June 24, 2020 07:00 ET |    Source: Karyopharm Therapeutics Inc.      
    NEWTON,    Mass., June 24, 2020 (GLOBE NEWSWIRE) -- Karyopharm    Therapeutics Inc. (Nasdaq:KPTI), an    innovation-driven pharmaceutical company, today announced that    the results of the Phase 2b SADAL (Selinexor    Against Diffuse    Aggressive Lymphoma) study    evaluating XPOVIO in patients with relapsed or refractory    diffuse large B-cell lymphoma (RR DLBCL) were published    online in    The Lancet Haematology. The SADAL study    evaluated selinexor, the Companys first-in-class, oral    Selective Inhibitor of Nuclear Export (SINE) compound for the    treatment of adult patients with RR DLBCL, not otherwise    specified, who have received at least two prior    therapies.
    The clinical    outcomes for patients with heavily pretreated relapsed or    refractory DLBCL are typically very poor, and hence results    from the multinational Phase 2b SADAL study are noteworthy,    said Prof Nagesh Kalakonda, University of Liverpool, lead    author of the manuscript. In this population, single-agent    oral XPOVIO (selinexor) demonstrated an overall response rate    of 28%, including a complete response rate of 12%. Responses    were seen in all subgroups regardless of age, gender, prior    therapy, DLBCL subtype or prior stem cell transplant therapy.    Importantly, patient responses were durable with a median    duration of response of 9.3 months (23.0 months for patients    who achieved a complete response). Finally, responses were    associated with longer survival, underscoring the potential of    oral XPO1 inhibition as an oral, non-chemotherapeutic option    for patients with RR DLBCL.  
    These    positive data further reinforce our strong belief that oral    XPOVIO offers patients an important new treatment option,    especially considering the patient population studied in SADAL    had an expected median survival of less than six months.    Furthermore, treatment with XPOVIO demonstrated deep and    durable responses with a safety profile qualitatively similar    to previous clinical studies with XPOVIO, said Sharon Shacham,    PhD, MBA, Founder, President and Chief Scientific Officer of    Karyopharm. We are proud to see these published clinical    results and are excited to now commercialize XPOVIO in our    second cancer indication on behalf of the patients and families    who are desperately in need of new treatment options.  
    The U.S. Food    and Drug Administration (FDA) approved XPOVIO on June 22, 2020    for the treatment of adult patients with RR DLBCL, not    otherwise specified, including DLBCL arising from follicular    lymphoma, after at least two lines of systemic therapy. This    indication was approved based on response rate under the FDAs    Accelerated Approval Program, which was developed to allow for    expedited approval of drugs that treat serious conditions and    that fill an unmet medical need. Continued approval for this    indication may be contingent upon verification and description    of clinical benefit in a confirmatory trial(s). A Marketing    Authorization Application for selinexor for RR DLBCL is planned    for submission to the European Medicines Agency in 2021.  
    The    Phase 2b SADAL Study Results  
    The published    results are based on the multi-center, single-arm Phase 2b    SADAL study (NCT02227251), which evaluated 127 patients (median    of 2 prior treatment regimens) with RR DLBCL. Patients received    a fixed 60 mg dose of XPOVIO given orally twice weekly for a    four-week cycle. Patients with germinal center B-cell (GCB) or    non-GCB subtypes of DLBCL were included in enrollment.  
    The SADAL    study met its primary endpoint of overall response rate (ORR)    with an ORR of 28%, including 15 complete responses (CRs) and    21 partial responses (PRs). An additional 11 patients    experienced stable disease (SD) for a disease control rate of    37.0%. The ORR in the 59 patients with the GCB-subtype was 34%    and the ORR in the 63 patients with the non-GCB subtype was    21%. In addition, there were 5 patients enrolled whose subtype    was unclassified and 1 of these patients achieved a CR while 2    of these patients achieved a partial response (PR).  
    Key secondary    endpoints included a median duration of response (DOR) in the    responding patients of 9.3 months and median overall survival    (OS) across the entire study population of 9.1 months. Median    OS has not yet been reached in patients who achieved either a    CR or PR. In patients who had stable disease, the median OS was    18.3 months. Patients whose disease progressed or had no    response to XPOVIO had a median OS of 4.3 months, which is    consistent with the expected poor prognosis for patients who    have RR DLBCL and have been previously treated with two or more    lines of therapy.  
    All 127    patients were included in the safety analyses. The most common    treatment-related adverse events (AEs) were cytopenias along    with gastrointestinal and constitutional symptoms and were    generally reversible and managed with dose modifications and/or    standard supportive care. The most common non-hematologic AEs    were nausea (58%), fatigue (47%), and decreased appetite (37%)    and were mostly Grade 1 and 2 events. As expected, the most    common Grade 3 and 4 AEs were thrombocytopenia (46%),    neutropenia (24%) and anemia (22%) and were generally not    associated with clinical sequelae.  
