Journal Publication

Selinexor-tislelizumab shows 75% response after PD-1 blockade failure in NK/T-cell lymphoma

The phase 1b TOUCH trial reports a 75% overall response and 43.8% complete response in 16 checkpoint-exposed patients with relapsed NK/T-cell lymphoma, a population with no established second-line standard.

By AppliedXLJuly 13, 2026Trial NCT04425070

Executive Summary

A checkpoint-experienced cohort of relapsed NK/T-cell lymphoma patients responded to a combination that pairs an oral nuclear export inhibitor with a PD-1 antibody, including responses in patients whose disease had not responded to checkpoint blockade at all.
Patients who progress after PD-1 blockade in this lymphoma have no established next therapy, so a response rate and durability signal in this specific population addresses a real treatment gap rather than replicating an existing option.
The regimen showed no dose-limiting toxicities, but more than half of patients had a grade 3 or higher treatment-related adverse event, primarily blood-count toxicity, a tolerability profile that will need larger follow-up to characterize fully.
The results come from a small, single-arm efficacy population, so durability and comparative benefit against other emerging options in this lymphoma remain to be established with longer follow-up and larger cohorts.

The stake

Relapsed or refractory extranodal NK/T-cell lymphoma (R/R NKTCL) is described in the published abstract as a highly lethal disease, particularly once patients progress after PD-1 blockade-based therapy. Preclinical work cited in the abstract suggested that inhibiting exportin-1 (XPO1), the nuclear-export protein selinexor targets, could enhance antitumor immunity and synergize with PD-1 blockade rather than simply repeating it. That rationale, re-engaging an immune response after checkpoint blockade has already failed, is the question this cohort was designed to test. Selinexor

How it was done

The trial is a multicenter, open-label phase 1b study conducted under the TOUCH acronym, evaluating selinexor plus tislelizumab in patients previously treated with L-asparaginase-containing regimens. It followed a standard 3+3 dose-escalation design before moving to dose expansion. Seventeen patients enrolled in this cohort; 16 had prior checkpoint-inhibitor exposure and made up the efficacy-evaluable population. Median follow-up reached 21.7 months. The broader registry trial, NCT04425070, is a Phase 1/2 study across 56 total enrolled patients in China evaluating selinexor-based regimens in relapsed peripheral T- and NK/T-cell lymphoma, with AEs/SAEs and overall response rate as its registered primary outcome measures. Selinexor+1

The result: 75% ORR, 43.8% CR

Among the 16 checkpoint-exposed, efficacy-evaluable patients, the overall response rate was 75.0% (12 of 16), including complete responses in 43.8% (7 of 16). Responses occurred even in patients whose disease had been primarily refractory to checkpoint blockade, meaning it had never responded to PD-1 therapy in the first place. Median progression-free survival was 6.1 months (95% CI, 2.9 to not estimable), with a 2-year progression-free survival rate of 37.5%. Median overall survival was not reached, and the 2-year overall survival rate was 73.4%, a durability signal that sits alongside the shorter median PFS and gives the response rate more weight than a short-lived remission would carry. Selinexor

Safety

No dose-limiting toxicities were observed in the dose-escalation design. Grade 3 or higher treatment-emergent adverse events occurred in 52.9% of patients, with hematologic toxicities, effects on blood cell counts, the most common category. The combination is described as having manageable toxicity alongside its activity, a tolerability read consistent with the known class-safety pattern for XPO1 inhibitors, which are hematologic-toxicity-driven agents. Selinexor

The competitive frame

No trial in the current Peripheral T-cell Lymphoma landscape shares selinexor's nuclear-export mechanism; the phase 3 programs advancing in this indication target HDAC (belinostat), EZH2 (XNW5004), JAK1 (golidocitinib) and DHFR (pralatrexate) instead. That makes this checkpoint-failure population, and the exportin-1 mechanism tested here, mechanistically distinct from the late-stage competitive set rather than a direct rival to it. The relevant comparison is not to those programs' response rates but to the absence of any established therapy once a patient has already progressed on PD-1 blockade, the specific gap this cohort was designed to address.

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