Adding selinexor to temozolomide for recurrent glioblastoma.
Official title: A Phase 1 and Randomized Phase 2 Trial of Selinexor and Temozolomide in Recurrent Glioblastoma
Run by National Cancer Institute (NCI) · NCT05432804 · Data updated 2026-11-12
This trial tests whether adding selinexor to standard temozolomide helps adults with IDH‑wildtype, MGMT‑methylated glioblastoma that has come back.
Quick facts
| Phase | Phase1; Phase2 |
|---|---|
| Study type | Interventional |
| Ages | 18 Years and up |
| Sex | All |
| Enrollment | 97 (estimated) |
| Sponsor | National Cancer Institute (NCI) NIH |
| Drugs / interventions | bevacizumab, chemotherapy |
| Locations | 39 sites (Phoenix, Arizona and 38 other locations) |
| Status | Recruiting |
| Started | March 20, 2023 |
| Main results expected | June 30, 2027 |
| Study ends | June 30, 2027 |
| Registry record updated | November 9, 2026 |
| Trial ID | NCT05432804 on ClinicalTrials.gov |
Is this trial a fit for you?
✓Likely a good fit
Adults (≥18) with histologically confirmed recurrent IDH‑wildtype, MGMT‑methylated glioblastoma who received prior temozolomide plus radiotherapy, have measurable disease at recurrence, and have undergone resection or biopsy at the time of first recurrence are ideal candidates.
✕Probably not a fit
Patients with IDH‑mutant or MGMT‑unmethylated tumors, those who have already received additional therapies for their recurrence, or those with poor organ function or inability to attend the trial sites are unlikely to be eligible or to benefit.
A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.
What this trial studies
This phase I/II trial begins with a dose‑escalation phase to determine the maximum tolerated dose of selinexor given sequentially after fixed-dose temozolomide, then moves to a randomized phase II comparing temozolomide plus selinexor versus temozolomide plus placebo. Patients receive temozolomide on days 1–5 of each 28‑day cycle with selinexor administered per the defined schedule in the combination arm. Primary endpoints are dose‑limiting toxicities and progression‑free survival, with secondary endpoints including response rate, 6‑month PFS, overall survival, and safety. Correlative biomarker work includes RNA sequencing, whole exome sequencing, and targeted testing of p53, EGFR, and Mcl‑1 to identify signatures of vulnerability that might predict response.
Why it matters
Potential benefit: If successful, the combination could better shrink or stabilize recurrent glioblastoma and prolong progression‑free survival compared with temozolomide alone.
How similar studies have gone: Selinexor has demonstrated activity in certain hematologic malignancies and limited signals in some solid tumors, but combining selinexor with temozolomide for recurrent glioblastoma is relatively novel with limited prior clinical data.
Who can join: the full rules
Show full inclusion / exclusion criteria
Inclusion Criteria: * Patients must have histologically confirmed glioblastoma (IDH wild-type, MGMT promoter methylated) that has undergone resection or biopsy upon first recurrence. Recurrence at site of prior involvement is defined by histopathological evidence of viable neoplastic cells associated with any of the following: mitotic activity, increased proliferation rate, micro-endothelial proliferation, or pseudo-palisading necrosis * Prior to resection or biopsy, patients must have measurable disease, defined as at least one bi-dimensional contrast-enhancing lesion with clearly defined margins, with 2 perpendicular diameters of at least 10 mm, visible on \>= 2 axial slices * Patients must have received first-line treatment of temozolomide plus radiotherapy * Patients must not have received any prior therapy aside from resection or biopsy for their recurrent disease * Age \>= 18 years. Because no dosing or adverse event data are currently available on the use of selinexor (KPT-330) in combination with temozolomide in patients \< 18 years of age, children are excluded from this study * Karnofsky performance status \>= 60% (Eastern Cooperative Oncology Group \[ECOG\] =\< 2) * Absolute neutrophil count \>= 1,500/mcL * Platelets \>= 100,000/mcL * Hemoglobin \>= 10 g/dL * Total bilirubin =\< 2 x institutional upper limit of normal (ULN) * Aspartate aminotransferase (AST) (serum glutamic oxaloacetic transaminase \[SGOT\])/alanine transaminase (ALT) (serum glutamic-pyruvic transaminase \[SGPT\]) =\< 3 x institutional ULN * Glomerular filtration rate (GFR) \>= 30 mL/min/1.73 m\^2 * Human immunodeficiency virus (HIV)-infected patients on effective anti-retroviral therapy with undetectable viral load within 6 months are eligible for this trial * For patients with evidence of chronic hepatitis B virus (HBV) infection, the HBV viral load must be undetectable on suppressive therapy, if indicated * Patients with a history of hepatitis C virus (HCV) infection must have been treated and cured. For patients with HCV infection who are currently on treatment, they are eligible if they have an undetectable HCV viral load * Patients with a prior or concurrent malignancy whose natural history or treatment does not have the potential to interfere with the safety or efficacy assessment of the investigational regimen are eligible for this trial * Patients with known history or current symptoms of cardiac disease, or history of treatment with cardiotoxic agents, should have a clinical risk assessment of cardiac function using the New York Heart Association Functional Classification. To be eligible for this trial, patients should be class 2B or better * The effects of selinexor (KPT-330) and temozolomide on the developing human fetus are unknown. For this reason and because selective nuclear export inhibitors as well as deoxyribonucleic acid (DNA) alkylating agents 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 and for the duration of study participation, and for 180 days after the last dose of temozolomide. 