    The patient    population described in this publication includes data from 127    patients in the SADAL study while the FDA approved label    includes data from seven additional patients or 134 patients    total. As such, there are minor differences in the efficacy and    safety percentages between the two sources.  
    About    XPOVIO (selinexor)  
    XPOVIO is a    first-in-class, oral Selective Inhibitor of Nuclear Export    (SINE) compound. XPOVIO functions by selectively binding to and    inhibiting the nuclear export protein exportin 1 (XPO1, also    called CRM1). XPOVIO blocks the nuclear export of tumor    suppressor, growth regulatory and anti-inflammatory proteins,    leading to accumulation of these proteins in the nucleus and    enhancing their anti-cancer activity in the cell. The forced    nuclear retention of these proteins can counteract a multitude    of the oncogenic pathways that, unchecked, allow cancer cells    with severe DNA damage to continue to grow and divide in an    unrestrained fashion. Karyopharm received accelerated U.S. Food    and Drug Administration (FDA) approval of XPOVIO in July 2019    in combination with dexamethasone for the treatment of adult    patients with relapsed refractory multiple myeloma (RRMM) who    have received at least four prior therapies and whose disease    is refractory to at least two proteasome inhibitors, at least    two immunomodulatory agents, and an anti-CD38 monoclonal    antibody. Karyopharm has also submitted a Marketing    Authorization Application (MAA) to the European Medicines    Agency (EMA) with a request for conditional approval of    selinexor in this same RRMM indication. Karyopharm submitted a    supplemental New Drug Application (sNDA) to the FDA requesting    an expansion of its current indication to include the treatment    for patients with multiple myeloma after at least one prior    line of therapy based on the positive results from the Phase 3    BOSTON study which evaluated selinexor in combination with    Velcade (bortezomib) and low-dose dexamethasone. In June 2020,    Karyopharm received accelerated FDA approval of XPOVIO for its    second indication in adult patients with relapsed or refractory    diffuse large B-cell lymphoma (DLBCL), not otherwise specified,    including DLBCL arising from follicular lymphoma, after at    least 2 lines of systemic therapy. Selinexor is also being    evaluated in several other mid-and later-phase clinical trials    across multiple cancer indications, including as a potential    backbone therapy in combination with approved myeloma therapies    (STOMP), in liposarcoma (SEAL) and in endometrial cancer    (SIENDO), among others. Additional Phase 1, Phase 2 and Phase 3    studies are ongoing or currently planned, including multiple    studies in combination with approved therapies in a variety of    tumor types to further inform Karyopharms clinical development    priorities for selinexor. Additional clinical trial information    for selinexor is available at http://www.clinicaltrials.gov.  
    For more    information about Karyopharms products or clinical trials,    please contact the Medical Information department at:  
    Tel: +1 (888)    209-9326    Email: medicalinformation@karyopharm.com  
    IMPORTANT SAFETY    INFORMATION  
    Thrombocytopenia: XPOVIO can    cause life-threatening thrombocytopenia, potentially leading to    hemorrhage. Thrombocytopenia was reported in patients with    multiple myeloma (MM) and developed or worsened in patients    with DLBCL.  
    Thrombocytopenia is the leading cause of dosage    modifications. Monitor platelet counts at baseline and    throughout treatment. Monitor more frequently during the first    3 months of treatment. Institute platelet transfusion and/or    other treatments as clinically indicated. Monitor patients for    signs and symptoms of bleeding and evaluate promptly.    Interrupt, reduce dose, or permanently discontinue based on    severity of adverse reaction.  
    Neutropenia: XPOVIO can cause    life-threatening neutropenia, potentially increasing the risk    of infection. Neutropenia and febrile neutropenia occurred in    patients with MM and in patients with DLBCL.  
    Obtain white    blood cell counts with differential at baseline and throughout    treatment. Monitor more frequently during the first 3 months of    treatment. Monitor patients for signs and symptoms of    concomitant infection and evaluate promptly. Consider    supportive measures, including antimicrobials and growth    factors (e.g., G-CSF). Interrupt, reduce dose, or permanently    discontinue based on severity of adverse reaction (AR).  
    Gastrointestinal Toxicity:    XPOVIO can cause severe gastrointestinal toxicities in patients    with MM and DLBCL.  
    Nausea/Vomiting: Provide    prophylactic antiemetics. Administer 5-HT3 receptor antagonists    and other anti-nausea agents prior to and during treatment with    XPOVIO. Interrupt, reduce dose, or permanently discontinue    based on severity of ARs. Administer intravenous fluids to    prevent dehydration and replace electrolytes as clinically    indicated.  
