This phase II trial studies how well selinexor work in treating patients with small-cell lung cancer that has returned after a period of improvement. One specific way cancer cells continue to grow is by getting rid of certain proteins called "tumor suppressor proteins: that would normally cause cancer cells to die. Selinexor works by trapping "tumor suppressing proteins" within the cell and may cause the cancer cells to die or stop growing.
PRIMARY OBJECTIVES: I. To evaluate the efficacy of single agent selinexor as measured by progression free survival (PFS) in patients with relapsed chemotherapy-sensitive small cell lung cancer. SECONDARY OBJECTIVES: I. To evaluate the objective tumor response rate and disease control rate as determined by radiographic response. II. To evaluate the overall survival (OS) in patients with relapsed small cell lung cancer. III. To evaluate safety and tolerability of single agent selinexor in these patient populations. IV. Comparison between each patient's time to progression (TTP) on selinexor with the TTP of his/her previous therapy(ies). V. To evaluate correlative endpoints including tumor biopsy and analysis of secreted factors, leukocyte ribonucleic acid (RNA) analysis. TERTIARY OBJECTIVES: I. Analysis of secreted factors (nerve growth factor \[NGF\], brain-derived neurotrophic factor \[BDNF\]). II. Tumor biopsy (baseline and cycle 2). OUTLINE: Patients receive selinexor orally (PO) twice weekly. Courses repeat every 21 days in the absence of disease progression or unacceptable toxicity. After completion of study treatment, patients are followed up monthly for 3 months, every 3 months for 1 year, and then every 6 months thereafter.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
1
Ohio State University Comprehensive Cancer Center
Columbus, Ohio, United States
Progression Free Survival
Estimated by the method of Kaplan and Meier for each cohort. Appropriate one-sided 90% confidence boundary will also be calculated for the final test Kaplan-Meyer test statistic at 12 weeks.
Time frame: Time from the date of study registration to the date of disease progression or to the date of last observation when no event (disease progression) has occurred, assessed up to 4 years
Objective Response Rate (Complete Response [CR] or Partial Response [PR]) by RECIST
The overall response rate will be calculated as the number of PRs and CRs divided by the total number of evaluable patients. Estimates will be accompanied by exact binomial confidence intervals as well.
Time frame: Up to 4 years
Disease Control Rate (CR, PR, and Stable Disease)
Estimates will be accompanied by exact binomial confidence intervals.
Time frame: Up to 4 years
Overall Survival
Kaplan-Meier curves will be used to estimate overall survival. Consider Cox proportional hazards models to explore a limited set of confounding factors.
Time frame: Date of study registration to the date of event (i.e., death) or the date of last follow-up if no event has occurred at their last evaluation assessed up to 4 years
Frequency of Adverse Events Defined as Adverse Events That Are Classified as Either Not Related, Possibly, Probably, or Definitely Related to Study Treatment as Per NCI CTCAE v4.0
Summarized by descriptive statistics for each of the disease cohorts. The maximum grade for each type of toxicity will be recorded for each patient, and frequency tables will be reviewed to determine toxicity patterns. In addition, review all adverse event data that is graded as 3, 4, or 5 and classified as either "unrelated" or "unlikely to be related" to study treatment in the event of an actual relationship developing.
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Time frame: Up to 4 years
Incidence of Severe (Grade 3+) Adverse Events or Toxicities as Per NCI CTCAE v4.0
The incidence of severe (grade 3+) adverse events or toxicities will be described.
Time frame: Up to 4 years
Tolerability of the Regimen Assessed Through Number of Patients Who Required Dose Modifications and/or Dose Delays
Time frame: Up to 4 years
Proportion of Patients Who go Off Treatment Due to Adverse Reactions or Even Those Who Refuse Further Treatment for Lesser Toxicities That Inhibit Their Willingness to Continue Participation on the Trial
Time frame: Up to 4 years