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Selinexor (KPT-330) in Combination With Temozolomide and Radiation Therapy in Patients With Newly Diagnosed Glioblastoma

A Phase I Clinical Trial of Selinexor (KPT-330) in Combination With Temozolomide and Radiation Therapy in Patients With Newly Diagnosed Glioblastoma

Status
Active, not recruiting
Phases
Phase 1
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT04216329
Enrollment
11
Registered
2020-01-02
Start date
2020-07-07
Completion date
2028-07-30
Last updated
2026-01-23

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Glioblastoma, Gliosarcoma, Newly Diagnosed

Keywords

Radiotherapy, GBM, Gliosarcoma

Brief summary

Background: Glioblastoma is a type of brain cancer. Treatments include radiation, chemotherapy, and surgery. But survival rates are poor. Researchers think that the drug selinexor, when combined with chemotherapy and radiation, might help. Objective: To learn the highest dose of selinexor that people with brain cancer can tolerate when given with temozolomide and radiation therapy. Eligibility: People ages 18 and older with brain cancer that has not been treated with chemotherapy or radiation. Design: Participants will be screened under another protocol. Before participants start treatment, they will have tests: Neurological and physical evaluations Blood and urine tests Possible computed tomography (CT) scan or magnetic resonance imaging (MRI) of the brain if they have not had one in 3 weeks. Participants will lie in a machine that takes pictures of the body. They may have a dye injected into a vein. Surveys about their well-being Participants will have radiation to the brain for up to 6 weeks. This will usually be given once a day, Monday through Friday. Starting the second day of radiation, participants will take selinexor by mouth once a week. They will take it in weeks 1, 2, 4, and 5. The timing may be changed. Starting the first day of radiation, participants will take temozolomide by mouth once a day until they complete radiation. Participants will have blood tests once per week during treatment. Participants will have a follow-up visit 1 month after they complete treatment. Then they will have visits at least every 2 months for the first 2 years, then at least every 3 months for another year. Visits will include MRIs and blood tests.

Detailed description

Background: * Although radiation has been shown to improve outcomes in patients with glioblastoma (GBM), median survival remains poor. Even with the addition of temozolomide (TMZ) to surgical resection and radiotherapy, most GBMs will recur in field or adjacent to the high dose radiation volume. * High rates of local failure indicate that GBM cells in situ are relatively radioresistant and that the effectiveness of GBM radiotherapy would benefit from additional radiosensitization. * Selinexor has recently been shown to enhance the radiosensitivity of glioma cells both in vitro and in vivo. Objectives: -Assess the safety, tolerability, and maximum tolerated dose of selinexor when combined with temozolomide and radiotherapy in patients with newly diagnosed glioblastoma and gliosarcoma. Eligibility: * Men and women greater than 18 years old * Histologically confirmed newly diagnosed glioblastoma or gliosarcoma * Karnofsky Performance Scale (KPS) greater than or equal to 70 * Patients who have not previously been treated with chemotherapy or radiation therapy Design: * This is a Phase I trial to determine the safety and tolerability of selinexor in combination with external beam radiation therapy (RT) and temozolomide in patients with newly diagnosed glioblastoma or gliosarcoma using a "3 plus 3 design" and three dose escalation levels, with 3 patients per dose level (provided no dose limiting toxicity (DLT), a maximum of 21 patients will be enrolled. * Patients will be treated with external beam radiation therapy in a standard manner with temozolomide given daily during radiation. Selinexor will be administered concurrent with the RT/temozolomide. * We anticipate accrual of 21 evaluable patients which will take approximately 2 years. The accrual ceiling has been set to 24 patients.

Interventions

DRUGSelinexor

Selinexor will be administered orally at an initial dose of 80 mg. The first dose will be given on day 2 of radiation and will thereafter be administered weekly on the second day of weekly radiation on weeks 1, 2, 4, and 5. If this dose level is tolerated, the dose will be escalated to 60 mg twice a week (days 1 and 4) on weeks 1,2,4,5. The third and final dose level will also be 60mg administered twice weekly for 6 weeks starting on days 1 and 4 radiation.

DRUGTemozolomide

Temozolomide will begin on the first day or evening prior of radiation and be administered orally daily at a dose of 75 mg/m\^2 during the radiation treatment. Temozolomide will continue until the completion of radiation and then will be stopped. Beginning 1-month post-radiation therapy (RT), the adjuvant temozolomide will be given per standard of care.

RADIATIONGeneric Radiation therapy (RT)

Radiation therapy (RT) will be administered daily (Monday to Friday)

OTHERSelective serotonin receptor (5-HT3) antagonists

Anti-emetic for breakthrough nausea.

OTHEROlanzapine

2.5mg to 5mg once a day if weight loss is rapid.

DIETARY_SUPPLEMENTSalt tablets

To treat hyponatremia, add salt tablets to participants diet per institutional guidelines.

OTHERAnti-diarrheal

Treat diarrhea with an anti-diarrheal per institutional guidelines

Sponsors

National Cancer Institute (NCI)
Lead SponsorNIH

Study design

Allocation
NA
Intervention model
SEQUENTIAL
Primary purpose
TREATMENT
Masking
NONE

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

* INCLUSION CRITERIA: 1. Histological diagnosis * Pathologically confirmed glioblastoma or gliosarcoma (including astrocytoma, grade IV) 2. Patients must be eligible for definitive external beam radiotherapy and temozolomide. 3. Age \>18 years. Because no dosing or adverse event data are currently available on the use of Selinexor in combination with Temodar in patients \<18 years of age, children are excluded from this study. 4. Patients should have a Karnofsky performance scale (KPS) greater than or equal to 70 5. Absolute neutrophil count (ANC) \>1.5x10\^9/L; platelet count \>100x10\^9/L; and hemoglobin (Hb) \>9.0 g/dL. Note: the use of transfusion or other intervention prior to cycle 1 day 1 to achieve Hb \>9.0 g/dL is acceptable. 6. Ability of subject or Legally Authorized Representative (LAR) to understand and the willingness to sign a written informed consent document. 7. The effects of Selinexor on the developing human fetus are unknown. For this reason and because Selinexor agents as well as other therapeutic agents used in this trial are known to be teratogenic, women of child-bearing potential and men must agree to use adequate contraception (hormonal or barrier method of birth control; abstinence) prior to study entry, for the duration of study treatment and for one month after treatment. Should a woman become pregnant or suspect she is pregnant while she or her partner is participating in this study, she should inform her treating physician immediately. 8. Patients must have had surgery and/or biopsy not greater than 8 weeks prior to initial evaluation to be eligible for this study.

