Pivotal trial dossier · BioIntel

A Study of Rituximab-Gemcitabine-Dexamethasone-Platinum (R-GDP) With or Without Selinexor in Patients With Relapsed/Refractory Diffuse Large B-cell Lymphoma

Karyopharm Therapeutics Inc · Ph2/Ph3 · NCT04442022   month only — not a planning date enrolment is a target
Readout due
2026-12-01
Ph2/Ph3
Patients
501
estimated
Sites
38
6 countries
Arms
6
randomized
Masking
Double
blinding depth

Design

AllocationRandomized
MaskingDouble
Primary purposeTreatment
Arms6
Planned duration75 months
Started2020-09-03

What is being measured

Endpoint classsurvival
Primary outcomes2
Stated asPhase 2: Overall Response Rate (ORR): Based on Lugano Criteria 2014 | Phase 3: Progression-free Survival (PFS): Based on Lugano Criteria 2014
Endpoint class is inferred from the sponsor's own wording of the primary outcome. Hard endpoints such as survival are generally harder to hit than scales or laboratory surrogates.

Population

ConditionRelapsed/Refractory Diffuse Large B-cell Lymphoma
Therapeutic areaoncology
Patient pre-selectionbiomarker / selected population
Modalitycell_therapy
SexALL

Evidence trail

Linked references0 on the registry record
Results postednot yet
Stopped earlyno

Sponsor's recent catalyst filings

8-K events from this sponsor in the last 90 days. Context for how active and how newsworthy the company has been — not evidence about this trial.

Reference-class base rate

64%
historical share of Phase 3 trials in this class that reached approval
This is a base rate, not a prediction about this trial. It is what happened to comparable trials historically. It is not a model fitted on outcomes — no outcome labels exist for trials that have not read out — and it uses none of this trial's own results.

How this number was reached

  1. Published Phase 3 → approval rate for oncology: 35.5% (Wong/Siah/Lo 2019) and 43.9% (BIO/Informa 2011–2020).
  2. Trial selects patients by biomarker. In oncology this is the one well-evidenced stratification: 63.6% for biomarker-selected versus 33.6% for all-comers, so the stratified rate replaces the band.

Design flags

Flags are shown separately rather than folded into the number. Wood et al. (BMJ 2008) measured effect-size inflation, not approval probability, so multiplying it into an approval rate would misuse the finding.

Deliberately not adjusted for

Enrollment sizeno evidenced association with Phase 3 success
Number of sitesno evidenced association
Endpoint typeno evidenced association with success once area is held
Phase 2 designsingle-arm vs randomised Phase 2 does not predict Phase 3
Each of these is visible in the registry and each is evidenced to be null for Phase 3 success. Using them would add false precision.

Evidenced, but not in the registry

Sponsor approval track record51%→81% (Danzon 2005) — not a registry field
Orphan designationaOR 2.3 — zero CT.gov fields carry FDA designations
Phase 2 effect-size shrinkagerHR 0.73 — requires prior-trial results
The standing criticism, stated plainly. Hampson et al. (Pharmaceutical Statistics 2022;21(2):439–459, eight of nine authors at Novartis) argue that starting from industry rates and applying subjective adjustments "lacks transparency and fails to make full use of data from previous clinical trials". That criticism applies to this figure. The response here is to show every input and to refuse unsupported adjustments, not to claim the objection does not apply.
Rates: Wong, Siah & Lo, Biostatistics 2019 (CC BY 4.0; corrigendum values) and BIO/Informa/QLS Clinical Development Success Rates 2011–2020 (cited, not reproduced). MIT Project ALPHA is not used — its terms restrict use to governmental, charitable or social purposes and bar redistribution.