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    Clinical Trial Results:
    NGR007: A phase II study of NGR-hTNF administered in combination with doxorubicin every 3 weeks in patients affected by advanced or metastatic small cell lung carcinoma (SCLC) previously treated with at least one therapeutic regimen.

    Summary
    EudraCT number
    2006-005700-14
    Trial protocol
    IT  
    Global end of trial date
    18 Nov 2015

    Results information
    Results version number
    v1(current)
    This version publication date
    05 May 2019
    First version publication date
    05 May 2019
    Other versions

    Trial information

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    Trial identification
    Sponsor protocol code
    NGR007
    Additional study identifiers
    ISRCTN number
    -
    US NCT number
    NCT00483509
    WHO universal trial number (UTN)
    -
    Sponsors
    Sponsor organisation name
    MolMed S.p.A.
    Sponsor organisation address
    Via Olgettina, 58, Milano, Italy, 20132
    Public contact
    Clinical Operations, MolMed S.p.A., 0039 02212771, clinical.operations@molmed.com
    Scientific contact
    Clinical Operations, MolMed S.p.A., 0039 02212771, clinical.operations@molmed.com
    Paediatric regulatory details
    Is trial part of an agreed paediatric investigation plan (PIP)
    No
    Does article 45 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Does article 46 of REGULATION (EC) No 1901/2006 apply to this trial?
    No
    Results analysis stage
    Analysis stage
    Final
    Date of interim/final analysis
    05 Dec 2017
    Is this the analysis of the primary completion data?
    No
    Global end of trial reached?
    Yes
    Global end of trial date
    18 Nov 2015
    Was the trial ended prematurely?
    No
    General information about the trial
    Main objective of the trial
    Antitumour activity defined as progression free survival (PFS).
    Protection of trial subjects
    The responsible investigator will ensure that this study is conducted in full conformance with either the principles of the "Declaration of Helsinki" (as amended in Tokyo, Venice, Hong Kong, South Africa and Edinburgh) or the laws and regulations of the country in which the study was conducted, whichever affords the greater protection to the individual. The protocol has been written and the study will be conducted in conformity to the "Guideline for Good Clinical Practice" (recommended for adoption at step 4 of the ICH process on 1 May 1996 and on 10 June 1996 by the ICH Steering Committee and acknowledged as ministerial decree, on 15 July 1997, by the Italian Ministry of Health). The study descriptions were submitted to the IEC before study start. All patient received all the information about the study and they gave their written acceptance through informed consent signature. Sponsor provided a full insurance coverage. All personal data complied with local law for privacy protection. All data recorded has been coded.
    Background therapy
    Patients previously treated with at least one therapeutic regimen (including treatment with doxorubicin, radiotherapy, chemotherapy).
    Evidence for comparator
    -
    Actual start date of recruitment
    14 Feb 2007
    Long term follow-up planned
    No
    Independent data monitoring committee (IDMC) involvement?
    No
    Population of trial subjects
    Number of subjects enrolled per country
    Country: Number of subjects enrolled
    Italy: 28
    Worldwide total number of subjects
    28
    EEA total number of subjects
    28
    Number of subjects enrolled per age group
    In utero
    0
    Preterm newborn - gestational age < 37 wk
    0
    Newborns (0-27 days)
    0
    Infants and toddlers (28 days-23 months)
    0
    Children (2-11 years)
    0
    Adolescents (12-17 years)
    0
    Adults (18-64 years)
    16
    From 65 to 84 years
    12
    85 years and over
    0

    Subject disposition

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    Recruitment
    Recruitment details
    Study period: 14 February 2007 (first enrollment); 17 May 2011 (LPLV). Between 14 February 2007 and 16 October 2007, 9 patients had previously been enrolled and treated with NGR-hTNF in monotherapy. Due to lack of monotherapy efficacy, this patient cohort was closed to accrual (data presented for descriptive purpose only). 5 clinical sites in Italy

    Pre-assignment
    Screening details
    Planned sample size: 27 patients; Patients screened n.: 28; Patients screening failure n.: 0.

