A Study of the Drug Selinexor With Radiation Therapy in Patients With Newly-Diagnosed Diffuse Intrinsic Pontine (DIPG) Glioma and High-Grade Glioma (HGG)
A Phase 1/2 Trial of Selinexor (KPT-330) and Radiation Therapy in Newly-Diagnosed Pediatric Diffuse Intrinsic Pontine Glioma (DIPG) and High-Grade Glioma (HGG)
- Malignant Glioma
At a glance
- Phase
- Phase 1
- Study type
- Interventional
- Sponsor
- National Cancer Institute (NCI)
- Enrolment target
- 132
- Started
- 31 May 2022
- Main results due
- 30 June 2027
- Study sites
- 128
- Registry updated
- 25 September 2026
Can you take part?
- Ages 12 months to 21 years.
- Open to any sex.
- You need the condition being studied — healthy volunteers are not accepted.
These are the headline rules only. Every study has a longer list, and whether you are eligible is decided by the research team at the site — never by this page.
Read the full eligibility criteria
Inclusion Criteria:
* PRE ENROLLMENT: Patients must be =\< 25 years of age at the time of enrollment on APEC14B1 part A central nervous system (CNS)/high grade glioma (HGG) pre-enrollment eligibility screening
* Please note:
* This required age range applies to pre-enrollment eligibility for all HGG patients. Individual treatment protocols may have different age criteria.
* Non-DIPG patients with tumors that do not harbor an H3K27M-mutation and are \>= 18 years of age will not be eligible to enroll on ACNS1821 (Step 1).
* PRE ENROLLMENT: Patient is suspected of having localized, newly diagnosed HGG, excluding metastatic disease, OR patient has an institutional diagnosis of DIPG
* Please note: there are specific radiographic criteria for DIPG patient enrollment on ACNS1821 (Step 1)
* As of February 14, 2025, stratum DIPG and stratum DMG have closed to accrual, and no patients will be enrolled on these strata after Amendment #4.
* PRE ENROLLMENT:
* For patients with non-pontine tumors: Patients and/or their parents or legal guardians must have signed informed consent for eligibility screening on APEC14B1 Part A.
* For patients with DIPG: Patients and/or their parents or legal guardians must have signed informed consent for ACNS1821.
* Note: As of February 14, 2025, stratum DIPG and stratum DMG have closed to accrual, and no patients will be enrolled on these strata after Amendment #4.
* PRE ENROLLMENT:
* For patients with non-pontine tumors only, the specimens obtained at the time of diagnostic biopsy or surgery must be submitted through APEC14B1 ASAP, preferably within 5 calendar days of definitive surgery
* STEP 1: Patients must be \>= 12 months and =\< 21 years of age at the time of enrollment
* STEP 1: Patients must have newly-diagnosed DIPG or HGG (including DMG).
* STEP 1: Stratum DIPG (Closed with Amendment #4)
* As of February 14, 2025, stratum DIPG and stratum DMG have closed to accrual, and no patients will be enrolled on these strata after Amendment #4.
* Patients with newly-diagnosed typical DIPG, defined as tumors with a pontine epicenter and diffuse involvement of at least 2/3 of the pons on at least 1 axial T2 weighted image, are eligible. No histologic confirmation is required.
* Patients with pontine tumors that do not meet radiographic criteria for typical DIPG (e.g., focal tumors or those involving less than 2/3 of the pontine cross-sectional area with or without extrapontine extension) are eligible if the tumors are biopsied and proven to be high-grade gliomas (such as anaplastic astrocytoma, glioblastoma, high-grade glioma not otherwise specified \[NOS\], and/or H3 K27M-mutant) by institutional diagnosis.
* STEP 1: Stratum DMG (with H3 K27M mutation) (Closed with Amendment #4)
* As of February 14, 2025, stratum DIPG and stratum DMG have closed to accrual, and no patients will be enrolled on these strata after Amendment #4.
* Patients must have newly-diagnosed non-pontine H3 K27M-mutant HGG without BRAF V600 or IDH1 mutations as confirmed by Rapid Central Pathology and Molecular Screening Reviews performed on APEC14B1
* Note: Patients need not have either measurable or evaluable disease, i.e., DMG patients may have complete resection of their tumor prior to enrollment. Primary spinal tumors are eligible for enrollment. For rare H3 K27M-mutant HGG in non-midline structures (e.g., cerebral hemispheres), these patients will be considered part of Stratum DMG.