Exclusion criteria

<!-- --> 1. Patients who are receiving any other investigational agents and have had prior therapy including: * Patients who have previously received radiation therapy (RT) to the brain. * Patients who received chemotherapy for the treatment of their glioma * Patients who are being treated with implanted Gliadel wafers * Patients who are being treated with tumor treating fields. 2. History of allergic reactions attributed to compounds of similar chemical or biologic composition to selinexor or temozolomide used in study. 3 Patients with coagulation problems and medically significant bleeding in the month prior to start of treatment (peptic ulcers, epistaxis, spontaneous bleeding). Prior history of deep vein thrombosis (DVT) or pulmonary embolism (PE) is not exclusionary. 4\. Patients with active uncontrolled or suspected infections 5\. Patients with severe liver dysfunction defined as: * Total bilirubin \> 1.5 x upper limit of normal (ULN) Note: Subjects with Gilberts syndrome should not be excluded as long as total bilirubin is \< 3.0 x ULN and documentation to support diagnosis is available. * Serum glutamate pyruvate transaminase (SGPT) or called as Alanine aminotransferase (ALT) greater than or equal to 3 x ULN = 135 U/L; for the purpose of this study, the ULN for SGPT is 45 U/L * Serum glutamic oxaloacetic transaminase (SGOT) or called as Aspartate aminotransferase (AST) greater than or equal to 3 x ULN = 150 U/L; for the purpose of this study, the ULN for SGOT is 50 U/L * Serum albumin greater than or equal to 2 x ULN 6\. Known active hepatitis A, B, or C infection 7\. Human immunodeficiency virus (HIV) patients are not eligible because of their immunocompromised status and overlap of side effects between highly active antiretroviral therapy (HAART) and radiation therapy. 8 Patients must not have significantly diseased or obstructed gastrointestinal tract malabsorption, uncontrolled vomiting or diarrhea, or inability to swallow oral medication. 9\. Pregnant women are excluded from this study because Selinexor could have the potential for teratogenic or abortifacient effects. Because there is an unknown but potential risk for adverse events in nursing infants secondary to treatment of the mother with Selinexor, breastfeeding should be discontinued if the mother is treated with Selinexor. These potential risks may also apply to temozolomide used in this study. 10\. Patients with pre-existing known or suspected radiation sensitivity syndromes will be excluded due to potential confounding effect on outcome.

Design outcomes

Primary

MeasureTime frameDescription
Maximum Tolerated Dose (MTD) of Selinexor7 weeksThe MTD is the dose level at which no more than 1 of up to 6 participants experience dose limiting-toxicity (DLT) within 1 month of completion of treatment, and the dose below that at which at least 2 (of\< =6) participants have DLT as a result of selinexor/radiation therapy (RT)/temozolomide.

Secondary

MeasureTime frameDescription
Dose-limiting Toxicities of Selinexor to Concurrent Radiation Therapy and Temozolomide Assessed by the Common Terminology Criteria for Adverse Events (CTCAE) and Radiation Therapy Oncology Group (RTOG)Measured each week of treatment and up to 30 days post treatment; approximately 6-7 weeks with another month added on = ~ 11 weeks to monitor.Dose-limiting toxicities of Selinexor to concurrent radiation therapy and temozolomide. A DLT is defined as a clinically significant adverse event assessed as unrelated to tumor progression, intercurrent illness or concomitant medications and meets any of the criteria such as any Grade 3 or 4 toxicity per Common Terminology Criteria for Adverse Events (CTCAE) v5.0; and any Grade 3 or 4 toxicity per Radiation Therapy Oncology Group (RTOG) acute morbidity. CTCAE: Grade 3 is severe, and Grade 4 is life-threatening. RTOG: Grade 3 Brain/Central nervous system (CNS): neurologic findings present sufficient to require home care; Skin: confluent moist desquamation other than skin folds; Eye: severe keratitis; Ear: severe external otitis; and Grade 4 Brain/CNS is serious neurologic impairment; Skin: ulceration; Eye: loss of vision; and Ear: deafness.DLT's include all adverse events, including clinically significant abnormal findings on laboratory evaluations, regardless of severity.
Dose-limiting Toxicities Effects on Quality of Life (QOL)Measured each week of treatment and up to 30 days post treatment; approximately 6-7 weeks with another month added on = ~ 11 weeks to monitor.Define the dose-limiting toxicities (DLT) effects on quality of life (QOL) in the setting of the addition of Selinexor to concurrent radiation therapy and temozolomide. A DLT is defined as a clinically significant adverse event assessed as unrelated to tumor progression, intercurrent illness or concomitant medications and meets any of the criteria such as any Grade 3 or 4 toxicity per Common Terminology Criteria for Adverse Events (CTCAE) v5.0; and any Grade 3 or 4 toxicity per Radiation Therapy Oncology Group (RTOG) acute morbidity. QOL life scores will be summarized. DLT's include all adverse events (AE), including clinically significant abnormal findings on laboratory evaluations, regardless of severity. Evaluations completed on participants weekly or complications requiring admission to the emergency room (ER)/hospital are also included in the collection of AEs to determine if DLT.
Dose-limiting Toxicities (DLT) Effects on NeurocognitionMeasured each week of treatment and up to 30 days post treatment; approximately 6-7 weeks with another month added on = ~ 11 weeks to monitor.Define the dose-limiting toxicities effects on neurocognition in the setting of the addition of Selinexor to concurrent radiation therapy and temozolomide. A DLT is defined as a clinically significant adverse event assessed as unrelated to tumor progression, intercurrent illness or concomitant medications and meets any of the criteria such as any Grade 3 or 4 toxicity per Common Terminology Criteria for Adverse Events (CTCAE) v5.0; and any Grade 3 or 4 toxicity per Radiation Therapy Oncology Group (RTOG) acute morbidity. DLT's include all adverse events (AE), including clinically significant abnormal findings on laboratory evaluations, regardless of severity. Evaluations completed on participants weekly or complications requiring admission to the emergency room (ER)/hospital are also included in the collection of AE's to determine if DLT.
Patient-Reported Outcomes Measurement Information System (PROMIS) Depression ScaleBaseline and completion of treatment, up to 3 yearsThe PROMIS depression questionnaire in the setting of the addition of Selinexor to concurrent radiation therapy and temozolomide. A DLT is defined as a clinically significant adverse event assessed as unrelated to tumor progression, intercurrent illness or concomitant medications and meets any of the criteria such as any Grade 3 or 4 toxicity per Common Terminology Criteria for Adverse Events (CTCAE) v5.0; and any Grade 3 or 4 toxicity per Radiation Therapy Oncology Group (RTOG) acute morbidity. QOL life scores from questionnaires rating symptoms on a scale of 1 (never) - 5 (very often several times a day) will be summarized. A score of 1 is the best outcome. A score of 5 is worst outcome. The difference between two timepoints - baseline and close of treatment is also reported.