    Period 1
    Period 1 title
    Overall trial (overall period)
    Is this the baseline period?
    Yes
    Allocation method
    Non-randomised - controlled
    Blinding used
    Not blinded

    Arms
    Arm title
    NGR-hTNF plus doxorubicin
    Arm description
    Patients will receive NGR-hTNF at dose of 0.8 μg/m² by a 60 minutes iv infusion in combination with doxorubicin 75 mg/m2 as slow infusion of 15 minutes starting 60 minutes after the end of NGR-hTNF infusion, every 3 weeks.
    Arm type
    Experimental

    Investigational medicinal product name
    NGR-hTNF
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Concentrate for solution for infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Patients will receive NGR-hTNF at dose of 0.8 μg/m² by a 60 minutes iv infusion, every 3 weeks. Before infusion to patients, NGR-hTNF in phosphate buffered saline (PBS) will be diluted to the appropriate concentration with 0.9% NaCl containing human serum albumin (HSA).

    Investigational medicinal product name
    Doxorubicin
    Investigational medicinal product code
    Other name
    Pharmaceutical forms
    Solution for injection/infusion
    Routes of administration
    Intravenous use
    Dosage and administration details
    Doxorubicin 75 mg/m2 will be administrated as slow infusion of 15 minutes starting 60 minutes after the end of NGR-hTNF infusion

    Number of subjects in period 1
    NGR-hTNF plus doxorubicin
    Started
    28
    Completed
    28

    Baseline characteristics

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    Baseline characteristics reporting groups
    Reporting group title
    NGR-hTNF plus doxorubicin
    Reporting group description
    Patients will receive NGR-hTNF at dose of 0.8 μg/m² by a 60 minutes iv infusion in combination with doxorubicin 75 mg/m2 as slow infusion of 15 minutes starting 60 minutes after the end of NGR-hTNF infusion, every 3 weeks.

    Reporting group values
    NGR-hTNF plus doxorubicin Total
    Number of subjects
    28 28
    Age categorical
    Patients >18 years affected by SCLC previously treated with at least one therapeutic regimen (including doxorubicin).
    Units: Subjects
        Adults (18-64 years)
    16 16
        From 65-84 years
    12 12
        85 years and over
    0 0
    Age continuous
    Units: years
        arithmetic mean (full range (min-max))
    62.5 (41.0 to 76.0) -
    Gender categorical
    Units: Subjects
        Female
    9 9
        Male
    19 19

    End points

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    End points reporting groups
    Reporting group title
    NGR-hTNF plus doxorubicin
    Reporting group description
    Patients will receive NGR-hTNF at dose of 0.8 μg/m² by a 60 minutes iv infusion in combination with doxorubicin 75 mg/m2 as slow infusion of 15 minutes starting 60 minutes after the end of NGR-hTNF infusion, every 3 weeks.

    Primary: progression free survival (PFS)

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    End point title
    progression free survival (PFS) [1]
    End point description
    Progression-free survival was defined as the time from the baseline CT scan to the first observation of disease progression, or death due to any cause, whichever occurred earlier, or the last date the patient was known to be progression free and alive. The proportion of Progression Free survivors at 18 weeks, will be computed on all registered patients, on an ITT basis.
    End point type
    Primary
    End point timeframe
    Progression free survival (PFS) at 18 weeks.
    Notes
    [1] - No statistical analyses have been specified for this primary end point. It is expected there is at least one statistical analysis for each primary end point.
    Justification: This is a single-arm study therefore a “comparison group” is not applicable. The PFS at 18 weeks, was computed on all registered patients, on an ITT basis. Kaplan-Meier curve of PFS, defined as the time from the baseline CT scan until the first observation of disease progression, or death due to any cause, whichever occurred earlier, or the last date the patient was known to be progression free or alive, was provided for descriptive purposes
    End point values
    NGR-hTNF plus doxorubicin
    Number of subjects analysed
    28
    Units: months
    13
    No statistical analyses for this end point

    Adverse events

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    Adverse events information
    Timeframe for reporting adverse events
    All Serious Adverse Events (SAE), related or not to the protocol treatment, occurring during the trial and within 30 days after the last treatment administration, were reported by MolMed S.p.A. within 24 hours of the initial observation of the event.
    Assessment type
    Systematic
    Dictionary used for adverse event reporting
    Dictionary name
    MedDRA
    Dictionary version
    22
    Reporting groups
    Reporting group title
    NGR-hTNF plus Doxorubicin
    Reporting group description
    -

