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Selective Inhibitor of Nuclear Export (SINE)

Selinexor for Myelofibrosis (ESSENTIAL Trial)

Phase 2
Waitlist Available
Led By Srinivas Tantravahi, MD
Research Sponsored by University of Utah
Eligibility Criteria Checklist
Specific guidelines that determine who can or cannot participate in a clinical trial
Must have
Eastern Cooperative Oncology Group (ECOG) performance status ≤ 2
Diagnosis of primary myelofibrosis (PMF), post-essential thrombocytosis (PET-MF) or post-polycythemia vera (PPV-MF)
Must not have
Major surgery ≤ 4 weeks prior to C1D1
BSA < 1.4 m2 at baseline, calculated by the Dubois or Mosteller methods
Timeline
Screening 3 weeks
Treatment Varies
Follow Up up to 5.5 months
Awards & highlights
No Placebo-Only Group

Summary

This trial is testing selinexor, a medication that may help treat certain blood disorders. It focuses on patients with primary or secondary myelofibrosis who do not respond to or cannot tolerate common treatments like ruxolitinib. Selinexor works by blocking a protein that helps harmful cells grow and survive. Selinexor is the first oral selective inhibitor of nuclear export compound tested for cancer treatment.

Who is the study for?
Adults diagnosed with primary or secondary myelofibrosis who haven't responded well to, or can't tolerate, JAK1/2 inhibitors like ruxolitinib. They should be relatively active (ECOG ≤ 2), have a spleen enlarged by at least 5 cm if symptomatic or 10 cm regardless of symptoms, and meet specific blood count and organ function criteria.
What is being tested?
The trial is testing Selinexor's effectiveness and safety in patients with myelofibrosis who don't benefit from current treatments. It's an open-label study where all participants receive the drug; there's no comparison group.
What are the potential side effects?
Selinexor may cause nausea, vomiting, diarrhea, loss of appetite, weight loss, fatigue, low blood counts leading to increased risk of infections or bleeding problems. Some people might also experience changes in liver enzymes indicating liver stress.

Eligibility Criteria

Inclusion Criteria

You may be eligible if you check “Yes” for the criteria below
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I can take care of myself and am up and about more than 50% of my waking hours.
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I have been diagnosed with a type of myelofibrosis.

Exclusion Criteria

You may be eligible for the trial if you check “No” for criteria below:
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I have not had major surgery in the last 4 weeks.
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My body surface area is less than 1.4 square meters.
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I have no stomach or bowel problems affecting my ability to swallow pills.
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I am breastfeeding and cannot stop during the study.
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I do not have an active hepatitis A, B, or C infection.
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I haven't had cancer treatment in the last 2 weeks.
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I am allergic or cannot take certain medications needed for the trial.
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I have previously been treated with a SINE compound like selinexor.

Timeline

Screening ~ 3 weeks
Treatment ~ Varies
Follow Up ~up to 5.5 months
This trial's timeline: 3 weeks for screening, Varies for treatment, and up to 5.5 months for reporting.

Treatment Details

Study Objectives

Study objectives can provide a clearer picture of what you can expect from a treatment.
Primary study objectives
Count of Participants With Reduction in Spleen Volume
Secondary study objectives
Adverse Events That Occur
Change in Symptoms Score
Overall Response
+2 more

