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    Summary
    EudraCT Number:2009-016054-40
    Sponsor's Protocol Code Number:PM104-B-002-09
    National Competent Authority:Spain - AEMPS
    Clinical Trial Type:EEA CTA
    Trial Status:Completed
    Date on which this record was first entered in the EudraCT database:2009-11-23
    Trial results View results
    Index
    A. PROTOCOL INFORMATION
    B. SPONSOR INFORMATION
    C. APPLICANT IDENTIFICATION
    D. IMP IDENTIFICATION
    D.8 INFORMATION ON PLACEBO
    E. GENERAL INFORMATION ON THE TRIAL
    F. POPULATION OF TRIAL SUBJECTS
    G. INVESTIGATOR NETWORKS TO BE INVOLVED IN THE TRIAL
    N. REVIEW BY THE COMPETENT AUTHORITY OR ETHICS COMMITTEE IN THE COUNTRY CONCERNED
    P. END OF TRIAL
    Expand All   Collapse All
    A. Protocol Information
    A.1Member State ConcernedSpain - AEMPS
    A.2EudraCT number2009-016054-40
    A.3Full title of the trial
    Ensayo clínico de fase II, de optimización de dosis, abierto, de Zalypsis® (PM00104) en pacientes con mieloma múltiple recaído/refractario
    A.4.1Sponsor's protocol code numberPM104-B-002-09
    A.7Trial is part of a Paediatric Investigation Plan Information not present in EudraCT
    A.8EMA Decision number of Paediatric Investigation Plan
    B. Sponsor Information
    B.Sponsor: 1
    B.1.1Name of SponsorPharmaMar S.A.
    B.1.3.4CountrySpain
    B.3.1 and B.3.2Status of the sponsorCommercial
    B.4 Source(s) of Monetary or Material Support for the clinical trial:
    B.4.1Name of organisation providing support
    B.4.2Country
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisation
    B.5.2Functional name of contact point
    D. IMP Identification
    D.IMP: 1
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameZalypsis
    D.3.2Product code PM00104
    D.3.4Pharmaceutical form Powder for solution for infusion
    D.3.4.1Specific paediatric formulation Information not present in EudraCT
    D.3.7Routes of administration for this IMPIntravenous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.9.1CAS number 308359-57-1
    D.3.9.2Current sponsor codePM00104
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number2.5
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) Information not present in EudraCT
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy Information not present in EudraCT
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product Information not present in EudraCT
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 2
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.1.1Trade name Dexamethason-ratiopharm 4 mg Tabletten Dexamethason-ratiopharm 8 mg Tabletten
    D.2.1.1.2Name of the Marketing Authorisation holderRatiopharm GmbH
    D.2.1.2Country which granted the Marketing AuthorisationGermany
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameDexametasona
    D.3.4Pharmaceutical form Tablet
    D.3.4.1Specific paediatric formulation Information not present in EudraCT
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNDEXAMETASONA
    D.3.9.1CAS number 50-02-2
    D.3.9.3Other descriptive nameDEXAMETHASONE
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number4
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) Information not present in EudraCT
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy Information not present in EudraCT
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product Information not present in EudraCT
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.8 Information on Placebo
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    Mieloma Múltiple recaído / refractario
    MedDRA Classification
    E.1.3Condition being studied is a rare disease Yes
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    Fase de optimización:

    Objetivos principales:
    Determinar la dosis recomendada (DR) de PM00104 administrado como infusión i.v. de 1 hora los días 1, 8 y 15 cada cuatro semanas en pacientes con mieloma múltiple (MM) recaído/refractario.

    Fase de expansión:

