Trial Outcomes & Findings for Selinexor Plus High-Dose Melphalan (HDM) Before Autologous Hematopoietic Cell Transplantation for Multiple Myeloma (NCT NCT02780609)

NCT ID: NCT02780609

Last Updated: 2022-11-04

Results Overview

RPh2D/Maximum Tolerated Dose (MTD) of Selinexor when used in combination with high-dose melphalan as a conditioning regimen for hematopoietic cell transplant. MTD: the highest dose level at which 1 or less of 6 participants experience a dose limiting toxicity (DLT).

Recruitment status

COMPLETED

Study phase

PHASE1/PHASE2

Target enrollment

22 participants

Primary outcome timeframe

Up to 3 months

Results posted on

2022-11-04

Participant Flow

Participant milestones

Participant milestones
Measure
Phase 1 Level 1: Selinexor Plus HDM HCT
40 mg Selinexor given orally 2 to 3 hours prior to high dose-melphalan IV infusion Melphalan: Melphalan 100 mg/m\^2 IV over 30-45 minutes. Dexamethasone: Dexamethasone 20 mg PO (or IV) daily (on days -3, -2 and -1). Autologous Hematopoietic Cell Transplantation (HCT): Participant's own stem cells are collected from their blood, frozen, then given back to them after chemotherapy. Fosaprepitant: Fosaprepitant at 150 mg IV on days -3 and -2.
Phase 1 Level 2: Selinexor Plus HDM HCT
60 mg Selinexor given orally 2 to 3 hours prior to high dose-melphalan IV infusion Melphalan: Melphalan 100 mg/m\^2 IV over 30-45 minutes. Dexamethasone: Dexamethasone 20 mg PO (or IV) daily (on days -3, -2 and -1). Autologous Hematopoietic Cell Transplantation (HCT): Participant's own stem cells are collected from their blood, frozen, then given back to them after chemotherapy. Fosaprepitant: Fosaprepitant at 150 mg IV on days -3 and -2.
Phase 1 Level 3: Selinexor Plus HDM HCT
80 mg Selinexor given orally 2 to 3 hours prior to high dose-melphalan IV infusion Melphalan: Melphalan 100 mg/m\^2 IV over 30-45 minutes. Dexamethasone: Dexamethasone 20 mg PO (or IV) daily (on days -3, -2 and -1). Autologous Hematopoietic Cell Transplantation (HCT): Participant's own stem cells are collected from their blood, frozen, then given back to them after chemotherapy. Fosaprepitant: Fosaprepitant at 150 mg IV on days -3 and -2.
Phase 2: Selinexor Plus HDM HCT
80 mg Selinexor given orally 2 to 3 hours prior to high dose-melphalan IV infusion Melphalan: Melphalan 100 mg/m\^2 IV over 30-45 minutes. Dexamethasone: Dexamethasone 20 mg PO (or IV) daily (on days -3, -2 and -1). Autologous Hematopoietic Cell Transplantation (HCT): Participant's own stem cells are collected from their blood, frozen, then given back to them after chemotherapy. Fosaprepitant: Fosaprepitant at 150 mg IV on days -3 and -2.
Overall Study
STARTED
3
3
6
10
Overall Study
COMPLETED
3
3
6
10
Overall Study
NOT COMPLETED
0
0
0
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Selinexor Plus High-Dose Melphalan (HDM) Before Autologous Hematopoietic Cell Transplantation for Multiple Myeloma