    Diarrhea: Interrupt, reduce    dose, or permanently discontinue based on severity of ARs.    Provide standard anti-diarrheal agents, administer intravenous    fluids to prevent dehydration, and replace electrolytes as    clinically indicated.  
    Anorexia/Weight Loss: Monitor    weight, nutritional status, and volume status at baseline and    throughout treatment. Monitor more frequently during the first    3 months of treatment. Interrupt, reduce dose, or permanently    discontinue based on severity of ARs. Provide nutritional    support, fluids, and electrolyte repletion as clinically    indicated.  
    Hyponatremia: XPOVIO can cause    severe or life-threatening hyponatremia. Hyponatremia developed    in patients with MM and in patients with DLBCL.  
    Monitor    sodium level at baseline and throughout treatment. Monitor more    frequently during the first 2 months of treatment. Correct    sodium levels for concurrent hyperglycemia (serum glucose    >150 mg/dL) and high serum paraprotein levels. Assess    hydration status and manage hyponatremia per clinical    guidelines, including intravenous saline and/or salt tablets as    appropriate and dietary review. Interrupt, reduce dose, or    permanently discontinue based on severity of the AR.  
    Serious    Infection: XPOVIO can cause serious and fatal    infections. Most infections were not associated with Grade 3 or    higher neutropenia. Atypical infections reported after taking    XPOVIO include, but are not limited to, fungal pneumonia and    herpesvirus infection.  
    Monitor for    signs and symptoms of infection, and evaluate and treat    promptly.  
    Neurological Toxicity: XPOVIO    can cause life-threatening neurological toxicities.  
    Coadministration of XPOVIO with other products    that cause dizziness or mental status changes may increase the    risk of neurological toxicity.  
    Advise    patients to refrain from driving and engaging in hazardous    occupations or activities, such as operating heavy or    potentially dangerous machinery, until the neurological    toxicity fully resolves. Optimize hydration status, hemoglobin    level, and concomitant medications to avoid exacerbating    dizziness or mental status changes. Institute fall precautions    as appropriate.  
    Embryo-Fetal Toxicity: XPOVIO    can cause fetal harm when administered to a pregnant    woman.  
    Advise    pregnant women of the potential risk to a fetus. Advise females    of reproductive potential and males with a female partner of    reproductive potential to use effective contraception during    treatment with XPOVIO and for 1 week after the last    dose.  
    ADVERSE REACTIONS  
    The most    common adverse reactions (ARs) in 20% of patients with MM are    thrombocytopenia, fatigue, nausea, anemia, decreased appetite,    decreased weight, diarrhea, vomiting, hyponatremia,    neutropenia, leukopenia, constipation, dyspnea, and upper    respiratory tract infection.  
    The most    common ARs, excluding laboratory abnormalities, in 20% of    patients with DLBCL are fatigue, nausea, diarrhea, appetite    decrease, weight decrease, constipation, vomiting, and pyrexia.    Grade 3-4 laboratory abnormalities in 15% of patients included    thrombocytopenia, lymphopenia, neutropenia, anemia, and    hyponatremia. Grade 4 laboratory abnormalities in 5% were    thrombocytopenia, lymphopenia, and neutropenia.  
    In patients    with MM, fatal ARs occurred in 9% of patients. Serious ARs    occurred in 58% of patients. Treatment discontinuation rate due    to ARs was 27%. The most frequent ARs requiring permanent    discontinuation in 4% of patients included fatigue, nausea,    and thrombocytopenia.  
    In patients    with DLBCL, fatal ARs occurred in 3.7% of patients within 30    days, and 5% of patients within 60 days of last treatment; the    most frequent fatal AR was infection (4.5% of patients).    Serious ARs occurred in 46% of patients; the most frequent    serious AR was infection. Discontinuation due to ARs    occurred in 17% of patients.  
    USE    IN SPECIFIC POPULATIONS  
    In MM, no    overall difference in effectiveness of XPOVIO was observed in    patients >65 years old when compared with younger patients.    Patients 75 years old had a higher incidence of    discontinuation due to an AR than younger patients, a higher    incidence of serious ARs, and a higher incidence of fatal    ARs.  
    Clinical    studies in patients with relapsed or refractory DLBCL did not    include sufficient numbers of patients aged 65 and over to    determine whether they respond differently from younger    patients.  
    The effect of    end-stage renal disease (CLCR <15 mL/min) or    hemodialysis on XPOVIO pharmacokinetics is unknown.  
    Please see full Prescribing    Information.  
    To    report SUSPECTED ADVERSE REACTIONS, contact Karyopharm    Therapeutics Inc. at 1-888-209-9326 or FDA at 1-800-FDA-1088    or    http://www.fda.gov/medwatch.  