    Serious adverse events
    NGR-hTNF plus Doxorubicin
    Total subjects affected by serious adverse events
         subjects affected / exposed
    7 / 28 (25.00%)
         number of deaths (all causes)
    28
         number of deaths resulting from adverse events
    Nervous system disorders
    Seizure
         subjects affected / exposed
    1 / 28 (3.57%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Blood and lymphatic system disorders
    Febrile neutropenia
         subjects affected / exposed
    1 / 28 (3.57%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Neutropenia
         subjects affected / exposed
    1 / 28 (3.57%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Anaemia
         subjects affected / exposed
    1 / 28 (3.57%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    General disorders and administration site conditions
    Infectious fever
    Additional description: Pirexia
         subjects affected / exposed
    1 / 28 (3.57%)
         occurrences causally related to treatment / all
    0 / 0
         deaths causally related to treatment / all
    0 / 0
    Mucosal Inflammation
    Additional description: Mucositis
         subjects affected / exposed
    1 / 28 (3.57%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Gastrointestinal disorders
    Enteritis
         subjects affected / exposed
    1 / 28 (3.57%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Stomatitis
    Additional description: Oral mucositis
         subjects affected / exposed
    1 / 28 (3.57%)
         occurrences causally related to treatment / all
    1 / 1
         deaths causally related to treatment / all
    0 / 0
    Respiratory, thoracic and mediastinal disorders
    Pulmonary embolism
    Additional description: Bilateral Acute Pulmonary Embolism
         subjects affected / exposed
    1 / 28 (3.57%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Musculoskeletal and connective tissue disorders
    Muscular weakness
    Additional description: Inferior Leg Hypostenia
         subjects affected / exposed
    1 / 28 (3.57%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Infections and infestations
    Wound infection
    Additional description: Wound Infection With Grade 4 Neutropenia
         subjects affected / exposed
    1 / 28 (3.57%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Pneumonia
    Additional description: Bilateral Pneumonia
         subjects affected / exposed
    1 / 28 (3.57%)
         occurrences causally related to treatment / all
    0 / 1
         deaths causally related to treatment / all
    0 / 0
    Frequency threshold for reporting non-serious adverse events: 5%
    Non-serious adverse events
    NGR-hTNF plus Doxorubicin
    Total subjects affected by non serious adverse events
         subjects affected / exposed
    28 / 28 (100.00%)
    Vascular disorders
    Flushing
         subjects affected / exposed
    1 / 28 (3.57%)
         occurrences all number
    1
    Hypertension
         subjects affected / exposed
    2 / 28 (7.14%)
         occurrences all number
    2
    Hypotension
         subjects affected / exposed
    2 / 28 (7.14%)
         occurrences all number
    2
    Phlebitis
         subjects affected / exposed
    2 / 28 (7.14%)
         occurrences all number
    2
    General disorders and administration site conditions
    Asthenia
         subjects affected / exposed
    5 / 28 (17.86%)
         occurrences all number
    6
    Chills
         subjects affected / exposed
    15 / 28 (53.57%)
         occurrences all number
    20
    Extravasation
         subjects affected / exposed
    1 / 28 (3.57%)
         occurrences all number
    1
    Fatigue
         subjects affected / exposed
    13 / 28 (46.43%)
         occurrences all number
    14
    Feeling cold
         subjects affected / exposed
    3 / 28 (10.71%)
         occurrences all number
    3
    Injection site pain
         subjects affected / exposed
    1 / 28 (3.57%)
         occurrences all number
    1
    Injection site reaction
         subjects affected / exposed
    1 / 28 (3.57%)
         occurrences all number
    1
    Mucosal inflammation
         subjects affected / exposed
    6 / 28 (21.43%)
         occurrences all number
    9
    Oedema peripheral
         subjects affected / exposed
    1 / 28 (3.57%)
         occurrences all number
    1
    Pyrexia
         subjects affected / exposed
    8 / 28 (28.57%)
         occurrences all number
    8
    Wound infection
         subjects affected / exposed
    1 / 28 (3.57%)
         occurrences all number
    1
    Reproductive system and breast disorders
    Pelvic pain
         subjects affected / exposed