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Phase 1 Level 1: Selinexor Plus HDM HCT
n=3 Participants
40 mg Selinexor given orally 2 to 3 hours prior to high dose-melphalan IV infusion Melphalan: Melphalan 100 mg/m\^2 IV over 30-45 minutes. Dexamethasone: Dexamethasone 20 mg PO (or IV) daily (on days -3, -2 and -1). Autologous Hematopoietic Cell Transplantation (HCT): Participant's own stem cells are collected from their blood, frozen, then given back to them after chemotherapy. Fosaprepitant: Fosaprepitant at 150 mg IV on days -3 and -2.
Phase 1 Level 2: Selinexor Plus HDM HCT
n=3 Participants
60 mg Selinexor given orally 2 to 3 hours prior to high dose-melphalan IV infusion Melphalan: Melphalan 100 mg/m\^2 IV over 30-45 minutes. Dexamethasone: Dexamethasone 20 mg PO (or IV) daily (on days -3, -2 and -1). Autologous Hematopoietic Cell Transplantation (HCT): Participant's own stem cells are collected from their blood, frozen, then given back to them after chemotherapy. Fosaprepitant: Fosaprepitant at 150 mg IV on days -3 and -2.
Phase 1 Level 3: Selinexor Plus HDM HCT
n=6 Participants
80 mg Selinexor given orally 2 to 3 hours prior to high dose-melphalan IV infusion Melphalan: Melphalan 100 mg/m\^2 IV over 30-45 minutes. Dexamethasone: Dexamethasone 20 mg PO (or IV) daily (on days -3, -2 and -1). Autologous Hematopoietic Cell Transplantation (HCT): Participant's own stem cells are collected from their blood, frozen, then given back to them after chemotherapy. Fosaprepitant: Fosaprepitant at 150 mg IV on days -3 and -2.
Phase 2: Selinexor Plus HDM HCT
n=10 Participants
80 mg Selinexor given orally 2 to 3 hours prior to high dose-melphalan IV infusion Melphalan: Melphalan 100 mg/m\^2 IV over 30-45 minutes. Dexamethasone: Dexamethasone 20 mg PO (or IV) daily (on days -3, -2 and -1). Autologous Hematopoietic Cell Transplantation (HCT): Participant's own stem cells are collected from their blood, frozen, then given back to them after chemotherapy. Fosaprepitant: Fosaprepitant at 150 mg IV on days -3 and -2.
Total
n=22 Participants
Total of all reporting groups
Age, Categorical
<=18 years
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
0 Participants
n=21 Participants
Age, Categorical
Between 18 and 65 years
3 Participants
n=5 Participants
2 Participants
n=7 Participants
5 Participants
n=5 Participants
9 Participants
n=4 Participants
19 Participants
n=21 Participants
Age, Categorical
>=65 years
0 Participants
n=5 Participants
1 Participants
n=7 Participants
1 Participants
n=5 Participants
1 Participants
n=4 Participants
3 Participants
n=21 Participants
Sex: Female, Male
Female
1 Participants
n=5 Participants
1 Participants
n=7 Participants
3 Participants
n=5 Participants
4 Participants
n=4 Participants
9 Participants
n=21 Participants
Sex: Female, Male
Male
2 Participants
n=5 Participants
2 Participants
n=7 Participants
3 Participants
n=5 Participants
6 Participants
n=4 Participants
13 Participants
n=21 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
0 Participants
n=21 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
3 Participants
n=5 Participants
3 Participants
n=7 Participants
6 Participants
n=5 Participants
10 Participants
n=4 Participants
22 Participants
n=21 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
0 Participants
n=21 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
0 Participants
n=21 Participants
Race (NIH/OMB)
Asian
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
0 Participants
n=21 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
0 Participants
n=21 Participants
Race (NIH/OMB)
Black or African American
0 Participants
n=5 Participants
1 Participants
n=7 Participants
1 Participants
n=5 Participants
3 Participants
n=4 Participants
5 Participants
n=21 Participants
Race (NIH/OMB)
White
3 Participants
n=5 Participants
2 Participants
n=7 Participants
5 Participants
n=5 Participants
7 Participants
n=4 Participants
17 Participants
n=21 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
0 Participants
n=21 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
0 Participants
n=4 Participants
0 Participants
n=21 Participants
Region of Enrollment
United States
3 participants
n=5 Participants
3 participants
n=7 Participants
6 participants
n=5 Participants
10 participants
n=4 Participants
22 participants
n=21 Participants

PRIMARY outcome

Timeframe: Up to 3 months

RPh2D/Maximum Tolerated Dose (MTD) of Selinexor when used in combination with high-dose melphalan as a conditioning regimen for hematopoietic cell transplant. MTD: the highest dose level at which 1 or less of 6 participants experience a dose limiting toxicity (DLT).

