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Venetoclax

Participants receive eltanexor PO QD for 5 days per week for 14, 21, or 28 days every cycle, and venetoclax PO QD on days 1-14 of each cycle. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Participants undergo bone marrow aspiration and biopsy and blood sample collection throughout the study.

Eltanexor

Undergo bone marrow aspiration and biopsy

Bone Marrow Aspiration and Biopsy

Biospecimen Collection

Vanderbilt-Ingram Services for Timely Access

Vanderbilt-Ingram Service Services for Timely Access

Somedeb Ball, MD

This phase I trial tests the safety, side effects, and best dose of eltanexor in combination with venetoclax for the treatment of patients with myelodysplastic syndrome (MDS) or acute myeloid leukemia (AML) that has come back after a period of improvement (relapsed) or that has not responded to previous treatment (refractory). Eltanexor works by trapping "tumor suppressing proteins" within the cell, thus causing the cancer cells to die or stop growing. Venetoclax is in a class of medications called B-cell lymphoma-2 (BCL-2) inhibitors. It may stop the growth of cancer cells by blocking Bcl-2, a protein needed for cancer cell survival. Giving eltanexor together with venetoclax may be safe, tolerable and/or effective in treating patients with relapsed or refractory MDS or AML.

Primary objective:

• To establish the safe and biologically effective dose (BED) of eltanexor in combination with venetoclax in patients with R/R MDS and/or AML

Secondary objectives:

* To estimate the complete remission (CR) rate with eltanexor and venetoclax in patients with R/R MDS and/or AML
* To assess the overall response rate (ORR) following treatment with eltanexor/venetoclax
* To assess the overall survival of patients
* To assess the progression free survival (PFS) and duration of response (DOR) in patients treated with eltanexor/venetoclax

Exploratory objectives:

* To assess differential response between MDS and AML cohorts
* To develop and evaluate a phenotypic flow-based assay to predict response to eltanexor/venetoclax
* To assess the effect of mutational changes on response to eltanexor/venetoclax
* To measure the rates of measurable residual disease with eltanexor/venetoclax

OUTLINE: This is a dose-escalation study of eltanexor in combination with venetoclax.

Patients receive eltanexor orally (PO) once per day (QD) for 5 days per week for 14, 21, or 28 days every cycle, and venetoclax PO QD on days 1-14 of each cycle. Cycles repeat every 28 days in the absence of disease progression or unacceptable toxicity. Patients undergo bone marrow aspiration and biopsy and blood sample collection throughout the study.

After completion of study treatment, patients are followed up every 3 months for up to 24 months.

Eltanexor and Venetoclax in Relapsed or Refractory Myelodysplastic Syndrome and Acute Myeloid Leukemia

Phase Ib Study of Eltanexor and Venetoclax in Relapsed or Refractory Myelodysplastic Syndrome and Acute Myeloid Leukemia

Adverse medical events will be tabulated and graded according to the Common Terminology Criteria for Adverse Events (CTCAE) version 5.

By 95% (e.g. based on standard Gaussian methods or bootstrap methods, as appropriate) confidence intervals.

Will be estimated using the method of Kaplan and Meier accompanied by 95% (e.g. based on standard Gaussian methods or bootstrap methods, as appropriate) confidence intervals.

Karyopharm Therapeutics Inc

National Cancer Institute (NCI)

Vanderbilt-Ingram Cancer Center

Assistant Professor of Medicine

Study title	NCT ID	Conditions	Interventions	Eligibility	Organization	Link
Eltanexor and Venetoclax in Relapsed or Refractory Myelodysplastic Syndrome and Acute Myeloid Leukemia	NCT06399640	Relapsed Myelod... Refractory Myel... Acute Myeloid L... Recurrent Acute... Refractory Acut...	Eltanexor Venetoclax Bone Marrow Asp... Biospecimen Col...	18 Years -	Vanderbilt-Ingram Cancer Center
Eltanexor and Venetoclax in Relapsed or Refractory Myelodysplastic Syndrome and Acute Myeloid Leukemia	NCT06399640	Relapsed Myelod... Refractory Myel... Acute Myeloid L... Recurrent Acute... Refractory Acut...	Eltanexor Venetoclax Bone Marrow Asp... Biospecimen Col...	18 Years -	Vanderbilt-Ingram Cancer Center

Spots Global Cancer Trial Database for relapsed myelodysplastic syndrome