    1 / 28 (3.57%)
         occurrences all number
    1
    Respiratory, thoracic and mediastinal disorders
    Cough
         subjects affected / exposed
    4 / 28 (14.29%)
         occurrences all number
    4
    Dyspnoea
         subjects affected / exposed
    5 / 28 (17.86%)
         occurrences all number
    6
    Hiccups
         subjects affected / exposed
    1 / 28 (3.57%)
         occurrences all number
    1
    Hypoxia
         subjects affected / exposed
    1 / 28 (3.57%)
         occurrences all number
    1
    Increased bronchial secretion
         subjects affected / exposed
    1 / 28 (3.57%)
         occurrences all number
    1
    Pulmonary embolism
         subjects affected / exposed
    1 / 28 (3.57%)
         occurrences all number
    1
    Rhinorrhoea
         subjects affected / exposed
    1 / 28 (3.57%)
         occurrences all number
    1
    Psychiatric disorders
    Confusional state
         subjects affected / exposed
    2 / 28 (7.14%)
         occurrences all number
    2
    Depression
         subjects affected / exposed
    2 / 28 (7.14%)
         occurrences all number
    2
    Insomnia
         subjects affected / exposed
    2 / 28 (7.14%)
         occurrences all number
    2
    Investigations
    Aspartate aminotransferase increased
         subjects affected / exposed
    1 / 28 (3.57%)
         occurrences all number
    1
    Blood alkaline phosphatase increased
         subjects affected / exposed
    1 / 28 (3.57%)
         occurrences all number
    1
    Blood bilirubin increased
         subjects affected / exposed
    1 / 28 (3.57%)
         occurrences all number
    1
    Blood uric acid increased
         subjects affected / exposed
    1 / 28 (3.57%)
         occurrences all number
    2
    Electrocardiogram abnormal
         subjects affected / exposed
    1 / 28 (3.57%)
         occurrences all number
    1
    Gamma-glutamyltransferase increased
         subjects affected / exposed
    2 / 28 (7.14%)
         occurrences all number
    2
    Injury, poisoning and procedural complications
    Allergic transfusion reaction
         subjects affected / exposed
    1 / 28 (3.57%)
         occurrences all number
    1
    Injury
         subjects affected / exposed
    1 / 28 (3.57%)
         occurrences all number
    1
    Cardiac disorders
    Aortic valve incompetence
         subjects affected / exposed
    1 / 28 (3.57%)
         occurrences all number
    1
    Aortic valve sclerosis
         subjects affected / exposed
    1 / 28 (3.57%)
         occurrences all number
    1
    Atrial fibrillation
         subjects affected / exposed
    1 / 28 (3.57%)
         occurrences all number
    1
    Atrial hypertrophy
         subjects affected / exposed
    1 / 28 (3.57%)
         occurrences all number
    1
    Bundle branch block bilateral
         subjects affected / exposed
    1 / 28 (3.57%)
         occurrences all number
    1
    Bundle branch block right
         subjects affected / exposed
    1 / 28 (3.57%)
         occurrences all number
    1
    Mitral valve incompetence
         subjects affected / exposed
    2 / 28 (7.14%)
         occurrences all number
    2
    Pericardial effusion
         subjects affected / exposed
    1 / 28 (3.57%)
         occurrences all number
    1
    Sinus tachycardia
         subjects affected / exposed
    3 / 28 (10.71%)
         occurrences all number
    3
    Nervous system disorders
    Convulsion
         subjects affected / exposed
    1 / 28 (3.57%)
         occurrences all number
    1
    Dizziness
         subjects affected / exposed
    2 / 28 (7.14%)
         occurrences all number
    2
    Headache
         subjects affected / exposed
    1 / 28 (3.57%)
         occurrences all number
    1
    Hypotonia
         subjects affected / exposed
    1 / 28 (3.57%)
         occurrences all number
    1
    Paraesthesia
         subjects affected / exposed
    2 / 28 (7.14%)
         occurrences all number
    3
    Blood and lymphatic system disorders
    Anaemia
         subjects affected / exposed
    16 / 28 (57.14%)
         occurrences all number
    17
    Febrile neutropenia
         subjects affected / exposed
    2 / 28 (7.14%)
         occurrences all number
    2
    Leukopenia
         subjects affected / exposed
    18 / 28 (64.29%)
         occurrences all number
    42
    Lymphopenia
         subjects affected / exposed
    12 / 28 (42.86%)
         occurrences all number
    15
    Neutropenia
         subjects affected / exposed
    17 / 28 (60.71%)
         occurrences all number
    38
    Thrombocytopenia
         subjects affected / exposed
    10 / 28 (35.71%)
         occurrences all number