Outcome measures

Outcome measures
Measure
Selinexor Plus HDM HCT
n=12 Participants
The conditioning regimen begins 3 days prior to autologous transplant. Day 0 is the day of the autologous hematopoietic cell transplant. Melphalan will be given intravenously (IV) on Day -3 and Day -2; Dexamethasone will be given through via IV on Day -3, Day -2 and Day -1; fosaprepitant at 150 IV on days -3 and -2 will be given to patients an an antiemetic.Selinexor will be taken by mouth (PO) daily on the same day participants receive chemotherapy with melphalan. Selinexor: Selinexor will be given orally 2 to 3 hours prior to high dose-melphalan IV infusion. Phase I: Dose escalation beginning with 40 mg to determine the recommended Phase II dose (RPh2D). Phase II: Treatment at RPh2D. Melphalan: Melphalan 100 mg/m\^2 IV over 30-45 minutes. Dexamethasone: Dexamethasone 20 mg PO (or IV) daily (on days -3, -2 and -1). Autologous Hematopoietic Cell Transplantation (HCT): Participant's own stem cells are collected from their blood, frozen, then given back to them after chemotherapy. Fosaprepitant: Fosaprepitant at 150 mg IV on days -3 and -2.
Phase 1 Level 2: Selinexor Plus HDM HCT
60 mg Selinexor given orally 2 to 3 hours prior to high dose-melphalan IV infusion Melphalan: Melphalan 100 mg/m\^2 IV over 30-45 minutes. Dexamethasone: Dexamethasone 20 mg PO (or IV) daily (on days -3, -2 and -1).
Phase 1 Level 3: Selinexor Plus HDM HCT
80 mg Selinexor given orally 2 to 3 hours prior to high dose-melphalan IV infusion Melphalan: Melphalan 100 mg/m\^2 IV over 30-45 minutes. Dexamethasone: Dexamethasone 20 mg PO (or IV) daily (on days -3, -2 and -1).
Phase 2: Selinexor Plus HDM HCT
80 mg Selinexor given orally 2 to 3 hours prior to high dose-melphalan IV infusion Melphalan: Melphalan 100 mg/m\^2 IV over 30-45 minutes. Dexamethasone: Dexamethasone 20 mg PO (or IV) daily (on days -3, -2 and -1). Autologous Hematopoietic Cell Transplantation (HCT): Participant's own stem cells are collected from their blood, frozen, then given back to them after chemotherapy. Fosaprepitant: Fosaprepitant at 150 mg IV on days -3 and -2.
Phase I: Recommended Phase II Dose (RPh2D)
80 mg

PRIMARY outcome

Timeframe: 3 months post HCT

Complete response (CR) conversion rate. CR: Negative immunofixation of serum and urine, disappearance of any soft tissue plasmacytomas, and ≤ 5% plasma cells in bone marrow. tissue plasmacytomas, and ≤ 5% plasma cells in bone marrow. Complete Response conversion rate. CR: Negative immunofixation of serum and urine, disappearance of any soft tissue plasmacytomas, and ≤ 5% plasma cells in bone marrow.

Outcome measures

Outcome measures
Measure
Selinexor Plus HDM HCT
n=3 Participants
The conditioning regimen begins 3 days prior to autologous transplant. Day 0 is the day of the autologous hematopoietic cell transplant. Melphalan will be given intravenously (IV) on Day -3 and Day -2; Dexamethasone will be given through via IV on Day -3, Day -2 and Day -1; fosaprepitant at 150 IV on days -3 and -2 will be given to patients an an antiemetic.Selinexor will be taken by mouth (PO) daily on the same day participants receive chemotherapy with melphalan. Selinexor: Selinexor will be given orally 2 to 3 hours prior to high dose-melphalan IV infusion. Phase I: Dose escalation beginning with 40 mg to determine the recommended Phase II dose (RPh2D). Phase II: Treatment at RPh2D. Melphalan: Melphalan 100 mg/m\^2 IV over 30-45 minutes. Dexamethasone: Dexamethasone 20 mg PO (or IV) daily (on days -3, -2 and -1). Autologous Hematopoietic Cell Transplantation (HCT): Participant's own stem cells are collected from their blood, frozen, then given back to them after chemotherapy. Fosaprepitant: Fosaprepitant at 150 mg IV on days -3 and -2.
Phase 1 Level 2: Selinexor Plus HDM HCT
n=3 Participants
60 mg Selinexor given orally 2 to 3 hours prior to high dose-melphalan IV infusion Melphalan: Melphalan 100 mg/m\^2 IV over 30-45 minutes. Dexamethasone: Dexamethasone 20 mg PO (or IV) daily (on days -3, -2 and -1).
Phase 1 Level 3: Selinexor Plus HDM HCT
n=6 Participants
80 mg Selinexor given orally 2 to 3 hours prior to high dose-melphalan IV infusion Melphalan: Melphalan 100 mg/m\^2 IV over 30-45 minutes. Dexamethasone: Dexamethasone 20 mg PO (or IV) daily (on days -3, -2 and -1).
Phase 2: Selinexor Plus HDM HCT
n=10 Participants
80 mg Selinexor given orally 2 to 3 hours prior to high dose-melphalan IV infusion Melphalan: Melphalan 100 mg/m\^2 IV over 30-45 minutes. Dexamethasone: Dexamethasone 20 mg PO (or IV) daily (on days -3, -2 and -1). Autologous Hematopoietic Cell Transplantation (HCT): Participant's own stem cells are collected from their blood, frozen, then given back to them after chemotherapy. Fosaprepitant: Fosaprepitant at 150 mg IV on days -3 and -2.
Complete Response (CR)
0 percentage of participants with CR
33.3 percentage of participants with CR
16.6 percentage of participants with CR
10 percentage of participants with CR