Countries

United States

Contacts

PRINCIPAL_INVESTIGATORKevin A Camphausen, M.D.

National Cancer Institute (NCI)

Participant flow

Pre-assignment details

No participants were enrolled in Dose Level -1.

Participants by arm

ArmCount
Dose Level -1: Selinexor 80mg on Weeks 1, 4 With Temozolomide & Radiation
Participants with newly diagnosed glioblastoma or gliosarcoma. Selinexor with temozolomide and radiation. Dose Level -1: Selinexor 80mg on Weeks 1, 4 Temozolomide will begin on the first day or evening prior of radiation and be administered orally daily at a dose of 75 mg/m\^2 during the radiation treatment. Temozolomide will continue until the completion of radiation and then will be stopped. Beginning 1-month post-radiation therapy (RT), the adjuvant temozolomide will be given per standard of care.
0
Dose Level 1: Selinexor 80mg on Weeks 1, 2, 4, 5 With Temozolomide & Radiation
Participants with newly diagnosed glioblastoma or gliosarcoma. Selinexor with temozolomide and radiation. Dose Level 1: Selinexor 80mg on Weeks 1, 2, 4, 5 Temozolomide will begin on the first day or evening prior of radiation and be administered orally daily at a dose of 75 mg/m\^2 during the radiation treatment. Temozolomide will continue until the completion of radiation and then will be stopped. Beginning 1-month post-radiation therapy (RT), the adjuvant temozolomide will be given per standard of care.
3
Dose Level 2: Selinexor 60mg Twice a Week on Weeks 1, 2, 4, 5 With Temozolomide & Radiation
Participants with newly diagnosed glioblastoma or gliosarcoma. Selinexor with temozolomide and radiation. Dose Level 2: 60mg Twice a Week on Weeks 1, 2, 4, 5 Temozolomide will begin on the first day or evening prior of radiation and be administered orally daily at a dose of 75 mg/m\^2 during the radiation treatment. Temozolomide will continue until the completion of radiation and then will be stopped. Beginning 1-month post-radiation therapy (RT), the adjuvant temozolomide will be given per standard of care.
6
Dose Level 3: Selinexor 60mg Twice a Week, Weeks 1-6 With Temozolomide & Radiation
Participants with newly diagnosed glioblastoma or gliosarcoma. Selinexor with temozolomide and radiation. Dose Level 3: 60mg Twice a Week, Weeks 1-6 Temozolomide will begin on the first day or evening prior of radiation and be administered orally daily at a dose of 75 mg/m\^2 during the radiation treatment. Temozolomide will continue until the completion of radiation and then will be stopped. Beginning 1-month post-radiation therapy (RT), the adjuvant temozolomide will be given per standard of care.
2
Total11

Baseline characteristics

CharacteristicDose Level 1: Selinexor 80mg on Weeks 1, 2, 4, 5 With Temozolomide & RadiationDose Level 2: Selinexor 60mg Twice a Week on Weeks 1, 2, 4, 5 With Temozolomide & RadiationDose Level 3: Selinexor 60mg Twice a Week, Weeks 1-6 With Temozolomide & RadiationTotal
Age, Categorical
<=18 years
0 Participants0 Participants0 Participants0 Participants
Age, Categorical
>=65 years
0 Participants1 Participants0 Participants1 Participants
Age, Categorical
Between 18 and 65 years
3 Participants5 Participants2 Participants10 Participants
Age, Continuous54.33 years
STANDARD_DEVIATION 9.29
61 years
STANDARD_DEVIATION 5.66
57 years
STANDARD_DEVIATION 5.66
58.45 years
STANDARD_DEVIATION 6.77
Ethnicity (NIH/OMB)
Hispanic or Latino
0 Participants0 Participants0 Participants0 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
3 Participants6 Participants2 Participants11 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Asian
0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Black or African American
0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
More than one race
0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
White
3 Participants6 Participants2 Participants11 Participants
Region of Enrollment
United States
3 participants6 participants2 participants11 participants
Sex: Female, Male
Female
3 Participants3 Participants1 Participants7 Participants
Sex: Female, Male
Male
0 Participants3 Participants1 Participants4 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
deaths
Total, all-cause mortality
1 / 35 / 60 / 2
other
Total, other adverse events
3 / 36 / 62 / 2
serious
Total, serious adverse events
2 / 32 / 60 / 2

Outcome results

Primary

Maximum Tolerated Dose (MTD) of Selinexor

The MTD is the dose level at which no more than 1 of up to 6 participants experience dose limiting-toxicity (DLT) within 1 month of completion of treatment, and the dose below that at which at least 2 (of\< =6) participants have DLT as a result of selinexor/radiation therapy (RT)/temozolomide.

Time frame: 7 weeks

ArmMeasureValue (NUMBER)
All ParticipantsMaximum Tolerated Dose (MTD) of Selinexor60 mg/m^2
Secondary

Dose-limiting Toxicities (DLT) Effects on Neurocognition

Define the dose-limiting toxicities effects on neurocognition in the setting of the addition of Selinexor to concurrent radiation therapy and temozolomide. A DLT is defined as a clinically significant adverse event assessed as unrelated to tumor progression, intercurrent illness or concomitant medications and meets any of the criteria such as any Grade 3 or 4 toxicity per Common Terminology Criteria for Adverse Events (CTCAE) v5.0; and any Grade 3 or 4 toxicity per Radiation Therapy Oncology Group (RTOG) acute morbidity. DLT's include all adverse events (AE), including clinically significant abnormal findings on laboratory evaluations, regardless of severity. Evaluations completed on participants weekly or complications requiring admission to the emergency room (ER)/hospital are also included in the collection of AE's to determine if DLT.

