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Cancer

Selinexor Demonstrates Modest Anticancer Activity in Advanced Thymoma and Thymic Carcinoma

Strategic Insights

— 2 min read

Researchers from Georgetown University Medical Center have conducted parallel phase II clinical trials to evaluate the efficacy and safety of selinexor, an inhibitor of the nuclear receptor exportin-1 (XPO1/CRM1), in patients with advanced thymoma and thymic carcinoma. The trials, which enrolled 31 patients, demonstrated modest anticancer activity with limited responses and significant treatment-related adverse events. The research aimed to provide effective treatment options for patients with progressive disease after platinum-based chemotherapy.

Key Takeaways:

  • The trials involved 31 patients with advanced thymoma and thymic carcinoma who had progressive disease after treatment with at least one platinum-containing chemotherapy regimen.
  • The median age of the patients was 57 years, with 17 men and 14 women participating in the trials.
  • The primary objective of the trials was the overall response rate (ORR) assessed by Response Evaluation Criteria in Solid Tumors 1.1, with secondary objectives including progression-free survival (PFS), overall survival (OS), and adverse events (AEs) assessed per Common Terminology Criteria for Adverse Event version 4.03.
  • No complete response was observed in the thymoma group, but there was one complete response in the thymic carcinoma group (ORR 6.7%; 95% CI: 1.2%-29.8%).
  • The median duration of selinexor therapy was 4.5 months, with the most common treatment-related adverse events (TRAEs) being nausea (83.8%), vomiting (45.2%), anemia (41.9%), fatigue (38.7%), and asthenia (38.7%).
  • The most common grade 3 or higher TRAEs were anemia (16.1%), thrombocytopenia (12.9%), and asthenia (12.9%).
  • Twenty patients (64.5%) required dose reductions due to AEs and 20 patients (64.5%) required dose interruptions.
  • The median PFS was 13.6 months (95% CI: 6.3-44.3) in the thymoma group and 7.8 months (95% CI: 4.3-15.5) in the thymic carcinoma group.
  • The trials were halted prematurely due to overall low ORRs and budgetary constraints.

Statistics:

  • 31 patients were enrolled in the trials, with 16 patients having thymoma and 15 patients having thymic carcinoma.
  • The median age of the patients was 57 years, with a range of 41-81 years.
  • The median number of previous systemic therapies was 2 (range: 1-9).
  • The starting dose of selinexor was 60 mg twice weekly for 29 patients (93.5%) and 40 mg twice weekly for two patients (6.5%).
  • The median duration of selinexor therapy was 4.5 months.
  • The most common TRAEs were nausea (83.8%), vomiting (45.2%), anemia (41.9%), fatigue (38.7%), and asthenia (38.7%).
  • The most common grade 3 or higher TRAEs were anemia (16.1%), thrombocytopenia (12.9%), and asthenia (12.9%).
  • The median PFS was 13.6 months (95% CI: 6.3-44.3) in the thymoma group and 7.8 months (95% CI: 4.3-15.5) in the thymic carcinoma group.

Sources:

  • NewsRx. Georgetown University Medical Center Researchers Discuss Research in Thymoma (Parallel Phase II Clinical Trials of Selinexor in Patients With Advanced Thymoma and Thymic Carcinoma). Hematology Week. September 8, 2025; p 2418.
  • Parallel Phase II Clinical Trials of Selinexor in Patients With Advanced Thymoma and Thymic Carcinoma. JTO Clinical and Research Reports, 2025,6(9):100848. The publisher for JTO Clinical and Research Reports is Elsevier. A free version of this journal article is available at https://doi-org.sdpl.idm.oclc.org/10.1016/j.jtocrr.2025.100848.

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