* STEP 1: Stratum HGG (without H3 K27M mutation)
* Patients must have newly-diagnosed non-pontine H3 K27M-wild type HGG without BRAF V600 or IDH1 mutations as confirmed by Rapid Central Pathology and Molecular Screening Reviews performed on APEC14B1
* Please note:
* Patients who fall in this category and who are \>= 18 years of age are not eligible due to another standard-of-care regimen (radiation/temozolomide) that is available
* Patients need not have either measurable or evaluable disease, i.e., HGG patients may have complete resection of their tumor prior to enrollment. Primary spinal tumors are eligible for enrollment
* STEP 1: Patients must have a performance status corresponding to Eastern Cooperative Oncology Group (ECOG) scores of 0, 1 or 2. Use Karnofsky for patients \> 16 years of age and Lansky for patients =\<16 years of age. Patients who are unable to walk because of paralysis, but who are up in a wheelchair, will be considered ambulatory for the purpose of assessing the performance score.
* STEP 1: Peripheral absolute neutrophil count (ANC) \>= 1000/uL (within 7 days prior to step 1 enrollment)
* STEP 1: Platelet count \>= 100,000/uL (transfusion independent) (within 7 days prior to step 1 enrollment)
* STEP 1: Hemoglobin \>= 8.0 g/dL (may receive red blood cell \[RBC\] transfusions) (within 7 days prior to step 1 enrollment)
* STEP 1: Creatinine clearance or radioisotope glomerular filtration rate (GFR) \>= 70 mL/min/1.73 m\^2 (within 7 days prior to step 1 enrollment) or
A serum creatinine based on age/sex as follows (within 7 days prior to step 1 enrollment):
* Age / Maximum Serum Creatinine (mg/dL)
* 1 to \< 2 years / male: 0.6; female: 0.6
* 2 to \< 6 years / male: 0.8; female: 0.8
* 6 to \< 10 years / male: 1; female: 1
* 10 to \< 13 years / male: 1.2; female: 1.2
* 13 to \< 16 years / male: 1.5; female: 1.4
* \>= 16 years / male: 1.7; female: 1.4
* STEP 1: Total bilirubin =\< 1.5 x upper limit of normal (ULN) for age
* STEP 1: Serum glutamate pyruvate transaminase (SGPT) (alanine aminotransferase \[ALT\]) =\< 135 U/L. For the purpose of this study, the ULN for SGPT is 45 U/L.
* STEP 1: Serum amylase =\< 1.5 x ULN
* STEP 1: Serum lipase =\< 1.5 x ULN
* STEP 1: No evidence of dyspnea at rest, no exercise intolerance, and a pulse oximetry \> 94% if there is clinical indication for determination.
* STEP 1: Patients with seizure disorder may be enrolled if on anticonvulsants and well controlled.
* STEP 1: Patients must be enrolled and protocol therapy must begin no later than 31 days after the date of radiographic diagnosis (in the case of non-biopsied DIPG patients only) or definitive surgery, whichever is the later date (Day 0).
For patients who have a biopsy followed by resection, the date of resection will be considered the date of definitive diagnostic surgery. If a biopsy only was performed, the biopsy date will be considered the date of definitive diagnostic surgery.
Exclusion Criteria:
* STEP 1: Patients must not have received any prior therapy for their central nervous system (CNS) malignancy except for surgery and steroid medications.
* STEP 1: Patients who are currently receiving another investigational drug are not eligible.
* STEP 1: Patients who are currently receiving other anti-cancer agents are not eligible.
* STEP 1: Patients \>=18 years of age who have H3 K27M-wild type HGG.
* STEP 1: Patients who have an uncontrolled infection.
* STEP 1: Patients who have received a prior solid organ transplantation.
* STEP 1: Patients with grade \> 1 extrapyramidal movement disorder.
* STEP 1: Patients with known macular degeneration, uncontrolled glaucoma, or cataracts.