Time frame: Measured each week of treatment and up to 30 days post treatment; approximately 6-7 weeks with another month added on = ~ 11 weeks to monitor.

ArmMeasureGroupValue (NUMBER)
All ParticipantsDose-limiting Toxicities (DLT) Effects on NeurocognitionGrade 3 DLT-RTOG0 toxicities
All ParticipantsDose-limiting Toxicities (DLT) Effects on NeurocognitionGrade 4 DLT-CTCAE0 toxicities
All ParticipantsDose-limiting Toxicities (DLT) Effects on NeurocognitionGrade 4 DLT-RTOG0 toxicities
All ParticipantsDose-limiting Toxicities (DLT) Effects on NeurocognitionGrade 3 DLT-CTCAE0 toxicities
Dose Level 2: Selinexor 60mg Twice a Week on Weeks 1, 2, 4, 5 With Temozolomide & RadiationDose-limiting Toxicities (DLT) Effects on NeurocognitionGrade 3 DLT-CTCAE0 toxicities
Dose Level 2: Selinexor 60mg Twice a Week on Weeks 1, 2, 4, 5 With Temozolomide & RadiationDose-limiting Toxicities (DLT) Effects on NeurocognitionGrade 3 DLT-RTOG00 toxicities
Dose Level 2: Selinexor 60mg Twice a Week on Weeks 1, 2, 4, 5 With Temozolomide & RadiationDose-limiting Toxicities (DLT) Effects on NeurocognitionGrade 4 DLT-RTOG0 toxicities
Dose Level 2: Selinexor 60mg Twice a Week on Weeks 1, 2, 4, 5 With Temozolomide & RadiationDose-limiting Toxicities (DLT) Effects on NeurocognitionGrade 4 DLT-CTCAE0 toxicities
Dose Level 3: Selinexor 60mg Twice a Week, Weeks 1-6 With Temozolomide & RadiationDose-limiting Toxicities (DLT) Effects on NeurocognitionGrade 4 DLT-RTOG0 toxicities
Dose Level 3: Selinexor 60mg Twice a Week, Weeks 1-6 With Temozolomide & RadiationDose-limiting Toxicities (DLT) Effects on NeurocognitionGrade 4 DLT-CTCAE0 toxicities
Dose Level 3: Selinexor 60mg Twice a Week, Weeks 1-6 With Temozolomide & RadiationDose-limiting Toxicities (DLT) Effects on NeurocognitionGrade 3 DLT-CTCAE0 toxicities
Dose Level 3: Selinexor 60mg Twice a Week, Weeks 1-6 With Temozolomide & RadiationDose-limiting Toxicities (DLT) Effects on NeurocognitionGrade 3 DLT-RTOG0 toxicities
Secondary

Dose-limiting Toxicities Effects on Quality of Life (QOL)

Define the dose-limiting toxicities (DLT) effects on quality of life (QOL) in the setting of the addition of Selinexor to concurrent radiation therapy and temozolomide. A DLT is defined as a clinically significant adverse event assessed as unrelated to tumor progression, intercurrent illness or concomitant medications and meets any of the criteria such as any Grade 3 or 4 toxicity per Common Terminology Criteria for Adverse Events (CTCAE) v5.0; and any Grade 3 or 4 toxicity per Radiation Therapy Oncology Group (RTOG) acute morbidity. QOL life scores will be summarized. DLT's include all adverse events (AE), including clinically significant abnormal findings on laboratory evaluations, regardless of severity. Evaluations completed on participants weekly or complications requiring admission to the emergency room (ER)/hospital are also included in the collection of AEs to determine if DLT.

Time frame: Measured each week of treatment and up to 30 days post treatment; approximately 6-7 weeks with another month added on = ~ 11 weeks to monitor.

ArmMeasureGroupValue (NUMBER)
All ParticipantsDose-limiting Toxicities Effects on Quality of Life (QOL)Grade 3 DLT-CTCAE0 toxicities
All ParticipantsDose-limiting Toxicities Effects on Quality of Life (QOL)Grade 4 DLT-CTCAE0 toxicities
All ParticipantsDose-limiting Toxicities Effects on Quality of Life (QOL)Grade 3 DLT-RTOG0 toxicities
All ParticipantsDose-limiting Toxicities Effects on Quality of Life (QOL)Grade 4 DLT-RTOG0 toxicities
Dose Level 2: Selinexor 60mg Twice a Week on Weeks 1, 2, 4, 5 With Temozolomide & RadiationDose-limiting Toxicities Effects on Quality of Life (QOL)Grade 3 DLT-CTCAE0 toxicities
Dose Level 2: Selinexor 60mg Twice a Week on Weeks 1, 2, 4, 5 With Temozolomide & RadiationDose-limiting Toxicities Effects on Quality of Life (QOL)Grade 4 DLT-RTOG0 toxicities
Dose Level 2: Selinexor 60mg Twice a Week on Weeks 1, 2, 4, 5 With Temozolomide & RadiationDose-limiting Toxicities Effects on Quality of Life (QOL)Grade 4 DLT-CTCAE0 toxicities
Dose Level 2: Selinexor 60mg Twice a Week on Weeks 1, 2, 4, 5 With Temozolomide & RadiationDose-limiting Toxicities Effects on Quality of Life (QOL)Grade 3 DLT-RTOG0 toxicities
Dose Level 3: Selinexor 60mg Twice a Week, Weeks 1-6 With Temozolomide & RadiationDose-limiting Toxicities Effects on Quality of Life (QOL)Grade 4 DLT-RTOG0 toxicities
Dose Level 3: Selinexor 60mg Twice a Week, Weeks 1-6 With Temozolomide & RadiationDose-limiting Toxicities Effects on Quality of Life (QOL)Grade 4 DLT-CTCAE0 toxicities
Dose Level 3: Selinexor 60mg Twice a Week, Weeks 1-6 With Temozolomide & RadiationDose-limiting Toxicities Effects on Quality of Life (QOL)Grade 3 DLT-RTOG0 toxicities
Dose Level 3: Selinexor 60mg Twice a Week, Weeks 1-6 With Temozolomide & RadiationDose-limiting Toxicities Effects on Quality of Life (QOL)Grade 3 DLT-CTCAE0 toxicities
Secondary