Side effects data

From 2022 Phase 3 trial • 402 Patients • NCT03110562
50%
Thrombocytopenia
45%
Anaemia
39%
Nausea
29%
Decreased appetite
29%
Diarrhoea
27%
Weight decreased
24%
Neuropathy peripheral
24%
Vomiting
23%
Fatigue
21%
Neutropenia
21%
Cataract
15%
Asthenia
12%
Upper respiratory tract infection
11%
Pyrexia
11%
Constipation
8%
Oedema peripheral
8%
Pneumonia
6%
Lymphopenia
6%
Dizziness
6%
Insomnia
6%
Dehydration
6%
Back pain
6%
Leukopenia
6%
Bronchitis
6%
Cough
5%
Acute kidney injury
5%
Abdominal pain
5%
Muscular weakness
5%
Lower respiratory tract infection
3%
Pain in extremity
3%
Sepsis
3%
Hyperglycaemia
3%
Urinary tract infection
3%
Nasopharyngitis
3%
Hyponatraemia
3%
Toothache
3%
Disturbance in attention
3%
Cardiac failure
3%
Hypertension
2%
Peripheral swelling
2%
Haemoglobin decreased
2%
Blood uric acid increased
2%
Cardiac failure acute
2%
Pulmonary contusion
2%
Embolism
2%
Blood creatinine increased
2%
Paraesthesia
2%
Infection
2%
Respiratory syncytial virus infection
2%
Dyspepsia
2%
Syncope
2%
Clostridium difficile infection
2%
Compression fracture
2%
Multiple fractures
2%
Myocardial infarction
2%
C-reactive protein increased
2%
Cerebral haemorrhage
2%
Ischaemic stroke
2%
Sudden death
2%
Oropharyngeal pain
2%
Cognitive disorder
2%
Confusional state
2%
Influenza
2%
Septic shock
2%
Osteonecrosis of jaw
2%
Taste disorder
2%
Hyperkalaemia
2%
Depression
2%
Cerebrovascular accident
2%
Bronchitis viral
100%
80%
60%
40%
20%
0%
Study treatment Arm
SVdX Arm: Selinexor + Bortezomib + Dexamethasone
SdX Arm: Selinexor + Dexamethasone
SVd Arm: Selinexor + Bortezomib + Dexamethasone
Vd Arm: Bortezomib + Dexamethasone

Awards & Highlights

No Placebo-Only Group
All patients enrolled in this study will receive some form of active treatment.

Trial Design

1Treatment groups
Experimental Treatment
Group I: Selinexor, all patientsExperimental Treatment1 Intervention
Single Arm Study, all patients will get selinexor
Treatment
First Studied
Drug Approval Stage
How many patients have taken this drug
Selinexor
2020
Completed Phase 3
~1730

Research Highlights

Information in this section is not a recommendation. We encourage patients to speak with their healthcare team when evaluating any treatment decision.
Mechanism Of Action
Side Effect Profile
Prior Approvals
Other Research
The most common treatments for Primary Myelofibrosis (PMF) include JAK inhibitors such as ruxolitinib and experimental therapies like selinexor. Ruxolitinib works by inhibiting the JAK-STAT pathway, which is often overactive in PMF, thereby reducing inflammation and splenomegaly, and improving symptoms and quality of life. Selinexor, a Selective Inhibitor of Nuclear Export, blocks the export of tumor suppressor proteins from the nucleus, leading to the accumulation of these proteins in the nucleus and inducing cancer cell death. These treatments are crucial for PMF patients as they target the underlying disease mechanisms, potentially slowing disease progression and alleviating symptoms.
[Myelofibrosis: A review].Rescue of a primary myelofibrosis model by retinoid-antagonist therapy.

Find a Location

Who is running the clinical trial?

University of UtahLead Sponsor
1,147 Previous Clinical Trials
1,699,103 Total Patients Enrolled
Karyopharm Therapeutics IncIndustry Sponsor
88 Previous Clinical Trials
7,556 Total Patients Enrolled
Srinivas Tantravahi, MDPrincipal InvestigatorUniversity of Utah

Media Library

Selinexor (Selective Inhibitor of Nuclear Export (SINE)) Clinical Trial Eligibility Overview. Trial Name: NCT03627403 — Phase 2
Myelofibrosis Research Study Groups: Selinexor, all patients
Myelofibrosis Clinical Trial 2023: Selinexor Highlights & Side Effects. Trial Name: NCT03627403 — Phase 2
Selinexor (Selective Inhibitor of Nuclear Export (SINE)) 2023 Treatment Timeline for Medical Study. Trial Name: NCT03627403 — Phase 2
~3 spots leftby Dec 2025