OTHER_PRE_SPECIFIED outcome

Timeframe: at 24 months

Population: All evaluable participants treated at dose level 3/RP2D.

Progression Free Survival defined as the time from start of treatment to the time of progression or death.

Outcome measures

Outcome measures
Measure
Selinexor Plus HDM HCT
n=15 Participants
The conditioning regimen begins 3 days prior to autologous transplant. Day 0 is the day of the autologous hematopoietic cell transplant. Melphalan will be given intravenously (IV) on Day -3 and Day -2; Dexamethasone will be given through via IV on Day -3, Day -2 and Day -1; fosaprepitant at 150 IV on days -3 and -2 will be given to patients an an antiemetic.Selinexor will be taken by mouth (PO) daily on the same day participants receive chemotherapy with melphalan. Selinexor: Selinexor will be given orally 2 to 3 hours prior to high dose-melphalan IV infusion. Phase I: Dose escalation beginning with 40 mg to determine the recommended Phase II dose (RPh2D). Phase II: Treatment at RPh2D. Melphalan: Melphalan 100 mg/m\^2 IV over 30-45 minutes. Dexamethasone: Dexamethasone 20 mg PO (or IV) daily (on days -3, -2 and -1). Autologous Hematopoietic Cell Transplantation (HCT): Participant's own stem cells are collected from their blood, frozen, then given back to them after chemotherapy. Fosaprepitant: Fosaprepitant at 150 mg IV on days -3 and -2.
Phase 1 Level 2: Selinexor Plus HDM HCT
60 mg Selinexor given orally 2 to 3 hours prior to high dose-melphalan IV infusion Melphalan: Melphalan 100 mg/m\^2 IV over 30-45 minutes. Dexamethasone: Dexamethasone 20 mg PO (or IV) daily (on days -3, -2 and -1).
Phase 1 Level 3: Selinexor Plus HDM HCT
80 mg Selinexor given orally 2 to 3 hours prior to high dose-melphalan IV infusion Melphalan: Melphalan 100 mg/m\^2 IV over 30-45 minutes. Dexamethasone: Dexamethasone 20 mg PO (or IV) daily (on days -3, -2 and -1).
Phase 2: Selinexor Plus HDM HCT
80 mg Selinexor given orally 2 to 3 hours prior to high dose-melphalan IV infusion Melphalan: Melphalan 100 mg/m\^2 IV over 30-45 minutes. Dexamethasone: Dexamethasone 20 mg PO (or IV) daily (on days -3, -2 and -1). Autologous Hematopoietic Cell Transplantation (HCT): Participant's own stem cells are collected from their blood, frozen, then given back to them after chemotherapy. Fosaprepitant: Fosaprepitant at 150 mg IV on days -3 and -2.
Phase 1 and Phase 2 Percentage of Participants Treated at Dose Level 3/RP2D With Progression Free Survival (PFS)
66.7 percent of participants
Interval 35.8 to 85.4

OTHER_PRE_SPECIFIED outcome

Timeframe: at 24 months

Population: All evaluable participants treated at dose level 3/RP2D.

Rate of participants' survival at time of evaluation.