Dose-limiting Toxicities of Selinexor to Concurrent Radiation Therapy and Temozolomide Assessed by the Common Terminology Criteria for Adverse Events (CTCAE) and Radiation Therapy Oncology Group (RTOG)

Dose-limiting toxicities of Selinexor to concurrent radiation therapy and temozolomide. A DLT is defined as a clinically significant adverse event assessed as unrelated to tumor progression, intercurrent illness or concomitant medications and meets any of the criteria such as any Grade 3 or 4 toxicity per Common Terminology Criteria for Adverse Events (CTCAE) v5.0; and any Grade 3 or 4 toxicity per Radiation Therapy Oncology Group (RTOG) acute morbidity. CTCAE: Grade 3 is severe, and Grade 4 is life-threatening. RTOG: Grade 3 Brain/Central nervous system (CNS): neurologic findings present sufficient to require home care; Skin: confluent moist desquamation other than skin folds; Eye: severe keratitis; Ear: severe external otitis; and Grade 4 Brain/CNS is serious neurologic impairment; Skin: ulceration; Eye: loss of vision; and Ear: deafness.DLT's include all adverse events, including clinically significant abnormal findings on laboratory evaluations, regardless of severity.

Time frame: Measured each week of treatment and up to 30 days post treatment; approximately 6-7 weeks with another month added on = ~ 11 weeks to monitor.

ArmMeasureGroupValue (NUMBER)
All ParticipantsDose-limiting Toxicities of Selinexor to Concurrent Radiation Therapy and Temozolomide Assessed by the Common Terminology Criteria for Adverse Events (CTCAE) and Radiation Therapy Oncology Group (RTOG)Grade 3 DLT - CTCAE8 toxicities
All ParticipantsDose-limiting Toxicities of Selinexor to Concurrent Radiation Therapy and Temozolomide Assessed by the Common Terminology Criteria for Adverse Events (CTCAE) and Radiation Therapy Oncology Group (RTOG)Grade 3 DLT - RTOG0 toxicities
All ParticipantsDose-limiting Toxicities of Selinexor to Concurrent Radiation Therapy and Temozolomide Assessed by the Common Terminology Criteria for Adverse Events (CTCAE) and Radiation Therapy Oncology Group (RTOG)Grade 4 DLT - CTCAE1 toxicities
All ParticipantsDose-limiting Toxicities of Selinexor to Concurrent Radiation Therapy and Temozolomide Assessed by the Common Terminology Criteria for Adverse Events (CTCAE) and Radiation Therapy Oncology Group (RTOG)Grade 4 DLT - RTOG0 toxicities
Dose Level 2: Selinexor 60mg Twice a Week on Weeks 1, 2, 4, 5 With Temozolomide & RadiationDose-limiting Toxicities of Selinexor to Concurrent Radiation Therapy and Temozolomide Assessed by the Common Terminology Criteria for Adverse Events (CTCAE) and Radiation Therapy Oncology Group (RTOG)Grade 4 DLT - RTOG0 toxicities
Dose Level 2: Selinexor 60mg Twice a Week on Weeks 1, 2, 4, 5 With Temozolomide & RadiationDose-limiting Toxicities of Selinexor to Concurrent Radiation Therapy and Temozolomide Assessed by the Common Terminology Criteria for Adverse Events (CTCAE) and Radiation Therapy Oncology Group (RTOG)Grade 3 DLT - CTCAE19 toxicities
Dose Level 2: Selinexor 60mg Twice a Week on Weeks 1, 2, 4, 5 With Temozolomide & RadiationDose-limiting Toxicities of Selinexor to Concurrent Radiation Therapy and Temozolomide Assessed by the Common Terminology Criteria for Adverse Events (CTCAE) and Radiation Therapy Oncology Group (RTOG)Grade 4 DLT - CTCAE0 toxicities
Dose Level 2: Selinexor 60mg Twice a Week on Weeks 1, 2, 4, 5 With Temozolomide & RadiationDose-limiting Toxicities of Selinexor to Concurrent Radiation Therapy and Temozolomide Assessed by the Common Terminology Criteria for Adverse Events (CTCAE) and Radiation Therapy Oncology Group (RTOG)Grade 3 DLT - RTOG0 toxicities
Dose Level 3: Selinexor 60mg Twice a Week, Weeks 1-6 With Temozolomide & RadiationDose-limiting Toxicities of Selinexor to Concurrent Radiation Therapy and Temozolomide Assessed by the Common Terminology Criteria for Adverse Events (CTCAE) and Radiation Therapy Oncology Group (RTOG)Grade 4 DLT - RTOG0 toxicities
Dose Level 3: Selinexor 60mg Twice a Week, Weeks 1-6 With Temozolomide & RadiationDose-limiting Toxicities of Selinexor to Concurrent Radiation Therapy and Temozolomide Assessed by the Common Terminology Criteria for Adverse Events (CTCAE) and Radiation Therapy Oncology Group (RTOG)Grade 3 DLT - RTOG0 toxicities
Dose Level 3: Selinexor 60mg Twice a Week, Weeks 1-6 With Temozolomide & RadiationDose-limiting Toxicities of Selinexor to Concurrent Radiation Therapy and Temozolomide Assessed by the Common Terminology Criteria for Adverse Events (CTCAE) and Radiation Therapy Oncology Group (RTOG)Grade 4 DLT - CTCAE2 toxicities
Dose Level 3: Selinexor 60mg Twice a Week, Weeks 1-6 With Temozolomide & RadiationDose-limiting Toxicities of Selinexor to Concurrent Radiation Therapy and Temozolomide Assessed by the Common Terminology Criteria for Adverse Events (CTCAE) and Radiation Therapy Oncology Group (RTOG)Grade 3 DLT - CTCAE6 toxicities
Secondary

Patient-Reported Outcomes Measurement Information System (PROMIS) Depression Scale

The PROMIS depression questionnaire in the setting of the addition of Selinexor to concurrent radiation therapy and temozolomide. A DLT is defined as a clinically significant adverse event assessed as unrelated to tumor progression, intercurrent illness or concomitant medications and meets any of the criteria such as any Grade 3 or 4 toxicity per Common Terminology Criteria for Adverse Events (CTCAE) v5.0; and any Grade 3 or 4 toxicity per Radiation Therapy Oncology Group (RTOG) acute morbidity. QOL life scores from questionnaires rating symptoms on a scale of 1 (never) - 5 (very often several times a day) will be summarized. A score of 1 is the best outcome. A score of 5 is worst outcome. The difference between two timepoints - baseline and close of treatment is also reported.