* STEP 1: Patients with metastatic disease are not eligible; MRI of spine with and without contrast must be performed if metastatic disease is suspected by the treating physician.
* STEP 1: Patients with gliomatosis cerebri type 1 or 2 are not eligible, with the exception of H3 K27M-mutant bithalamic tumors.
* STEP 1: Patients who are not able to receive protocol specified radiation therapy.
* STEP 1:
* Female patients who are pregnant are ineligible since there is yet no available information regarding human fetal or teratogenic toxicities.
* Lactating females are not eligible unless they have agreed not to breastfeed their infants. It is not known whether selinexor is excreted in human milk.
* Female patients of childbearing potential are not eligible unless a negative pregnancy test result has been obtained.
* Sexually active patients of reproductive potential are not eligible unless they have agreed to use two effective methods of birth control (including a medically accepted barrier method of contraception, e.g., male or female condom) for the duration of their study participation and for 90 days after the last dose of selinexor. Abstinence is an acceptable method of birth control.What this study is about
In the sponsor’s own words, from the registry.
This phase I/II trial tests the safety, side effects, and best dose of selinexor given in combination with standard radiation therapy in treating children and young adults with newly diagnosed diffuse intrinsic pontine glioma (DIPG) or high-grade glioma (HGG) with a genetic change called H3 K27M mutation. It also tests whether combination of selinexor and standard radiation therapy works to shrink tumors in this patient population. Glioma is a type of cancer that occurs in the brain or spine. Glioma is considered high risk (or high-grade) when it is growing and spreading quickly. The term, risk, refers to the chance of the cancer coming back after treatment. DIPG is a subtype of HGG that grows in the pons (a part of the brainstem that controls functions like breathing, swallowing, speaking, and eye movements). This trial has two parts. The only difference in treatment between the two parts is that some subjects treated in Part 1 may receive a different dose of selinexor than the subjects treated in Part 2. In Part 1 (also called the Dose-Finding Phase), investigators want to determine the dose of selinexor that can be given without causing side effects that are too severe. This dose is called the maximum tolerated dose (MTD). In Part 2 (also called the Efficacy Phase), investigators want to find out how effective the MTD of selinexor is against HGG or DIPG. Selinexor blocks a protein called CRM1, which may help keep cancer cells from growing and may kill them. It is a type of small molecule inhibitor called selective inhibitors of nuclear export (SINE). Radiation therapy uses high energy to kill tumor cells and shrink tumors. The combination of selinexor and radiation therapy may be effective in treating patients with newly-diagnosed DIPG and H3 K27M-Mutant HGG.
Study sites(128)
Children's Hospital of Alabama
Birmingham, Alabama, United States
Recruiting
Banner Children's at Desert
Mesa, Arizona, United States
Recruiting
Phoenix Childrens Hospital
Phoenix, Arizona, United States
Active, not recruiting
Arkansas Children's Hospital
Little Rock, Arkansas, United States
Recruiting
Loma Linda University Medical Center
Loma Linda, California, United States
Recruiting
Miller Children's and Women's Hospital Long Beach
Long Beach, California, United States
Recruiting
Children's Hospital Los Angeles
Los Angeles, California, United States
Recruiting
Cedars-Sinai Medical Center
Los Angeles, California, United States
Recruiting
UCSF Benioff Children's Hospital Oakland
Oakland, California, United States
Recruiting
Kaiser Permanente-Oakland
Oakland, California, United States
Recruiting
Children's Hospital of Orange County
Orange, California, United States
Recruiting
Lucile Packard Children's Hospital Stanford University
Palo Alto, California, United States
Recruiting
Rady Children's Hospital - San Diego
San Diego, California, United States
Recruiting
UCSF Medical Center-Mission Bay
San Francisco, California, United States
Recruiting
Children's Hospital Colorado
Aurora, Colorado, United States
Recruiting
Connecticut Children's Medical Center
