Selinexor for Myelofibrosis

(ESSENTIAL Trial)

PB
Overseen ByPriscilla Blosser, RN
Age: 18+
Sex: Any
Trial Phase: Phase 2
Sponsor: University of Utah
Must be taking: Ruxolitinib, JAK1/2 inhibitors
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Prior Safety DataThis treatment has passed at least one previous human trial
Approved in 2 JurisdictionsThis treatment is already approved in other countries

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests the effectiveness of selinexor for individuals with myelofibrosis, a rare bone marrow disorder that causes severe symptoms and an enlarged spleen. It targets those who haven't responded to or can't tolerate current treatments such as ruxolitinib. Participants should have primary or secondary myelofibrosis and continue to experience significant symptoms despite previous treatment. The trial aims to determine if selinexor, a new potential drug, can improve their condition safely and effectively. As a Phase 2 trial, the research focuses on assessing the treatment's effectiveness in an initial, smaller group of participants.

Do I need to stop my current medications to join the trial?

The trial requires a washout period (time without taking certain medications) for any prohibited medications before starting the study treatment. If you are taking ruxolitinib or other JAK1/2 inhibitors, you must stop at least 3 days or 5 half-lives before the trial begins. It's best to discuss your specific medications with the trial team.

Is there any evidence suggesting that selinexor is likely to be safe for humans?

Research has shown that selinexor is generally well-tolerated by patients with myelofibrosis. In earlier studies, selinexor proved effective both alone and in combination with ruxolitinib. Safety information from these studies indicates that most patients managed the treatment without serious issues. Common side effects included fatigue, nausea, and reduced appetite, but these were usually manageable.

Early results from a study with 61 patients demonstrated that selinexor was safe for more than 12 months, suggesting it might be safe for longer use as well. However, each person's experience can differ, so discussing potential risks with a healthcare provider is always advisable.12345

Why do researchers think this study treatment might be promising for myelofibrosis?

Unlike the standard treatments for myelofibrosis, which often include JAK inhibitors like ruxolitinib, selinexor offers a different approach by targeting nuclear export. Selinexor works by inhibiting a protein called XPO1, which helps transport cancer-promoting molecules out of the cell nucleus. By blocking this process, selinexor can potentially restore normal cell function and slow disease progression. Researchers are excited because this unique mechanism of action could provide new hope for patients who may not respond well to existing therapies.

What evidence suggests that selinexor might be an effective treatment for myelofibrosis?

Research has shown that selinexor might improve symptoms in patients with myelofibrosis. Studies have found that patients taking selinexor had higher hemoglobin levels and required fewer blood transfusions. Additionally, selinexor has been associated with smaller spleen sizes, which can alleviate symptoms. In laboratory studies, selinexor decreased the number of active cancer cells and slowed their growth. These findings suggest that selinexor could be a promising treatment option for those who haven't had success with other therapies.16789

Who Is on the Research Team?

Srinivas K. Tantravahi | University of ...

Srinivas Tantravahi

Principal Investigator

University of Utah

Are You a Good Fit for This Trial?

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.

Inclusion Criteria

I have recovered from previous cancer treatment side effects, or they are mild and stable.
My blood, liver, and kidney functions are within normal ranges.
Able to provide informed consent and willing to sign an approved consent form that conforms to federal and institutional guidelines
See 7 more

Exclusion Criteria

I have not had major surgery in the last 4 weeks.
My body surface area is less than 1.4 square meters.
I do not have an active infection needing IV drugs within the last week.
See 9 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive selinexor for up to six cycles to assess efficacy and safety

5.5 months

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

Long-term follow-up

Participants are monitored for adverse events and overall survival

Up to 24 months

What Are the Treatments Tested in This Trial?

Interventions

  • Selinexor
Trial Overview 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.
How Is the Trial Designed?
1Treatment groups
Experimental Treatment
Group I: Selinexor, all patientsExperimental Treatment1 Intervention

Selinexor is already approved in United States, Canada for the following indications:

🇺🇸
Approved in United States as Xpovio for:
🇨🇦
Approved in Canada as Xpovio for:

Find a Clinic Near You

Who Is Running the Clinical Trial?

University of Utah

Lead Sponsor

Trials
1,169
Recruited
1,623,000+

Karyopharm Therapeutics Inc

Industry Sponsor

Trials
89
Recruited
7,200+

Richard Paulson

Karyopharm Therapeutics Inc

Chief Executive Officer since 2021

MBA from the University of Toronto's Rotman School of Management

Reshma Rangwala

Karyopharm Therapeutics Inc

Chief Medical Officer since 2023

MD, PhD

Citations

Karyopharm Reports First Quarter 2025 Financial Results ...Patients treated with selinexor had higher mean hemoglobin levels throughout the study duration and lower rates of red blood cell transfusions ...
Karyopharm Announces Completion of Enrollment in the ..."Selinexor plus ruxolitinib has the potential to be the first combination therapy approved for the treatment of myelofibrosis, depending on the ...
Selinexor plus ruxolitinib in JAK inhibitor treatment-naïve ...A Phase 1/3 study evaluating safety and efficacy of selinexor plus ruxolitinib for treatment of patients with JAK inhibitor (JAKi) treatment-naïve MF.
Selinexor With Ruxolitinib Continues to Demonstrate ...Selinexor with ruxolitinib demonstrated encouraging efficacy with a manageable safety profile in patients with myelofibrosis who were previously treated with ...
The Efficacy and Safety of Selinexor in Combination with ...Preclinical studies showed SEL decreased viable cells and colony formation both in newly diagnosed and RUX-exposed MF cells. ESSENTIAL trial showed SEL's ...
A novel application of XPO1 inhibition for the treatment of ...Additionally, outcomes are poor for patients who fail JAK inhibitors, highlighting the need for novel mechanism-based therapies and innovative combination ...
Karyopharm Reports Second Quarter 2025 Financial ...In addition, preliminary blinded aggregate safety data from the first 61 patients with a median follow-up of greater than 12 months may suggest ...
A novel application of XPO1 inhibition for the treatment ...Selinexor has shown clinical activity and tolerability in MF, both as monotherapy and, particularly, in combination with ruxolitinib.
Karyopharm Reports First Quarter 2025 Financial Results ...Karyopharm reports first quarter 2025 financial results and announces new data in myelofibrosis that further suggests selinexor may lead to meaningful spleen ...
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