CompletedPhase 3ACTRN12620000841976

C-SMART. COVID-19 Prevention and Treatment in Cancer. Arm 3: treatment among cancer patients with moderate COVID-19 infection.

COVID-19 Prevention and Treatment in Cancer; a Sequential Multiple Assignment Randomised Trial; C-SMART study. Arm 3: Effect of selinexor in cancer patients with moderate COVID-19 infection.

Sponsor

Peter MacCallum Cancer Centre

Enrollment

126 participants

Start Date

Sep 27, 2021

Study Type

Interventional

Conditions

Cancer COVID-19

Summary

A multi-centre Australian trial with four arms aims to evaluate several different immune modulating drugs for prevention and treatment of COVID-19 specifically in the cancer population. This study arm (arm 3) is evaluating the effect of Selinexor on the incidence of COVID-19 infection in cancer patients with moderate COVID-19 infection. Who is it for? You may be eligible to join this study arm if you are aged 18 and above, have any haematological or solid tumour, currently receiving cancer-related treatment, and are hospitalised with a moderate COVID-19 infection Study details Participants in this study arm are randomly allocated (by chance) to one of two groups. One group will receive oral Selinexor 3 times a week for 2 weeks while the other group will receive oral placebo 3 times a week for 2 weeks Participants will be followed for 60 days to assess effectiveness and safety. This study is one arm of a four arm, sequential multiple assignment randomisation trial where participants may become eligible and transition to different arms and treatments if they become exposed to COVID-19 or are hospitalised with an active moderate/severe COVID-19 infection. It is hoped this research will provide insight into the best practice for prevention and treatment COVID-19 in cancer patients as emerging standard of care measures are not always suitable to this especially vulnerable population.

Eligibility

Sex: Both males and femalesMin Age: 18 Yearss

Inclusion Criteria13

ARM 3
Age equal to or greater than 18 years of age.
Any haematological or solid tumour
Current or within the last 12 months received cancer related treatment such as chemotherapy, radiotherapy or targeted small molecule, cellular therapy or immune-modulating therapy
Signed written and verbal informed consent
Laboratory confirmation of SARS-CoV-2 by PCR as per local laboratory assays
Hospitalised
Symptoms of COVID-19 such as:
a. Fever equal to or greater than 38 degrees Celsius OR
b. Tachypnoea respiratory rate equal to or greater than 20 breaths/min OR
c. Pulse Oxygen saturation (SpO2) equal to or less than 94%
Concurrent standard of care antimicrobials, antivirals are allowed.
Female and male patients of child bearing potential will use highly effective contraception. In female child bearing potential participants a negative urine pregnancy test will be required.

Exclusion Criteria9

ARM 3
Unable to take oral medication
Any known allergic reactions to selinexor or concomitant medication-related contra-indications to selinexor.
Severe critical COVID-19 infection defined as:
a) Requiring invasive or non-invasive mechanical ventilation, ECMO
b) Anticipated unlikely to survive within 48 hours
In the opinion of the investigator and primary oncologist, participation in the study would not be in the best interests of the participant
Severe renal impairment defined as creatinine clearance (CrCL) < 20ml/min as calculated using the Cockcroft Gault formula
Severe hepatic impairment defined as aspartate transaminase (AST) or alanine transaminase (ALT) > 5 x upper limit of normal (ULN)

Interested in this trial?

Get notified about updates and connect with the research team.

Interventions

ARM 3 - Moderate COVID-19 infection Drug: Selinexor Dose: 20mg 3x weekly Duration: 14 days Mode: oral - self administered tablet adherence: supervised administration while inpatient. self reporte

ARM 3 - Moderate COVID-19 infection Drug: Selinexor Dose: 20mg 3x weekly Duration: 14 days Mode: oral - self administered tablet adherence: supervised administration while inpatient. self reported. Description of study design: This SMART design specifies that participants entering the trial who have had no known COVID-19 exposure are initially randomised to either low-dose intranasal IFN-a or placebo as pre-exposure prophylaxis against developing COVID-19. Any participants who have a known COVID-19 exposure are randomised to high-dose IFN-a or placebo as a post-exposure prophylaxis against developing COVID-19. If, at any stage after enrolling, a participant develops ‘moderate’ COVID-19, then they are then randomised to either selinexor or placebo, and if at any stage after enrolling the participant develops ‘severe’ COVID-19 they are then randomised to either lenzilumab or placebo. Importantly, participants enrolling into the trial can directly enter any of the four interventions if they meet the appropriate entry criteria.