Outcome measures

Outcome measures
Measure
Selinexor Plus HDM HCT
n=15 Participants
The conditioning regimen begins 3 days prior to autologous transplant. Day 0 is the day of the autologous hematopoietic cell transplant. Melphalan will be given intravenously (IV) on Day -3 and Day -2; Dexamethasone will be given through via IV on Day -3, Day -2 and Day -1; fosaprepitant at 150 IV on days -3 and -2 will be given to patients an an antiemetic.Selinexor will be taken by mouth (PO) daily on the same day participants receive chemotherapy with melphalan. Selinexor: Selinexor will be given orally 2 to 3 hours prior to high dose-melphalan IV infusion. Phase I: Dose escalation beginning with 40 mg to determine the recommended Phase II dose (RPh2D). Phase II: Treatment at RPh2D. Melphalan: Melphalan 100 mg/m\^2 IV over 30-45 minutes. Dexamethasone: Dexamethasone 20 mg PO (or IV) daily (on days -3, -2 and -1). Autologous Hematopoietic Cell Transplantation (HCT): Participant's own stem cells are collected from their blood, frozen, then given back to them after chemotherapy. Fosaprepitant: Fosaprepitant at 150 mg IV on days -3 and -2.
Phase 1 Level 2: Selinexor Plus HDM HCT
60 mg Selinexor given orally 2 to 3 hours prior to high dose-melphalan IV infusion Melphalan: Melphalan 100 mg/m\^2 IV over 30-45 minutes. Dexamethasone: Dexamethasone 20 mg PO (or IV) daily (on days -3, -2 and -1).
Phase 1 Level 3: Selinexor Plus HDM HCT
80 mg Selinexor given orally 2 to 3 hours prior to high dose-melphalan IV infusion Melphalan: Melphalan 100 mg/m\^2 IV over 30-45 minutes. Dexamethasone: Dexamethasone 20 mg PO (or IV) daily (on days -3, -2 and -1).
Phase 2: Selinexor Plus HDM HCT
80 mg Selinexor given orally 2 to 3 hours prior to high dose-melphalan IV infusion Melphalan: Melphalan 100 mg/m\^2 IV over 30-45 minutes. Dexamethasone: Dexamethasone 20 mg PO (or IV) daily (on days -3, -2 and -1). Autologous Hematopoietic Cell Transplantation (HCT): Participant's own stem cells are collected from their blood, frozen, then given back to them after chemotherapy. Fosaprepitant: Fosaprepitant at 150 mg IV on days -3 and -2.
Overall Survival (OS)
95.2 percent
Interval 70.7 to 99.3

OTHER_PRE_SPECIFIED outcome

Timeframe: 3 months post HCT

Population: Evaluable participants

Rate of participants who did not have Minimal Residual Disease (MRD) as assessed by flow cytometry.

Outcome measures

Outcome measures
Measure
Selinexor Plus HDM HCT
n=3 Participants
The conditioning regimen begins 3 days prior to autologous transplant. Day 0 is the day of the autologous hematopoietic cell transplant. Melphalan will be given intravenously (IV) on Day -3 and Day -2; Dexamethasone will be given through via IV on Day -3, Day -2 and Day -1; fosaprepitant at 150 IV on days -3 and -2 will be given to patients an an antiemetic.Selinexor will be taken by mouth (PO) daily on the same day participants receive chemotherapy with melphalan. Selinexor: Selinexor will be given orally 2 to 3 hours prior to high dose-melphalan IV infusion. Phase I: Dose escalation beginning with 40 mg to determine the recommended Phase II dose (RPh2D). Phase II: Treatment at RPh2D. Melphalan: Melphalan 100 mg/m\^2 IV over 30-45 minutes. Dexamethasone: Dexamethasone 20 mg PO (or IV) daily (on days -3, -2 and -1). Autologous Hematopoietic Cell Transplantation (HCT): Participant's own stem cells are collected from their blood, frozen, then given back to them after chemotherapy. Fosaprepitant: Fosaprepitant at 150 mg IV on days -3 and -2.
Phase 1 Level 2: Selinexor Plus HDM HCT
n=2 Participants
60 mg Selinexor given orally 2 to 3 hours prior to high dose-melphalan IV infusion Melphalan: Melphalan 100 mg/m\^2 IV over 30-45 minutes. Dexamethasone: Dexamethasone 20 mg PO (or IV) daily (on days -3, -2 and -1).
Phase 1 Level 3: Selinexor Plus HDM HCT
n=6 Participants
80 mg Selinexor given orally 2 to 3 hours prior to high dose-melphalan IV infusion Melphalan: Melphalan 100 mg/m\^2 IV over 30-45 minutes. Dexamethasone: Dexamethasone 20 mg PO (or IV) daily (on days -3, -2 and -1).
Phase 2: Selinexor Plus HDM HCT
n=9 Participants
80 mg Selinexor given orally 2 to 3 hours prior to high dose-melphalan IV infusion Melphalan: Melphalan 100 mg/m\^2 IV over 30-45 minutes. Dexamethasone: Dexamethasone 20 mg PO (or IV) daily (on days -3, -2 and -1). Autologous Hematopoietic Cell Transplantation (HCT): Participant's own stem cells are collected from their blood, frozen, then given back to them after chemotherapy. Fosaprepitant: Fosaprepitant at 150 mg IV on days -3 and -2.
Rate of Minimal Residual Disease (MRD)
33.3 percentage of participants
100 percentage of participants
16.7 percentage of participants
33.3 percentage of participants