Time frame: Baseline and completion of treatment, up to 3 years

ArmMeasureGroupValue (MEDIAN)
All ParticipantsPatient-Reported Outcomes Measurement Information System (PROMIS) Depression ScaleBaseline1.63 Score on a scale
All ParticipantsPatient-Reported Outcomes Measurement Information System (PROMIS) Depression ScaleCompletion of treatment1.22 Score on a scale
All ParticipantsPatient-Reported Outcomes Measurement Information System (PROMIS) Depression ScaleDifference between two timepoints-0.41 Score on a scale
Dose Level 2: Selinexor 60mg Twice a Week on Weeks 1, 2, 4, 5 With Temozolomide & RadiationPatient-Reported Outcomes Measurement Information System (PROMIS) Depression ScaleBaseline1.71 Score on a scale
Dose Level 2: Selinexor 60mg Twice a Week on Weeks 1, 2, 4, 5 With Temozolomide & RadiationPatient-Reported Outcomes Measurement Information System (PROMIS) Depression ScaleCompletion of treatment2.42 Score on a scale
Dose Level 2: Selinexor 60mg Twice a Week on Weeks 1, 2, 4, 5 With Temozolomide & RadiationPatient-Reported Outcomes Measurement Information System (PROMIS) Depression ScaleDifference between two timepoints0.71 Score on a scale
Dose Level 3: Selinexor 60mg Twice a Week, Weeks 1-6 With Temozolomide & RadiationPatient-Reported Outcomes Measurement Information System (PROMIS) Depression ScaleBaseline1.71 Score on a scale
Dose Level 3: Selinexor 60mg Twice a Week, Weeks 1-6 With Temozolomide & RadiationPatient-Reported Outcomes Measurement Information System (PROMIS) Depression ScaleDifference between two timepoints0.71 Score on a scale
Dose Level 3: Selinexor 60mg Twice a Week, Weeks 1-6 With Temozolomide & RadiationPatient-Reported Outcomes Measurement Information System (PROMIS) Depression ScaleCompletion of treatment2.42 Score on a scale
p-value: 0.02Students t-test
p-value: 0.07Students t-test
p-value: 0.02Students t-test
p-value: 0.07Students t-test
p-value: 0.02Students t-test
p-value: 0.07Students t-test
Other Pre-specified

Dose-limiting Toxicities (DLT) Effects on Quality of Life (QOL) Using the MD Anderson Symptom Inventory for Brain Tumors (MDSAI-BT)

DLT effects on quality of life (QOL) using the MD Anderson Symptom Inventory for Brain Tumors (MDASI-BT) in the setting of the addition of Selinexor to concurrent radiation therapy and temozolomide. A DLT is defined as a clinically significant adverse event assessed as unrelated to tumor progression, intercurrent illness or concomitant medications and meets any of the criteria such as any Grade 3 or 4 toxicity per Common Terminology Criteria for Adverse Events (CTCAE) v5.0; and any Grade 3 or 4 toxicity per Radiation Therapy Oncology Group (RTOG) acute morbidity. QOL life scores from questionnaires rating symptoms on a scale of 0 (symptoms not present)-10 (as bad as you can imagine) will be summarized. A score of 0 is the best outcome. A score of 10 is the worst outcome. The difference between two timepoints - baseline and close of treatment is also reported.

Time frame: Baseline and close of treatment, up to 3 years

ArmMeasureGroupValue (MEDIAN)
All ParticipantsDose-limiting Toxicities (DLT) Effects on Quality of Life (QOL) Using the MD Anderson Symptom Inventory for Brain Tumors (MDSAI-BT)Difference between two timepoints (BL & COT)0.39 Scores on a scale
All ParticipantsDose-limiting Toxicities (DLT) Effects on Quality of Life (QOL) Using the MD Anderson Symptom Inventory for Brain Tumors (MDSAI-BT)Baseline (BL)1.21 Scores on a scale
All ParticipantsDose-limiting Toxicities (DLT) Effects on Quality of Life (QOL) Using the MD Anderson Symptom Inventory for Brain Tumors (MDSAI-BT)Completion of treatment (COT)1.6 Scores on a scale
Dose Level 2: Selinexor 60mg Twice a Week on Weeks 1, 2, 4, 5 With Temozolomide & RadiationDose-limiting Toxicities (DLT) Effects on Quality of Life (QOL) Using the MD Anderson Symptom Inventory for Brain Tumors (MDSAI-BT)Difference between two timepoints (BL & COT)0.61 Scores on a scale
Dose Level 2: Selinexor 60mg Twice a Week on Weeks 1, 2, 4, 5 With Temozolomide & RadiationDose-limiting Toxicities (DLT) Effects on Quality of Life (QOL) Using the MD Anderson Symptom Inventory for Brain Tumors (MDSAI-BT)Completion of treatment (COT)1.77 Scores on a scale
Dose Level 2: Selinexor 60mg Twice a Week on Weeks 1, 2, 4, 5 With Temozolomide & RadiationDose-limiting Toxicities (DLT) Effects on Quality of Life (QOL) Using the MD Anderson Symptom Inventory for Brain Tumors (MDSAI-BT)Baseline (BL)1.17 Scores on a scale
Dose Level 3: Selinexor 60mg Twice a Week, Weeks 1-6 With Temozolomide & RadiationDose-limiting Toxicities (DLT) Effects on Quality of Life (QOL) Using the MD Anderson Symptom Inventory for Brain Tumors (MDSAI-BT)Difference between two timepoints (BL & COT)0.61 Scores on a scale
Dose Level 3: Selinexor 60mg Twice a Week, Weeks 1-6 With Temozolomide & RadiationDose-limiting Toxicities (DLT) Effects on Quality of Life (QOL) Using the MD Anderson Symptom Inventory for Brain Tumors (MDSAI-BT)Baseline (BL)1.17 Scores on a scale
Dose Level 3: Selinexor 60mg Twice a Week, Weeks 1-6 With Temozolomide & RadiationDose-limiting Toxicities (DLT) Effects on Quality of Life (QOL) Using the MD Anderson Symptom Inventory for Brain Tumors (MDSAI-BT)Completion of treatment (COT)1.77 Scores on a scale
Other Pre-specified

