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This study is a phase II multi-center prospective clinical trail which investigates the efficacy and safety of Selinexor combined with prednisone, etoposide and lenalidomide in the treatment of relapsed/refractory diffuse large B-cell lymphoma (DLBCL) patient with high p53 and/or c-myc expression.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| SPEL | Experimental |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Selinexor combined with Prednisone, Etoposide, and Lenalidomide | Combination Product | Selinexor combined with Prednisone, Etoposide, and Lenalidomide |
|
| Measure | Description | Time Frame |
|---|---|---|
| CR rate | complete remission rate after 4 cycles of SPEL regimen | At the end of Cycle 4 (each cycle is 28 days) |
| ORR | overall response rate after 4 cycles of SPEL regimen | At the end of Cycle 4 (each cycle is 28 days) |
| Measure | Description | Time Frame |
|---|---|---|
| AE | adverse event of SPEL regimen | from the first dose of SPEL regimen to 3 months after last dose of the regimen |
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Inclusion Criteria:
Any of the following as defined by the WHO, 2016 lymphoid neoplasm classifications and histologically confirmed:Diffuse large B-cell lymphoma with p53 and/ or c-Myc protein overexpression.
Note: a. The cutoff value for p53 protein overexpression by immunohistochemistry (IHC) is 50%; cutoff value for c-Myc protein overexpression is 30-40%; b. For patients with high expression of C-Myc, dual-color FISH probes detection method should be used to check whether there is Myc and BCL2 gene rearrangement, which is cut by 5%; c. We need 5-10 pathological white films with a thickness of 5-10 um for review.
Patients who cannot tolerate or are unwilling to undergo intensive salvage therapy due to age or frailty; patients who have received at most three prior lines of regimen, in which stem cell transplantation is considered first-line.
With a life expectancy of ≥ 3 months
Age ≥ 18 years
Eastern Cooperative Oncology Group (ECOG) performance status of 0, 1 or 2
At least 1 evaluable or measurable lesion that meets Lugano2014 criteria [Evaluable lesions: PET/CT examination showed increased uptake in lymph nodes or extranodal areas (higher than that in the liver), and pet/ct features were consistent with lymphoma. Measurable disease: Nodular lesions with longest diameter (LDi) greater than > 15mm or extranodal lesion with LDi >10mm. and FDG-PET positive lesions]
All screening laboratory tests should be performed according to the protocol and within 14 days before enrollment. Screening laboratory values must meet the following criteria: Routine blood tests (no blood transfusion, no G-CSF, no drug correction within 14 days before screening) : a. Hb≥80g/L;b.ANC≥1.0×109/L;c.PLT≥75×109/L.
Blood biochemistry: a.TBIL≤1.5×upper limit of normal (ULN), or TBIL≤3×ULN(if due to liver involvement); b. ALT and AST≤3×ULN, or AST and ALT≤5.0 x ULN(if due to liver involvement); c. Serum creatinine ≤1.5×ULN, or Estimated creatinine clearance ≥ 50 mL/min (calculated using the formula of Cockcroft-Gault).
Coagulation function (unless the subject is receiving anticoagulant treatment and the coagulation parameters (PT/INR and APTT) are within the expected range of anticoagulant treatment at the time of screening): INR≤1.5×ULN; APTT≤1.5×ULN.
Written informed consent of the patient
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Hongwei Xue, doctor | Contact | +8613475875599 | hwx326@sina.com | |
| Yawen Wang, doctor | Contact | 18661801601 | wangyawang09@163.com |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| the affiliated hospital of Qingdao University | Qingdao | Shandong | 266000 | China |
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| ID | Term |
|---|---|
| D012008 | Recurrence |
| ID | Term |
|---|---|
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ID | Term |
|---|---|
| D011241 | Prednisone |
| D005047 | Etoposide |
| D000077269 | Lenalidomide |
| ID | Term |
|---|---|
| D011244 | Pregnadienediols |
| D011245 | Pregnadienes |
| D011278 | Pregnanes |
| D013256 | Steroids |
| D000072473 | Fused-Ring Compounds |
| D011083 | Polycyclic Compounds |
| D011034 | Podophyllotoxin |
| D013764 | Tetrahydronaphthalenes |
| D009281 | Naphthalenes |
| D011084 | Polycyclic Aromatic Hydrocarbons |
| D006841 | Hydrocarbons, Aromatic |
| D006844 | Hydrocarbons, Cyclic |
| D006838 | Hydrocarbons |
| D009930 | Organic Chemicals |
| D005960 | Glucosides |
| D006027 | Glycosides |
| D002241 | Carbohydrates |
| D010797 | Phthalimides |
| D010795 | Phthalic Acids |
| D000146 | Acids, Carbocyclic |
| D002264 | Carboxylic Acids |
| D010881 | Piperidones |
| D010880 | Piperidines |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |
| D054833 | Isoindoles |
| D006574 | Heterocyclic Compounds, 2-Ring |
| D000072471 | Heterocyclic Compounds, Fused-Ring |
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