European Union.

C Haslund (C)

Aalborg University Hospital, Aalborg, Denmark.

T Nottrup (T)

Department of Oncology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.

S N Han (SN)

Department of Obstetrics and Gynaecology, Division of Gynecologic Oncology, University Hospital Leuven, Leuven Cancer Institute, Leuven, Belgium, European Union.

N Concin (N)

Department of Obstetrics and Gynaecology, Division of Gynecologic Oncology, University Hospital Leuven, Leuven Cancer Institute, Leuven, Belgium, European Union.

T J Unger (TJ)

Karyopharm Therapeutics Newton, MA, USA.

Y Chai (Y)

Karyopharm Therapeutics Newton, MA, USA.

N Au (N)

Karyopharm Therapeutics Newton, MA, USA.

T Rashal (T)

Karyopharm Therapeutics Newton, MA, USA.

A Joshi (A)

Karyopharm Therapeutics Newton, MA, USA.

M Crochiere (M)

Karyopharm Therapeutics Newton, MA, USA.

Y Landesman (Y)

Karyopharm Therapeutics Newton, MA, USA.

J Shah (J)

Karyopharm Therapeutics Newton, MA, USA.

S Shacham (S)

Karyopharm Therapeutics Newton, MA, USA.

M Kauffman (M)

Karyopharm Therapeutics Newton, MA, USA.

M R Mirza (MR)

Karyopharm Therapeutics Newton, MA, USA.

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Classifications MeSH