Adverse Events

Phase 1 Level 1: Selinexor Plus HDM HCT

Serious events: 3 serious events
Other events: 3 other events
Deaths: 2 deaths

Phase 1 Level 2: Selinexor Plus HDM HCT

Serious events: 2 serious events
Other events: 2 other events
Deaths: 0 deaths

Phase 1 Level 3: Selinexor Plus HDM HCT

Serious events: 3 serious events
Other events: 6 other events
Deaths: 2 deaths

Phase 2: Selinexor Plus HDM HCT

Serious events: 5 serious events
Other events: 10 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Phase 1 Level 1: Selinexor Plus HDM HCT
n=3 participants at risk
40 mg Selinexor given orally 2 to 3 hours prior to high dose-melphalan IV infusion Melphalan: Melphalan 100 mg/m\^2 IV over 30-45 minutes. Dexamethasone: Dexamethasone 20 mg PO (or IV) daily (on days -3, -2 and -1). Autologous Hematopoietic Cell Transplantation (HCT): Participant's own stem cells are collected from their blood, frozen, then given back to them after chemotherapy. Fosaprepitant: Fosaprepitant at 150 mg IV on days -3 and -2.
Phase 1 Level 2: Selinexor Plus HDM HCT
n=3 participants at risk
60 mg Selinexor given orally 2 to 3 hours prior to high dose-melphalan IV infusion Melphalan: Melphalan 100 mg/m\^2 IV over 30-45 minutes. Dexamethasone: Dexamethasone 20 mg PO (or IV) daily (on days -3, -2 and -1). Autologous Hematopoietic Cell Transplantation (HCT): Participant's own stem cells are collected from their blood, frozen, then given back to them after chemotherapy. Fosaprepitant: Fosaprepitant at 150 mg IV on days -3 and -2.
Phase 1 Level 3: Selinexor Plus HDM HCT
n=6 participants at risk
80 mg Selinexor given orally 2 to 3 hours prior to high dose-melphalan IV infusion Melphalan: Melphalan 100 mg/m\^2 IV over 30-45 minutes. Dexamethasone: Dexamethasone 20 mg PO (or IV) daily (on days -3, -2 and -1). Autologous Hematopoietic Cell Transplantation (HCT): Participant's own stem cells are collected from their blood, frozen, then given back to them after chemotherapy. Fosaprepitant: Fosaprepitant at 150 mg IV on days -3 and -2.
Phase 2: Selinexor Plus HDM HCT
n=10 participants at risk
80 mg Selinexor given orally 2 to 3 hours prior to high dose-melphalan IV infusion Melphalan: Melphalan 100 mg/m\^2 IV over 30-45 minutes. Dexamethasone: Dexamethasone 20 mg PO (or IV) daily (on days -3, -2 and -1). Autologous Hematopoietic Cell Transplantation (HCT): Participant's own stem cells are collected from their blood, frozen, then given back to them after chemotherapy. Fosaprepitant: Fosaprepitant at 150 mg IV on days -3 and -2.
Blood and lymphatic system disorders
Febrile Neutropenia
66.7%
2/3 • Number of events 2 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
33.3%
1/3 • Number of events 1 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
0.00%
0/6 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
50.0%
5/10 • Number of events 5 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
Nervous system disorders
Headache
0.00%
0/3 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
0.00%
0/3 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
16.7%
1/6 • Number of events 1 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
10.0%
1/10 • Number of events 1 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
General disorders
Fever
0.00%
0/3 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
0.00%
0/3 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
33.3%
2/6 • Number of events 2 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
20.0%
2/10 • Number of events 2 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
Gastrointestinal disorders
Diarrhea
0.00%
0/3 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
0.00%
0/3 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
16.7%
1/6 • Number of events 1 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
0.00%
0/10 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
Renal and urinary disorders
Acute kidney injury
0.00%
0/3 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
0.00%
0/3 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
16.7%
1/6 • Number of events 2 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
0.00%
0/10 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
Infections and infestations
Sepsis
0.00%
0/3 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
0.00%
0/3 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
16.7%
1/6 • Number of events 1 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
0.00%
0/10 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
Vascular disorders
Hypotension
0.00%
0/3 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
0.00%
0/3 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
16.7%
1/6 • Number of events 1 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
0.00%
0/10 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
General disorders
Neck edema
33.3%
1/3 • Number of events 1 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
0.00%
0/3 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
0.00%
0/6 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
0.00%
0/10 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
Vascular disorders
Thromboembolic event
33.3%
1/3 • Number of events 1 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
0.00%
0/3 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
0.00%
0/6 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
0.00%
0/10 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
Gastrointestinal disorders
Abdominal pain
33.3%
1/3 • Number of events 1 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
0.00%
0/3 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
0.00%
0/6 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
0.00%
0/10 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
Gastrointestinal disorders
Small intestinal obstruction
33.3%
1/3 • Number of events 1 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
0.00%
0/3 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
0.00%
0/6 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
0.00%
0/10 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
Infections and infestations
Lung infection
33.3%
1/3 • Number of events 1 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
0.00%
0/3 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
0.00%
0/6 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
0.00%
0/10 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
Metabolism and nutrition disorders
Hypernatremia
33.3%
1/3 • Number of events 1 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
0.00%
0/3 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
0.00%
0/6 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
0.00%
0/10 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
Gastrointestinal disorders
Nausea
33.3%
1/3 • Number of events 1 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
0.00%
0/3 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
16.7%
1/6 • Number of events 1 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
0.00%
0/10 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
Gastrointestinal disorders
Vomiting
0.00%
0/3 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
0.00%
0/3 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
16.7%
1/6 • Number of events 1 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
0.00%
0/10 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
Metabolism and nutrition disorders
Hyperglycemia
0.00%
0/3 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
33.3%
1/3 • Number of events 1 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
0.00%
0/6 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
0.00%
0/10 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
Infections and infestations
Urinary tract infection
0.00%
0/3 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
33.3%
1/3 • Number of events 1 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
0.00%
0/6 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
0.00%
0/10 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
Infections and infestations
Abdominal infection
0.00%
0/3 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
0.00%
0/3 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
16.7%
1/6 • Number of events 1 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
0.00%
0/10 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.

