Multinational phase 2-3 study of selinexor for previously treated metastatic dedifferentiated liposarcoma

Current treatment options of advanced dedifferentiated liposarcoma (DD-LPS) are limited in number and efficacy. In preclinical models and a phase 1 study antitumor activity of selinexor was observed for DD-LPS. The multinational phase 2-3 SEAL study evaluated selinexor for previously treated DD-LPS with progression on approved agents. Patients were randomized to selinexor or placebo (crossover permitted. The median PFS was signifcantly longer with selinexor than with placebo, as was the time to next treatment, although no difference was observed in overall survival, possibly due to crossover (58.8% of patients in the placebo group). Exploratory RNA sequencing analysis showed that the absence of CALB1 expression was associated with longer PFS with selinexor compared with placebo.