National Cancer Institute (NCI) Patient-Reported Outcomes Version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE)

The NCI PRO-CTCAE in the setting of the addition of Selinexor to concurrent radiation therapy and temozolomide. A DLT is defined as a clinically significant adverse event assessed as unrelated to tumor progression, intercurrent illness or concomitant medications and meets any of the criteria such as any Grade 3 or 4 toxicity per Common Terminology Criteria for Adverse Events (CTCAE) v5.0; and any Grade 3 or 4 toxicity per Radiation Therapy Oncology Group (RTOG) acute morbidity. QOL life scores from questionnaires rating symptoms on a scale of 0 (None) - 4 (Very severe) will be summarized. A score of 0 is the best outcome. A score of 4 is the worst outcome. The difference between two timepoints - baseline and close of treatment is also reported.

Time frame: Baseline and completion of treatment, up to 3 years

ArmMeasureGroupValue (MEDIAN)
All ParticipantsNational Cancer Institute (NCI) Patient-Reported Outcomes Version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE)Completion of treatment (COT)0.87 Scores on a scale
All ParticipantsNational Cancer Institute (NCI) Patient-Reported Outcomes Version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE)Baseline (BL)0.29 Scores on a scale
All ParticipantsNational Cancer Institute (NCI) Patient-Reported Outcomes Version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE)Difference between two timepoints (BL & COT)0.58 Scores on a scale
Dose Level 2: Selinexor 60mg Twice a Week on Weeks 1, 2, 4, 5 With Temozolomide & RadiationNational Cancer Institute (NCI) Patient-Reported Outcomes Version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE)Completion of treatment (COT)0.83 Scores on a scale
Dose Level 2: Selinexor 60mg Twice a Week on Weeks 1, 2, 4, 5 With Temozolomide & RadiationNational Cancer Institute (NCI) Patient-Reported Outcomes Version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE)Baseline (BL)0.53 Scores on a scale
Dose Level 2: Selinexor 60mg Twice a Week on Weeks 1, 2, 4, 5 With Temozolomide & RadiationNational Cancer Institute (NCI) Patient-Reported Outcomes Version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE)Difference between two timepoints (BL & COT)0.3 Scores on a scale
Dose Level 3: Selinexor 60mg Twice a Week, Weeks 1-6 With Temozolomide & RadiationNational Cancer Institute (NCI) Patient-Reported Outcomes Version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE)Baseline (BL)0.53 Scores on a scale
Dose Level 3: Selinexor 60mg Twice a Week, Weeks 1-6 With Temozolomide & RadiationNational Cancer Institute (NCI) Patient-Reported Outcomes Version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE)Difference between two timepoints (BL & COT)0.3 Scores on a scale
Dose Level 3: Selinexor 60mg Twice a Week, Weeks 1-6 With Temozolomide & RadiationNational Cancer Institute (NCI) Patient-Reported Outcomes Version of the Common Terminology Criteria for Adverse Events (PRO-CTCAE)Completion of treatment (COT)0.83 Scores on a scale
Other Pre-specified

Neuro-quality of Life (QOL) Assessment Cognition Function

The Neuro-QOL assessment Cognition Function in the setting of the addition of Selinexor to concurrent radiation therapy and temozolomide. A DLT is defined as a clinically significant adverse event assessed as unrelated to tumor progression, intercurrent illness or concomitant medications and meets any of the criteria such as any Grade 3 or 4 toxicity per Common Terminology Criteria for Adverse Events (CTCAE) v5.0; and any Grade 3 or 4 toxicity per Radiation Therapy Oncology Group (RTOG) acute morbidity. QOL life scores from questionnaires rating symptoms on a scale of 5 (Never) -1 (Very often-several times a day), e.g., thinking slow, will be summarized. A score of 5 is the best outcome. A score of 1 is the worst outcome. The difference between two timepoints - baseline and close of treatment is also reported.

Time frame: Baseline and completion of treatment, up to 3 years

ArmMeasureGroupValue (MEDIAN)
All ParticipantsNeuro-quality of Life (QOL) Assessment Cognition FunctionDifference between two timepoints (BL & COT)-0.03 Score on a scale
All ParticipantsNeuro-quality of Life (QOL) Assessment Cognition FunctionCompletion of treatment (COT)4.39 Score on a scale
All ParticipantsNeuro-quality of Life (QOL) Assessment Cognition FunctionBaseline (BL)4.42 Score on a scale
Dose Level 2: Selinexor 60mg Twice a Week on Weeks 1, 2, 4, 5 With Temozolomide & RadiationNeuro-quality of Life (QOL) Assessment Cognition FunctionCompletion of treatment (COT)3.67 Score on a scale
Dose Level 2: Selinexor 60mg Twice a Week on Weeks 1, 2, 4, 5 With Temozolomide & RadiationNeuro-quality of Life (QOL) Assessment Cognition FunctionBaseline (BL)4.17 Score on a scale
Dose Level 2: Selinexor 60mg Twice a Week on Weeks 1, 2, 4, 5 With Temozolomide & RadiationNeuro-quality of Life (QOL) Assessment Cognition FunctionDifference between two timepoints (BL & COT)-0.875 Score on a scale
Dose Level 3: Selinexor 60mg Twice a Week, Weeks 1-6 With Temozolomide & RadiationNeuro-quality of Life (QOL) Assessment Cognition FunctionBaseline (BL)4.17 Score on a scale
Dose Level 3: Selinexor 60mg Twice a Week, Weeks 1-6 With Temozolomide & RadiationNeuro-quality of Life (QOL) Assessment Cognition FunctionDifference between two timepoints (BL & COT)-0.875 Score on a scale
Dose Level 3: Selinexor 60mg Twice a Week, Weeks 1-6 With Temozolomide & RadiationNeuro-quality of Life (QOL) Assessment Cognition FunctionCompletion of treatment (COT)3.67 Score on a scale
Other Pre-specified