Other adverse events

Other adverse events
Measure
Phase 1 Level 1: Selinexor Plus HDM HCT
n=3 participants at risk
40 mg Selinexor given orally 2 to 3 hours prior to high dose-melphalan IV infusion Melphalan: Melphalan 100 mg/m\^2 IV over 30-45 minutes. Dexamethasone: Dexamethasone 20 mg PO (or IV) daily (on days -3, -2 and -1). Autologous Hematopoietic Cell Transplantation (HCT): Participant's own stem cells are collected from their blood, frozen, then given back to them after chemotherapy. Fosaprepitant: Fosaprepitant at 150 mg IV on days -3 and -2.
Phase 1 Level 2: Selinexor Plus HDM HCT
n=3 participants at risk
60 mg Selinexor given orally 2 to 3 hours prior to high dose-melphalan IV infusion Melphalan: Melphalan 100 mg/m\^2 IV over 30-45 minutes. Dexamethasone: Dexamethasone 20 mg PO (or IV) daily (on days -3, -2 and -1). Autologous Hematopoietic Cell Transplantation (HCT): Participant's own stem cells are collected from their blood, frozen, then given back to them after chemotherapy. Fosaprepitant: Fosaprepitant at 150 mg IV on days -3 and -2.
Phase 1 Level 3: Selinexor Plus HDM HCT
n=6 participants at risk
80 mg Selinexor given orally 2 to 3 hours prior to high dose-melphalan IV infusion Melphalan: Melphalan 100 mg/m\^2 IV over 30-45 minutes. Dexamethasone: Dexamethasone 20 mg PO (or IV) daily (on days -3, -2 and -1). Autologous Hematopoietic Cell Transplantation (HCT): Participant's own stem cells are collected from their blood, frozen, then given back to them after chemotherapy. Fosaprepitant: Fosaprepitant at 150 mg IV on days -3 and -2.
Phase 2: Selinexor Plus HDM HCT
n=10 participants at risk
80 mg Selinexor given orally 2 to 3 hours prior to high dose-melphalan IV infusion Melphalan: Melphalan 100 mg/m\^2 IV over 30-45 minutes. Dexamethasone: Dexamethasone 20 mg PO (or IV) daily (on days -3, -2 and -1). Autologous Hematopoietic Cell Transplantation (HCT): Participant's own stem cells are collected from their blood, frozen, then given back to them after chemotherapy. Fosaprepitant: Fosaprepitant at 150 mg IV on days -3 and -2.
Blood and lymphatic system disorders
Anemia
0.00%
0/3 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
0.00%
0/3 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
0.00%
0/6 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
50.0%
5/10 • Number of events 8 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
Gastrointestinal disorders
Diarrhea
0.00%
0/3 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
0.00%
0/3 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
33.3%
2/6 • Number of events 2 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
10.0%
1/10 • Number of events 1 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
Nervous system disorders
Dizziness
0.00%
0/3 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
0.00%
0/3 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
16.7%
1/6 • Number of events 1 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
0.00%
0/10 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
Blood and lymphatic system disorders
Febrile neutropenia
33.3%
1/3 • Number of events 1 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
33.3%
1/3 • Number of events 1 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
33.3%
2/6 • Number of events 2 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
50.0%
5/10 • Number of events 5 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
General disorders
Gait disturbance
0.00%
0/3 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
0.00%
0/3 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
16.7%
1/6 • Number of events 1 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
0.00%
0/10 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
Investigations
Neutrophil count decreased
0.00%
0/3 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
0.00%
0/3 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
16.7%
1/6 • Number of events 3 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
80.0%
8/10 • Number of events 17 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
General disorders
Pain
0.00%
0/3 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
0.00%
0/3 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
0.00%
0/6 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
10.0%
1/10 • Number of events 1 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
Nervous system disorders
Peripheral sensory neuropathy
0.00%
0/3 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
0.00%
0/3 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
0.00%
