Digital measurement of functional status of patients with glioblastoma.

Authors

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Yasaman Damestani

Karyopharm Therapeutics Inc., Newton, MA

Yasaman Damestani , Minesh P. Mehta , Howard Colman , Kevin A. Camphausen , Michael Weller , Evanthia Galanis , Martin J. Van Den Bent , John Frederick De Groot , Andrew B. Lassman , Andreas Felix Hottinger , Louis B. Nabors , J Paul Duic , Kai Li , Yang Liu , Shijie Tang , Sharon Tamir , Eran Shacham , Jatin J. Shah , Sharon Shacham , Patrick Y. Wen

Organizations

Karyopharm Therapeutics Inc., Newton, MA, Miami Cancer Institute, Baptist Health South Florida, Miami, FL, University of Utah-Huntsman Cancer Institute, Salt Lake City, UT, Radiation Oncology Branch, National Cancer Institute at the National Institutes of Health, Mclean, VA, Department of Neurology, University Hospital and University of Zurich, Zurich, Switzerland, Mayo Clinic Cancer Center, Mayo Clinic, Rochester, MN, Erasmus University Medical Center (MC) Cancer Institute, Rotterdam, Netherlands, The University of Texas, MD Anderson Cancer Center, Department of Neuro-Oncology, Houston, TX, Columbia University Irving Medical Center, New York, NY, Department of Clinical Neurosciences, Centre Hospitalier Universitaire Vaudois & Lausanne University, Lausanne, Switzerland, Division of Neuro-oncology, Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, Dana-Farber Cancer Institute, Boston, MA

Research Funding

Pharmaceutical/Biotech Company
Karyopharm Therapeutics Inc

Background: Among the primary aims of new therapies for glioblastoma (GBM) are the reduction of morbidity and restoration or preservation of quality of life (QoL). Selinexor (SEL) is a first-in class, oral, selective inhibitor of nuclear export which blocks exportin 1 (XPO1), forcing the nuclear retention and reactivation of tumor suppressor proteins, ultimately causing cell death in cancer cells. SEL is approved for the treatment of previously treated multiple myeloma and DLBCL. XPORT-GBM-029 (NCT04421378) is a phase 1 dose finding study followed by an open-label randomized phase 2, 3-arm trial to evaluate SEL in combination with standard therapies for newly diagnosed and recurrent GBM: Arm A (ndGBM, uMGMT) – radiation +/- SEL; Arm B (ndGBM, mMGMT) – radiation and temozolomide +/- SEL; Arm C (rGBM) – lomustine +/- SEL at first relapse. We look to identify sensitive, reliable, and clinically meaningful digital assessments of the functional status of ndGBM and rGBM patients via a patient-centric approach. Methods: XPORT-GBM-029 incorporates standard clinical and imaging evaluations of GBM progression with novel digital tools that objectively measure motor and cognitive function. The study is conducted at 50 sites globally with the aim of enrolling 350 patients with newly diagnosed and recurrent GBM. Following discussions with KOLs and patient advocacy partners at EndbrainCancer, we surveyed GBM patients and their caregivers to identify disease manifestations critical to patients’ QoL. The survey revealed four key areas impacting patients’ QoL that can be affected by GBM therapies and can be objectively monitored: cognitive function, lateralization, fatigue, and sleep. In this trial we use objective measurements to evaluate SEL’s effects on GBM patients’ QoL. Patients wear inertial sensors to measure their activity and sleep and complete a cognitive battery at baseline and before each MRI. Results: Associations between objective digital measures of activity, gait, fatigue, sleep, and cognition will be examined with respect to clinical assessments including physical examinations, modified Response Assessment in Neuro-Oncology (mRANO), Neurologic Assessment in Neuro-Oncology (NANO), Karnofsky Performance Score (KPS) and Patient Reported Outcome (PRO) QoL questionnaires. Descriptive summary statistics and plots are employed in exploratory data analysis, and other advanced data mining methods may also be considered. Conclusions: XPORT-GBM-029 trial is probably the first large, prospective, longitudinal study in GBM patients employing digital markers and may provide useful information regarding the utility of wearable and mobile devices for measuring functional outcomes in clinical trials. Clinical trial information: NCT04421378

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Abstract Details

Meeting

2021 ASCO Annual Meeting

Session Type

Poster Discussion Session

Session Title

Central Nervous System Tumors

Track

Central Nervous System Tumors

Sub Track

Primary CNS Tumors–Glioma

Clinical Trial Registration Number

NCT04421378

Citation

J Clin Oncol 39, 2021 (suppl 15; abstr 2016)

DOI

10.1200/JCO.2021.39.15_suppl.2016

Abstract #

2016

Abstract Disclosures

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