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Article History

Received: 22 October 2025

Accepted: 12 February 2026

First Online: 13 March 2026

Declarations

:

: Albiruni Razak reports research funding from Karyopharm Therapeutics. Amit Mahipal reports nothing to declare. Jennifer Diamond reports stock options and consulting fees from OnKure Therapeutics, consulting fees from Gilead. Research funding to institution for clinical trials from Takeda, Merck, Gilead, PUMA, Cosmo, Adlai Nortye, Mersana, AZ, BeOne, and MBrace. Antoni Ribas reports honoraria from consulting with Amgen and Merck, is or has been a member of the scientific advisory board and holds stock in Apricity, Arcus, Compugen, CytomX, Kite-Gilead, Larkspur, Lutris, Lyell, Merus, Sastra, Synthekine and Tango, has received research funding from Agilent and from Bristol-Myers Squibb through Stand Up to Cancer (SU2C), and patent royalties from Arsenal Bio. Jordan David Berlin reports current research support from Abbvie, Astellas, Atreca, Bayer, Dragonfly, I-Mab, Lilly, Incyte, EMD Serono, Pfizer, BMS, Tyra, Totus, Sumitomo Dainippon Pharma Oncology, 23 and me, parthenon/Incendia, hibercell, ribosciences, NCI, BMS; advisory boards for the past 3 years for Mirati, EMD Serono, Ipsen, Merck, Sharp, Dohme, Merus, Bms, Bexion (unpaid), Mekanistic, Agenus (pending), Astellas, Amplia, Taiho, Regeneron 1/25, Beigene 1/25; DSMB for Astra Zeneca, Novocure, Boehringer-Ingelheim, I-SPY and; IDSC work and ECOG-ACRIN GI Chair for NCI. Asfar S. Azmi received research funding from Colorado Chromatography, Blackstone Therapeutics, Purple Biotec, FanWave, RLL Therapeutics and Exelixis. Asfar S. Azmi serves as a council advisory member for Guidepoint and GLG. Tomer Mark, Christopher Walker, Yi Chai, Trinayan Kashyap, and Girish Gudi are employees of Karyopharm Therapeutics. Aung Naing reports research funding from NCI, EMD Serono, MedImmune, Healios Onc. Nutrition, Atterocor/Millendo, Amplimmune, ARMO BioSciences, Karyopharm Therapeutics, Incyte, Novartis, Regeneron, Merck, Bristol-Myers Squibb, Pfizer, CytomX Therapeutics, Neon Therapeutics, Calithera Biosciences, TopAlliance Biosciences, Eli Lilly, Kymab, PsiOxus, Arcus Biosciences, NeoImmuneTech, Immune-Onc Therapeutics, Surface Oncology, Monopteros Therapeutics, BioNTech SE, Seven & Eight Biopharma, SOTIO Biotech AG, and GV20 Therapeutics; advisory board/consulting fees from CTI, Deka Biosciences, Janssen Biotech, Mural Oncology, NGM Bio, PsiOxus Therapeutics, Immune-Onc Therapeutics, STCube Pharmaceuticals, OncoSec KEYNOTE-695, Genome & Company, CytomX Therapeutics, Nouscom, Merck Sharp & Dohme Corp, Servier, Lynx Health, AbbVie; Travel and accommodation expense from ARMO BioSciences, NeoImmuneTech, NGM Biopharmaceuticals, and honoraria for speaking engagements from AKH Inc, The Lynx Group, Society for Immunotherapy of Cancer (SITC), Korean Society of Medical Oncology (KSMO), Scripps Cancer Care Symposium, ASCO Direct Oncology Highlights, European Society for Medical Oncology (ESMO), CME Outfitters.

: This study was approved and performed in accordance with the International Conference on Harmonization, the Guidelines for Good Clinical Practice, appropriate regulatory requirements, including the Declaration of Helsinki, and with the approval of institutional review boards at individual enrolling institutions. The study was designed by the sponsor (Karyopharm Therapeutics).

: All patients provided written informed consent before study start.

: Not applicable.

: Karyopharm Therapeutics is committed to providing qualified scientific and medical researchers access to anonymized data and protocols from the company’s clinical trials for the purpose of conducting legitimate research. Karyopharm is also obligated to protect the rights and privacy of trial participants and, as such, has a procedure in place for evaluating and fulfilling requests for sharing company clinical trial data with qualified external scientific researchers as informed by industry guidelines. Data requestors can submit a proposal to medicalinformation@karyopharm.com .

: Not applicable.

: A.R.: Resources, investigation, formal analysis, writing—original draft, writing—review and editing. A.M.: writing—review and editing. J.D.: writing—review and editing. A.R.: writing—review and editing. J.D.B: writing—review and editing. A.A.: writing—review and editing. T.M: writing—review and editing. C.W.: Investigation and data curation. Y.C.: formal analysis. T.K.: Investigation and data curation. G.G.: Investigation, analysis, review and data curation. A.N.: Resources, investigation, formal analysis, writing—original draft, writing—review and editing.