    About    Karyopharm Therapeutics  
    Karyopharm    Therapeutics Inc. (Nasdaq: KPTI) is an innovation-driven    pharmaceutical company dedicated to the discovery, development,    and commercialization of novel first-in-class drugs directed    against nuclear export and related targets for the treatment of    cancer and other major diseases. Karyopharm's Selective    Inhibitor of Nuclear Export (SINE) compounds function by    binding with and inhibiting the nuclear export protein XPO1 (or    CRM1). Karyopharms lead compound, XPOVIO (selinexor),    received accelerated approval from the U.S. Food and Drug    Administration (FDA) in July 2019 in combination with    dexamethasone as a treatment for patients with heavily    pretreated multiple myeloma. In June 2020, XPOVIO was approved    by the FDA as a treatment for patients with relapsed or    refractory diffuse large B-cell lymphoma. A Marketing    Authorization Application for selinexor for patients with    heavily pretreated multiple myeloma is also currently under    review by the European Medicines Agency. In addition to    single-agent and combination activity against a variety of    human cancers, SINE compounds have also shown biological    activity in models of neurodegeneration, inflammation,    autoimmune disease, certain viruses and wound-healing.    Karyopharm has several investigational programs in clinical or    preclinical development. For more information, please visit    http://www.karyopharm.com.  
    Forward-Looking    Statements  
    This press    release contains forward-looking statements within the meaning    of The Private Securities Litigation Reform Act of 1995. Such    forward-looking statements include those regarding Karyopharms    beliefs regarding XPOVIOs ability to treat patients with    relapsed or refractory diffuse large B-cell lymphoma and    expectations related to other XPOVIO regulatory submissions.    Such statements are subject to numerous important factors,    risks and uncertainties, many of which are beyond Karyopharm's    control, that may cause actual events or results to differ    materially from Karyopharm's current expectations. For example,    there can be no guarantee that any positive developments in the    development or commercialization of Karyopharms drug candidate    portfolio will result in stock price appreciation. Managements    expectations and, therefore, any forward-looking statements in    this press release could also be affected by risks and    uncertainties relating to a number of other factors, including    the following: the risk that the COVID-19 pandemic could    disrupt Karyopharms business more severely than it currently    anticipates, including by reducing sales of XPOVIO,    interrupting or delaying research and development efforts,    impacting the ability to procure sufficient supply for the    development and commercialization of selinexor or other product    candidates, delaying ongoing or planned clinical trials,    impeding the execution of business plans, planned regulatory    milestones and timelines, or inconveniencing patients; the    adoption of XPOVIO in the commercial marketplace, the timing    and costs involved in commercializing XPOVIO or any of    Karyopharms drug candidates that receive regulatory approval;    the ability to retain regulatory approval of XPOVIO or any of    Karyopharms drug candidates that receive regulatory approval;    Karyopharm's results of clinical trials and preclinical    studies, including subsequent analysis of existing data and new    data received from ongoing and future studies; the content and    timing of decisions made by the U.S. Food and Drug    Administration and other regulatory authorities,    investigational review boards at clinical trial sites and    publication review bodies, including with respect to the need    for additional clinical studies; the ability of Karyopharm or    its third party collaborators or successors in interest to    fully perform their respective obligations under the applicable    agreement and the potential future financial implications of    such agreement; Karyopharm's ability to obtain and maintain    requisite regulatory approvals and to enroll patients in its    clinical trials; unplanned cash requirements and expenditures;    development of drug candidates by Karyopharms competitors for    indications in which Karyopharm is currently developing its    drug candidates; and Karyopharms ability to obtain, maintain    and enforce patent and other intellectual property protection    for any drug candidates it is developing. These and other risks    are described under the caption "Risk Factors" in Karyopharms    Quarterly Report on Form 10-Q for the quarter ended March 31,    2020, which was filed with the Securities and Exchange    Commission (SEC) on May 5, 2020, and in other filings that    Karyopharm may make with the SEC in the future. Any    forward-looking statements contained in this press release    speak only as of the date hereof, and, except as required by    law, Karyopharm expressly disclaims any obligation to update    any forward-looking statements, whether as a result of new    information, future events or otherwise.  
    Velcade is a    registered trademark of Takeda Pharmaceutical Company    Limited.  
    Contacts:  
    Investors:    Karyopharm Therapeutics Inc.    Ian Karp, Vice President, Investor and Public Relations    857-297-2241 | ikarp@karyopharm.com  
    Media:  
    FTI    Consulting    Simona Kormanikova or Robert Stanislaro    212-850-5600 |Simona.Kormanikova@fticonsulting.com or    robert.stanislaro@fticonsulting.com  
More:
Karyopharm Announces Publication of XPOVIO (Selinexor) Phase 2b SADAL Study Results in The Lancet Haematology - GlobeNewswire