Karyopharm Therapeutics reported mixed topline results from its phase III Sentry trial of Xpovio (selinexor) plus ruxolitinib in front-line myelofibrosis, meeting one co-primary endpoint on spleen volume reduction while missing statistical significance on a symptom score measure. The company said the data show a potentially promising overall survival signal with the combination. In a results framework centered on rapid, deep, and sustained spleen volume reduction, the trial’s spleen endpoint achieved statistical significance for patients achieving 35% or greater reduction. Karyopharm reported that symptom improvements at week 24 were comparable between arms, with the between-group difference not reaching statistical significance. Despite the miss on the second endpoint, Karyopharm said it plans to meet with the FDA about the prospects for a supplemental NDA (sNDA) for the myelofibrosis indication. The update keeps attention on selinexor’s role in combination regimens in MF and highlights how label outcomes may hinge on endpoint interpretation and regulatory willingness to weigh survival signals alongside mixture of efficacy measures.