Hartford, Connecticut, United States
Recruiting
Yale University
New Haven, Connecticut, United States
Recruiting
Alfred I duPont Hospital for Children
Wilmington, Delaware, United States
Recruiting
Children's National Medical Center
Washington D.C., District of Columbia, United States
Recruiting
Golisano Children's Hospital of Southwest Florida
Fort Myers, Florida, United States
Recruiting
Nemours Children's Clinic-Jacksonville
Jacksonville, Florida, United States
Recruiting
University of Miami Miller School of Medicine-Sylvester Cancer Center
Miami, Florida, United States
Recruiting
Miami Cancer Institute
Miami, Florida, United States
Active, not recruiting
Arnold Palmer Hospital for Children
Orlando, Florida, United States
Recruiting
Nemours Children's Hospital
Orlando, Florida, United States
Recruiting
Johns Hopkins All Children's Hospital
St. Petersburg, Florida, United States
Recruiting
Saint Joseph's Hospital/Children's Hospital-Tampa
Tampa, Florida, United States
Recruiting
Children's Healthcare of Atlanta - Arthur M Blank Hospital
Atlanta, Georgia, United States
Recruiting
Kapiolani Medical Center for Women and Children
Honolulu, Hawaii, United States
Recruiting
Saint Luke's Cancer Institute - Boise
Boise, Idaho, United States
Recruiting
University of Chicago Comprehensive Cancer Center
Chicago, Illinois, United States
Recruiting
OSF Children's Hospital of Illinois
Peoria, Illinois, United States
Recruiting
Riley Hospital for Children
Indianapolis, Indiana, United States
Recruiting
Blank Children's Hospital
Des Moines, Iowa, United States
Recruiting
University of Iowa/Holden Comprehensive Cancer Center
Iowa City, Iowa, United States
Recruiting
University of Kentucky/Markey Cancer Center
Lexington, Kentucky, United States
Recruiting
Norton Children's Hospital
Louisville, Kentucky, United States
Recruiting
Children's Hospital New Orleans
New Orleans, Louisiana, United States
Recruiting
Eastern Maine Medical Center
Bangor, Maine, United States
Recruiting
Maine Children's Cancer Program
Scarborough, Maine, United States
Recruiting
Johns Hopkins University/Sidney Kimmel Cancer Center
Baltimore, Maryland, United States
Recruiting
Dana-Farber Cancer Institute
Boston, Massachusetts, United States
Recruiting
C S Mott Children's Hospital
Ann Arbor, Michigan, United States
Recruiting
Children's Hospital of Michigan
Detroit, Michigan, United States
Recruiting
Corewell Health Grand Rapids Hospitals - Helen DeVos Children's Hospital
Grand Rapids, Michigan, United States
Recruiting
Children's Hospitals and Clinics of Minnesota - Minneapolis
Minneapolis, Minnesota, United States
Recruiting
University of Minnesota/Masonic Cancer Center
Minneapolis, Minnesota, United States
Recruiting
University of Mississippi Medical Center
Jackson, Mississippi, United States
Recruiting
Children's Mercy Hospitals and Clinics
Kansas City, Missouri, United States
Recruiting
Cardinal Glennon Children's Medical Center
St Louis, Missouri, United States
Recruiting
Washington University School of Medicine
St Louis, Missouri, United States
Recruiting
Mercy Hospital Saint Louis
St Louis, Missouri, United States
Recruiting
Children's Hospital and Medical Center of Omaha
Omaha, Nebraska, United States
Recruiting
University of Nebraska Medical Center
Omaha, Nebraska, United States
Recruiting
Hackensack University Medical Center
Hackensack, New Jersey, United States
Recruiting
Morristown Medical Center
Morristown, New Jersey, United States
Recruiting
Rutgers Cancer Institute of New Jersey-Robert Wood Johnson University Hospital
New Brunswick, New Jersey, United States
Recruiting
Newark Beth Israel Medical Center
Newark, New Jersey, United States
Recruiting
Saint Joseph's Regional Medical Center
Paterson, New Jersey, United States
Recruiting
Albany Medical Center
Albany, New York, United States
Recruiting
Showing 60 of 128 sites — filter to narrow it down. 123 of the 128 sites on this study are recruiting right now — a site can stop enrolling while the study as a whole is still open.
Source: ClinicalTrials.gov record NCT05099003. Trialion does not run this study, is not paid to refer anyone to it, and cannot enrol you. Eligibility is always decided by the research team at the site.
Not the right study?
Answer three questions and see the studies recruiting near you, in plain language.
Find a study for me