Number of Participants With Serious and/or Non-Serious Adverse Events Assessed by the Common Terminology Criteria for Adverse Events (CTCAE v5.0)

Here is the number of participants with serious and/or non-serious adverse events assessed by the Common Terminology Criteria for Adverse Events (CTCAE v5.0). A non-serious adverse event is any untoward medical occurrence. A serious adverse event is an adverse event or suspected adverse reaction that results in death, a life-threatening adverse drug experience, hospitalization, disruption of the ability to conduct normal life functions, congenital anomaly/birth defect or important medical events that jeopardize the patient or subject and may require medical or surgical intervention to prevent one of the previous outcomes mentioned. All adverse events, including clinically significant abnormal findings on laboratory evaluations, regardless of severity, will be followed until return to baseline or stabilization of event.

Time frame: Adverse events are documented from the first study intervention, Study Day 1, through 30 days after the subject received the last study drug administration, an average of 2.5 months.

ArmMeasureValue (COUNT_OF_PARTICIPANTS)
All ParticipantsNumber of Participants With Serious and/or Non-Serious Adverse Events Assessed by the Common Terminology Criteria for Adverse Events (CTCAE v5.0)3 Participants
Dose Level 2: Selinexor 60mg Twice a Week on Weeks 1, 2, 4, 5 With Temozolomide & RadiationNumber of Participants With Serious and/or Non-Serious Adverse Events Assessed by the Common Terminology Criteria for Adverse Events (CTCAE v5.0)6 Participants
Dose Level 3: Selinexor 60mg Twice a Week, Weeks 1-6 With Temozolomide & RadiationNumber of Participants With Serious and/or Non-Serious Adverse Events Assessed by the Common Terminology Criteria for Adverse Events (CTCAE v5.0)2 Participants
Other Pre-specified

Overall Survival (OS)

OS is defined as the time from initiation of treatment on protocol to date of death due to any cause. For participants alive as of last follow-up, time to death will be censored at last contact date.

Time frame: From initiation of treatment on protocol to date of death due to any cause, approximately months.

Other Pre-specified

Patient-Reported Outcomes Measurement Information System (PROMIS) Anxiety Scale

The PROMIS anxiety scale in the setting of the addition of Selinexor to concurrent radiation therapy and temozolomide. A DLT is defined as a clinically significant adverse event assessed as unrelated to tumor progression, intercurrent illness or concomitant medications and meets any of the criteria such as any Grade 3 or 4 toxicity per Common Terminology Criteria for Adverse Events (CTCAE) v5.0; and any Grade 3 or 4 toxicity per Radiation Therapy Oncology Group (RTOG) acute morbidity. QOL life scores from questionnaires rating symptoms on a scale of 1 (never) - 5 (always) will be summarized. A score of 1 is the best outcome. A score of 5 is the worst outcome. The difference between two timepoints - baseline and close of treatment is also reported.

Time frame: Baseline and completion of treatment, up to 3 years

ArmMeasureGroupValue (MEDIAN)
All ParticipantsPatient-Reported Outcomes Measurement Information System (PROMIS) Anxiety ScaleCompletion of treatment (COT)1.22 Score on a scale
All ParticipantsPatient-Reported Outcomes Measurement Information System (PROMIS) Anxiety ScaleBaseline (BL)1.63 Score on a scale
All ParticipantsPatient-Reported Outcomes Measurement Information System (PROMIS) Anxiety ScaleDifference between two timepoints (BL & COT)-0.41 Score on a scale
Dose Level 2: Selinexor 60mg Twice a Week on Weeks 1, 2, 4, 5 With Temozolomide & RadiationPatient-Reported Outcomes Measurement Information System (PROMIS) Anxiety ScaleCompletion of treatment (COT)2.42 Score on a scale
Dose Level 2: Selinexor 60mg Twice a Week on Weeks 1, 2, 4, 5 With Temozolomide & RadiationPatient-Reported Outcomes Measurement Information System (PROMIS) Anxiety ScaleBaseline (BL)1.71 Score on a scale
Dose Level 2: Selinexor 60mg Twice a Week on Weeks 1, 2, 4, 5 With Temozolomide & RadiationPatient-Reported Outcomes Measurement Information System (PROMIS) Anxiety ScaleDifference between two timepoints (BL & COT)0.71 Score on a scale
Dose Level 3: Selinexor 60mg Twice a Week, Weeks 1-6 With Temozolomide & RadiationPatient-Reported Outcomes Measurement Information System (PROMIS) Anxiety ScaleBaseline (BL)1.71 Score on a scale
Dose Level 3: Selinexor 60mg Twice a Week, Weeks 1-6 With Temozolomide & RadiationPatient-Reported Outcomes Measurement Information System (PROMIS) Anxiety ScaleDifference between two timepoints (BL & COT)0.71 Score on a scale
Dose Level 3: Selinexor 60mg Twice a Week, Weeks 1-6 With Temozolomide & RadiationPatient-Reported Outcomes Measurement Information System (PROMIS) Anxiety ScaleCompletion of treatment (COT)2.42 Score on a scale
p-value: 0.09Students t-test
p-value: 0.09Students t-test
p-value: 0.09Students t-test
Other Pre-specified

Progression Free Survival (PFS)

PFS is defined as the time from initiation of treatment on protocol to progression as per Response Assessment in Neuro-Oncology (RANO) criteria or death due to disease progression. Progressive disease is at least two sequential scans separated by at ≥4 weeks both exhibiting ≥25% increase in sum of products of perpendicular diameters or ≥40% increase in total volume of enhancing lesions. Clear clinical deterioration not attributable to other causes apart from tumor or attributable to changes in steroid use. Failure to return for evaluation as a result of death or deteriorating condition.

Time frame: From initiation of treatment on protocol to progression as per RANO criteria or death due to disease progression, approximately months

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026