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. Men treated or enrolled on this protocol must also agree to use adequate contraception prior to the study, for the duration of study participation, and 90 days after completion of study treatment administration * Ability to understand and the willingness to sign a written informed consent document. Participants with impaired decision-making capacity who have a legally-authorized representative (LAR) and/or family member available will also be eligible Exclusion Criteria: * Patients who have had chemotherapy must have full recovery of organ and marrow function following the nadir of the last chemotherapy cycle * Patients who have not recovered from adverse events due to prior anti-cancer therapy (i.e., have residual toxicities \> grade 1) with the exception of alopecia * Patients who are receiving any other investigational agents * Patients who have previously received bevacizumab * History of allergic reactions attributed to compounds of similar chemical or biologic composition to selinexor (KPT-330) or temozolomide * History of hypersensitivity to dacarbazine (DTIC), since both dacarbazine and temozolomide are metabolized to 5-(3-methyltriazen-1-yl)-imidazole-4-carboxamide (MTIC) * Patients with uncontrolled intercurrent illness * Pregnant women are excluded from this study because selinexor (KPT-330) is a selective inhibitor of nuclear export with 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 (KPT-330), breastfeeding is not allowed for mothers during treatment with selinexor (KPT-330) and for 7 days after the last dose. These potential risks may also apply to other agents used in this study * Hospitalized patients with severe coronavirus disease of 2019 (COVID-19) who are \>= 75 years old, or with a high-risk COVID-GRAM score, or with lactate dehydrogenase (LDH) \> 370 (U/L) AND D-Dimer \> 600 mcg/L FEU should not receive low-dose selinexor (KPT-330) pending additional results
Where it's running
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Mayo Clinic Hospital in Arizona
Phoenix, Arizona, United States Recruiting -
City of Hope Comprehensive Cancer Center
Duarte, California, United States Recruiting -
UCI Health - Chao Family Comprehensive Cancer Center and Ambulatory Care
Irvine, California, United States Recruiting -
UC San Diego Moores Cancer Center
La Jolla, California, United States Recruiting -
Keck Medicine of USC Koreatown
Los Angeles, California, United States Recruiting -
Los Angeles General Medical Center
Los Angeles, California, United States Recruiting
Show 33 more locations
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USC / Norris Comprehensive Cancer Center
Los Angeles, California, United States Recruiting -
UC Irvine Health/Chao Family Comprehensive Cancer Center
Orange, California, United States Recruiting -
University of California Davis Comprehensive Cancer Center
Sacramento, California, United States Recruiting -
UCHealth University of Colorado Hospital
Aurora, Colorado, United States Recruiting -
UM Sylvester Comprehensive Cancer Center at Coral Gables
Coral Gables, Florida, United States Recruiting -
UM Sylvester Comprehensive Cancer Center at Deerfield Beach
Deerfield Beach, Florida, United States Recruiting -
Mayo Clinic in Florida
Jacksonville, Florida, United States Recruiting -
University of Miami Miller School of Medicine-Sylvester Cancer Center
Miami, Florida, United States Recruiting -
Moffitt Cancer Center
Tampa, Florida, United States Recruiting -
Emory University Hospital Midtown
Atlanta, Georgia, United States Recruiting -
Emory University Hospital/Winship Cancer Institute
Atlanta, Georgia, United States Recruiting -
University of Chicago Comprehensive Cancer Center
Chicago, Illinois, United States Recruiting -
University of Chicago Medicine-Orland Park
Orland Park, Illinois, United States Recruiting -
University of Kentucky/Markey Cancer Center
Lexington, Kentucky, United States Recruiting -
Mayo Clinic in Rochester
Rochester, Minnesota, United States Recruiting -
Cooperman Barnabas Medical Center
Livingston, New Jersey, United States Recruiting -
Rutgers Cancer Institute of New Jersey
New Brunswick, New Jersey, United States Recruiting -
Rutgers New Jersey Medical School
Newark, New Jersey, United States Recruiting -
Laura and Isaac Perlmutter Cancer Center at NYU Langone
New York, New York, United States Recruiting -
NYP/Columbia University Medical Center/Herbert Irving Comprehensive Cancer Center
New York, New York, United States Recruiting -
Wake Forest University Health Sciences
Winston-Salem, North Carolina, United States Recruiting -
University of Cincinnati Cancer Center-UC Medical Center
Cincinnati, Ohio, United States Recruiting -
Cleveland Clinic Foundation
Cleveland, Ohio, United States Recruiting -
Ohio State University Comprehensive Cancer Center
Columbus, Ohio, United States Recruiting -
University of Cincinnati Cancer Center-West Chester
West Chester, Ohio, United States Recruiting -
University of Oklahoma Health Sciences Center
Oklahoma City, Oklahoma, United States Recruiting -
UPMC Hillman Cancer Center
Pittsburgh, Pennsylvania, United States Recruiting -
University of Wisconsin Carbone Cancer Center - Eastpark Medical Center
Madison, Wisconsin, United States Recruiting -
University of Wisconsin Carbone Cancer Center - University Hospital
Madison, Wisconsin, United States Recruiting -
Roswell Park Cancer Institute
Buffalo, New York, United States Active not recruiting -
Huntsman Cancer Institute/University of Utah
Salt Lake City, Utah, United States Suspended -
University of Virginia Cancer Center
Charlottesville, Virginia, United States Active not recruiting -
VCU Massey Comprehensive Cancer Center
Richmond, Virginia, United States Active not recruiting
Study contacts
- Principal investigator: Jana L Portnow — City of Hope Comprehensive Cancer Center LAO
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How to take part
- Review the eligibility criteria above with your treating physician.
- Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
- Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.