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Selinexor, Daratumumab, and Dexamethasone (XDd) for Light-Chain Cardiac Amyloidosis

12. august 2026 opdateret af: Yini Wang, Beijing Anzhen Hospital

Selinexor Combined With Daratumumab and Dexamethasone (XDd) for the Treatment of Patients With Advanced Light-Chain Cardiac Amyloidosis: A Prospective, Multicenter, Phase II Clinical Study

The goal of this clinical trial is to evaluate whether selinexor combined with daratumumab and dexamethasone (XDd) can treat patients with advanced light-chain cardiac amyloidosis. The main questions it aims to answer are:

Does XDd regimen achieve hematologic complete response in patients with advanced light-chain cardiac amyloidosis? Does XDd regimen improve cardiac response, organ response, progression-free survival, overall survival, quality of life, and safety?

Studieoversigt

Status

Ikke rekrutterer endnu

Betingelser

Intervention / Behandling

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

63

Fase

  • Fase 2

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Voksen
  • Ældre voksen

Tager imod sunde frivillige

Ingen

Beskrivelse

Inclusion Criteria:

  • Age ≥ 18 years.
  • Confirmed systemic light-chain amyloidosis, meeting both of the following:

    1. Tissue biopsy confirms amyloid deposition, and the amyloid precursor protein is immunoglobulin light chain or heavy-light chain. Pathologic evidence includes at least one of the following: Congo red staining positive with apple-green birefringence under polarized light microscopy; Light-chain restricted expression demonstrated by immunohistochemistry, immunofluorescence, or immunoelectron microscopy, or mass spectrometry confirming the precursor protein as immunoglobulin light chain; Electron microscopy showing nonbranching, rigid, randomly arranged fibrils with a diameter of 8 to 14 nm.
    2. Evidence of monoclonal immunoglobulin or free light chain in serum or urine, or detection of monoclonal plasma cells/B cells in bone marrow examination.
  • Clinical manifestations, physical examination, laboratory tests, or imaging studies confirm involvement of one or more organs, with mandatory cardiac involvement. Cardiac involvement is defined as either:

    1. Mean ventricular wall thickness > 12 mm on echocardiography, with other cardiac diseases excluded; or
    2. NT-proBNP > 332 ng/L in the absence of renal insufficiency and atrial fibrillation.
  • Mayo 2004 stage IIIa or IIIb disease, including newly diagnosed and relapsed/refractory patients.
  • Measurable disease in light-chain amyloidosis, defined by at least one of the following:

    1. Serum monoclonal protein ≥ 0.5 g/dL by serum protein electrophoresis and immunofixation performed by the central laboratory;
    2. Serum free light chain ≥ 50 mg/L with an abnormal kappa/lambda ratio; or
    3. Difference between involved and uninvolved free light chains (dFLC) ≥ 50 mg/L. Note: Urine Bence Jones proteinuria alone is not sufficient to define measurable disease for eligibility.
  • Not pregnant or breastfeeding. Men and women of childbearing potential must agree to use appropriate contraception before treatment, during treatment, during any treatment interruption, and for 4 weeks after treatment completion.
  • Written informed consent has been signed by the participant. If the participant is unable to sign because of their medical condition, informed consent may be signed by a legal guardian or immediate family member.

Exclusion Criteria:

  • Active hepatitis B virus (HBV) infection, hepatitis C virus (HCV) infection, or other acquired or congenital immunodeficiency disorders.
  • Baseline peripheral neuropathy or neuropathic pain of grade ≥ 2 according to NCI CTCAE v4.0.
  • Major surgery within 30 days before enrollment.
  • Epilepsy requiring medication, dementia, or other psychiatric conditions that prevent understanding of or compliance with the study protocol.
  • Any severe physical or psychiatric illness that may interfere with participation in this clinical study.
  • Any other condition that the investigator considers unsuitable for enrollment.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: N/A
  • Interventionel model: Enkelt gruppeopgave
  • Maskning: Ingen (Åben etiket)

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: XDd

Selinexor (X): 40 mg orally once weekly (QW) Daratumumab (D): 1800 mg per dose, subcutaneous injection; administered once weekly during cycles 1-2, once every 2 weeks during cycles 3-6, and once every 4 weeks from cycle 7 onward. One cycle is 4 weeks.

Dexamethasone (d): 20-40 mg once weekly (QW)

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Tidsramme
Hematologic complete response rate
Tidsramme: From enrollment to the end of treatment at 1 year
From enrollment to the end of treatment at 1 year

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Cardiac organ response rate
Tidsramme: From enrollment to the end of treatment at 1 year
From enrollment to the end of treatment at 1 year
Organ response rate (heart, kidney, and liver)
Tidsramme: From enrollment to the end of treatment at 1 year
From enrollment to the end of treatment at 1 year
Duration of response
Tidsramme: From first documented response until documented progression or death, assessed up to 1 years.
From first documented response until documented progression or death, assessed up to 1 years.
Time to response
Tidsramme: From first dose until first documented response, assessed up to 1 years
From first dose until first documented response, assessed up to 1 years
Progression-free survival
Tidsramme: From first dose until date of first documented progression or date of death from any cause, whichever came first, assessed up to 12 months.
From first dose until date of first documented progression or date of death from any cause, whichever came first, assessed up to 12 months.
Overall survival
Tidsramme: From first dose until date of death from any cause, assessed up to 12 months.
From first dose until date of death from any cause, assessed up to 12 months.
Quality of life assessed by EORTC QLQ-C30
Tidsramme: Through study completion, up to 1 year.
Mean change from baseline in EORTC Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30) Global health status/Quality of life score (range 0-100; higher scores indicate better quality of life)
Through study completion, up to 1 year.
Incidence and Severity of Adverse Events
Tidsramme: From the first dose through 28 days after the last dose
From the first dose through 28 days after the last dose
Biomarker Outcome: dFLC
Tidsramme: Baseline and every 4 weeks during treatment, up to 12 months.
Change from baseline in difference between involved and uninvolved free light chains (dFLC) (mg/L).
Baseline and every 4 weeks during treatment, up to 12 months.
Biomarker outcome: NT-proBNP
Tidsramme: Baseline and every 4 weeks during treatment, up to 12 months.
Change from baseline in N-terminal pro-B-type natriuretic peptide (NT-proBNP) (pg/mL)
Baseline and every 4 weeks during treatment, up to 12 months.
Biomarker outcome: MRD
Tidsramme: Baseline and at end of treatment, up to 12 months.
Minimal residual disease (MRD) status in bone marrow (assessed by multiparameter flow cytometry of bone marrow).
Baseline and at end of treatment, up to 12 months.

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Generelle publikationer

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Anslået)

13. juli 2026

Primær færdiggørelse (Anslået)

1. februar 2028

Studieafslutning (Anslået)

1. juni 2028

Datoer for studieregistrering

Først indsendt

13. juli 2026

Først indsendt, der opfyldte QC-kriterier

29. juli 2026

Først opslået (Faktiske)

4. august 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

13. august 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

12. august 2026

Sidst verificeret

1. august 2026

Mere information

Begreber relateret til denne undersøgelse

Andre undersøgelses-id-numre

  • XDd-LCA-Phase2

Plan for individuelle deltagerdata (IPD)

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