0/6 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
10.0%
1/10 • Number of events 1 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
Investigations
Platelet count decreased
0.00%
0/3 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
0.00%
0/3 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
16.7%
1/6 • Number of events 3 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
100.0%
10/10 • Number of events 27 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
Infections and infestations
Urinary tract infection
0.00%
0/3 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
33.3%
1/3 • Number of events 1 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
16.7%
1/6 • Number of events 1 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
0.00%
0/10 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
Investigations
White blood cell decreased
0.00%
0/3 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
0.00%
0/3 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
33.3%
2/6 • Number of events 3 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
100.0%
10/10 • Number of events 28 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
Renal and urinary disorders
Acute kidney injury
0.00%
0/3 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
0.00%
0/3 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
16.7%
1/6 • Number of events 3 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
0.00%
0/10 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
Infections and infestations
Catheter related infection
0.00%
0/3 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
0.00%
0/3 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
16.7%
1/6 • Number of events 1 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
0.00%
0/10 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
General disorders
Fever
0.00%
0/3 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
0.00%
0/3 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
0.00%
0/6 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
10.0%
1/10 • Number of events 1 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
Metabolism and nutrition disorders
Hyperglycemia
0.00%
0/3 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
33.3%
1/3 • Number of events 1 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
0.00%
0/6 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
0.00%
0/10 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
Vascular disorders
Hypotension
0.00%
0/3 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
0.00%
0/3 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
16.7%
1/6 • Number of events 1 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
0.00%
0/10 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
Infections and infestations
Infections and infestations - Other
0.00%
0/3 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
0.00%
0/3 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
16.7%
1/6 • Number of events 1 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
0.00%
0/10 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
Infections and infestations
Lung infection
0.00%
0/3 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
0.00%
0/3 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
16.7%
1/6 • Number of events 1 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
0.00%
0/10 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
Gastrointestinal disorders
Nausea
33.3%
1/3 • Number of events 1 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
0.00%
0/3 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
0.00%
0/6 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
0.00%
0/10 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
Infections and infestations
Sepsis
0.00%
0/3 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
0.00%
0/3 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
16.7%
1/6 • Number of events 1 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
0.00%
0/10 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
Vascular disorders
Thromboembolic event
33.3%
1/3 • Number of events 1 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
0.00%
0/3 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
0.00%
0/6 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.
0.00%
0/10 • Adverse events collected from date on study to 30 days after last treatment date, a total of 3 years and 8 months.

Additional Information

Taiga Nishihori, MD

Moffitt Cancer Center

Phone: 813-745-1856

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place