    20
    Eye disorders
    Conjunctivitis
         subjects affected / exposed
    3 / 28 (10.71%)
         occurrences all number
    4
    Eyelid ptosis
         subjects affected / exposed
    1 / 28 (3.57%)
         occurrences all number
    1
    Gastrointestinal disorders
    Constipation
         subjects affected / exposed
    5 / 28 (17.86%)
         occurrences all number
    5
    Diarrhoea
         subjects affected / exposed
    4 / 28 (14.29%)
         occurrences all number
    7
    Enteritis
         subjects affected / exposed
    1 / 28 (3.57%)
         occurrences all number
    1
    Gastritis
         subjects affected / exposed
    2 / 28 (7.14%)
         occurrences all number
    2
    Glossodynia
         subjects affected / exposed
    1 / 28 (3.57%)
         occurrences all number
    1
    Nausea
         subjects affected / exposed
    12 / 28 (42.86%)
         occurrences all number
    14
    Regurgitation
         subjects affected / exposed
    1 / 28 (3.57%)
         occurrences all number
    1
    Vomiting
         subjects affected / exposed
    5 / 28 (17.86%)
         occurrences all number
    8
    Skin and subcutaneous tissue disorders
    Alopecia
         subjects affected / exposed
    3 / 28 (10.71%)
         occurrences all number
    3
    Dry skin
         subjects affected / exposed
    3 / 28 (10.71%)
         occurrences all number
    3
    Nail disorder
         subjects affected / exposed
    1 / 28 (3.57%)
         occurrences all number
    1
    Pruritus
         subjects affected / exposed
    2 / 28 (7.14%)
         occurrences all number
    5
    Skin exfoliation
         subjects affected / exposed
    2 / 28 (7.14%)
         occurrences all number
    3
    Skin hyperpigmentation
         subjects affected / exposed
    1 / 28 (3.57%)
         occurrences all number
    1
    Musculoskeletal and connective tissue disorders
    Back pain
         subjects affected / exposed
    2 / 28 (7.14%)
         occurrences all number
    2
    Bone pain
         subjects affected / exposed
    1 / 28 (3.57%)
         occurrences all number
    1
    Monarthritis
         subjects affected / exposed
    1 / 28 (3.57%)
         occurrences all number
    1
    Neck pain
         subjects affected / exposed
    1 / 28 (3.57%)
         occurrences all number
    1
    Osteoarthritis
         subjects affected / exposed
    1 / 28 (3.57%)
         occurrences all number
    1
    Infections and infestations
    Bronchitis
         subjects affected / exposed
    1 / 28 (3.57%)
         occurrences all number
    1
    Oral candidiasis
         subjects affected / exposed
    1 / 28 (3.57%)
         occurrences all number
    1
    Pneumonia
         subjects affected / exposed
    2 / 28 (7.14%)
         occurrences all number
    2
    Respiratory tract infection
         subjects affected / exposed
    1 / 28 (3.57%)
         occurrences all number
    1
    Urinary tract infection
         subjects affected / exposed
    3 / 28 (10.71%)
         occurrences all number
    3
    Metabolism and nutrition disorders
    Anorexia
         subjects affected / exposed
    10 / 28 (35.71%)
         occurrences all number
    11
    Hyperuricaemia
         subjects affected / exposed
    1 / 28 (3.57%)
         occurrences all number
    1
    Hypocalcaemia
         subjects affected / exposed
    1 / 28 (3.57%)
         occurrences all number
    1
    Hypokalaemia
         subjects affected / exposed
    2 / 28 (7.14%)
         occurrences all number
    2
    Hyponatraemia
         subjects affected / exposed
    1 / 28 (3.57%)
         occurrences all number
    1
    Metabolic acidosis
         subjects affected / exposed
    1 / 28 (3.57%)
         occurrences all number
    1

    More information

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    Substantial protocol amendments (globally)

    Were there any global substantial amendments to the protocol? Yes
    Date
    Amendment
    15 Jul 2007
    - The treatment with NGR-hTNF in monotherapy was replaced by the combination of NGR-hTNF plus doxorubicin. - The collection and analysis of Circulating tumor cells (CTCs) and circulating endothelial cells (CECs) was suspended. - Evaluation of adaptative immune response was deleted.

    Interruptions (globally)

    Were there any global interruptions to the trial? No

    Limitations and caveats

    Limitations of the trial such as small numbers of subjects analysed or technical problems leading to unreliable data.
    None reported
    For support, Contact us.
    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

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