    Objetivos principales:
    Analizar la eficacia del tratamiento con PM00104, en pacientes con MM recaído o refractario al tratamiento estándar a la DR establecida durante la fase de optimización de la dosis.
    E.2.2Secondary objectives of the trial
    Fase de optimización: Evaluar la seguridad y la tolerabilidad de PM00104, analizar la eficacia, después del tratamiento con PM00104, en pacientes con MM recaído o refractario al tratamiento estándar, obtener información farmacocinética (FC) y farmacogenómica (FGx) adicional.
    Fase de expansión: Evaluar la seguridad y la tolerabilidad de PM00104, obtener información FC y FGx adicional, evaluar variables de valoración de tiempo hasta acontecimiento.
    E.2.3Trial contains a sub-study Yes
    E.2.3.1Full title, date and version of each sub-study and their related objectives
    SUBESTUDIO DE FARMACOGENÓMICA
    E.3Principal inclusion criteria
    1. Los pacientes deben dar su consentimiento informado por escrito de acuerdo con las directrices institucionales y locales.
    2. Edad >/= ; 18 años.
    3. Los pacientes deben haber sido diagnosticados previamente de MM de acuerdo con los criterios diagnósticos del International Myeloma Working Group (IMWG) (véase el Apéndice 1).
    4. Los pacientes deben tener enfermedad recaída o recaído/refractaria de acuerdo con la definición del IMGW (Apéndice 6), después de al menos dos, pero no más de cinco regímenes terapéuticos previos para el MM (las líneas terapéuticas se definen en el Apéndice 2).
    5. Los pacientes deben tener enfermedad medible, definida como sigue: En el MM secretor, la enfermedad medible se define como cualquier valor de proteínas monoclonales séricas cuantificable y, cuando proceda, excreción urinaria de cadenas ligeras de >/= 200 mg/24 horas.
    En el caso del MM oligosecretor o no secretor, la enfermedad mensurable se define por la presencia de plasmocitomas de partes blandas (no óseos) determinada por la exploración física o estudios radiológicos aplicables (esto es, RM, TAC) y por la presencia de cadenas ligeras libres séricas anormales (FLC): nivel de FLC afectado >/= 10 mg/dl siempre que el cociente de FLC sérico sea anormal.
    6. Recuperación de cualquier toxicidad derivada de tratamientos previos. Se permite la presencia de alopecia y de neuropatía periférica sintomática de grado < 2 de los Criterios de Toxicidad Comunes del National Cancer Institute (NCI-CTCAE, versión 4.0 [v4.0]).
    7. Los pacientes deben tener los siguientes valores de laboratorio antes del comienzo del tratamiento:
    a) Recuento absoluto de neutrófilos (RAN) >/= 1,0 x 109/l, (>/= 0,5 x 109/l si se debe a afectación amplia y documentada de la médula ósea (MO) por la enfermedad de >/= 50% en biopsia de MO).
    b) Hemoglobina >/= 8 g/dl.
    c) Recuento de plaquetas >/= 50 x 109/l (>/= 25 x 1000000000 /l si se debe a afectación amplia y documentada de la MO por la enfermedad).
    d) Calcio sérico corregido < 14 mg/dl.
    e) Aspartato aminotransferasa (AST) y alanina aminotransferasa (ALT) </=2,5 x el límite superior del rango de valores normal (LSN).
    f) Albúmina >/= 2,0 g/dl.
    g) Bilirrubina directa: </=1,0 x LSN.
    h) Aclaramiento de creatinina calculado o medido: >/=30 ml/min (calculado de acuerdo con la American Kidney Foundation: http://www.kidney.org/professionals/kdoqi/gfr_calculator.cfm).
    8. Estado funcional (Eastern Cooperative Oncology Group, ECOG) </= 2 (véase el Apéndice 3).
    9. Esperanza de vida >/=3 meses.
    10. Fracción de eyección del ventrículo izquierdo (FEVI) mediante ecocardiograma (ECO) o ventrículografía isotópica (MUGA) por encima del límite inferior de la normalidad (FEVI de al menos el 50%); se prefiere ECO.
    E.4Principal exclusion criteria
    1. Tratamiento previo con PM00104.
    2. Mujeres embarazadas o en la lactancia; varones y mujeres con capacidad reproductiva que no estén utilizando un método anticonceptivo eficaz a lo largo del período de tratamiento y durante los 3 meses siguientes a la suspensión del mismo. Métodos anticonceptivos aceptables incluyen la abstinencia completa, los dispositivos intrauterinos (DIU), los anticonceptivos orales, los implantes subdérmicos y los métodos de doble barrera (preservativo con esponja anticonceptiva o supositorio anticonceptivo).
    3. Antecedentes de cualquier otra enfermedad neoplásica en los últimos cinco años (excepto carcinoma basocelular, epitelioma cutáneo o carcinoma in situ de cualquier localización).
    4. Otras enfermedades o condiciones clínicas adversas relevantes: insuficiencia cardíaca congestiva o angina pectoris, infarto de miocardio dentro de los 24 meses previos a la inclusión en el estudio, Cardiopatía valvular clínicamente relevante o insuficiencia cardíaca congestiva o amiloidosis cardíaca, Radioterapia mediastínica previa, tratamiento previo con antraciclinas a dosis acumuladas superiores a las equivalentes a 400 mg/m2 de doxorrubicina, arritmia sintomática (no se incluye la taquicardia sinusal relacionada con anemia de grado </= 2) o cualquier arritmia que precise tratamiento continuado y/o prolongación de QT-QTc de grado >/=2, hipertensión arterial no controlada (esto es, que precisó un cambio de medicación dentro de los últimos tres meses o un ingreso hospitalario en los últimos seis meses), historia de trastornos neurológicos o psiquiátricos importantes, infección activa no controlada o antecedentes recientes de infección activa aguda que precisa antibióticos sistémicos, antivíricos o antifúngicos dentro de las dos semanas anteriores a la primera dosis, características morfológicas o citológicas de mielodisplasia y/o aplasia postquimioterapia en la evaluación de la MO, hepatopatía no neoplásica importante (p. ej., cirrosis, hepatitis crónica activa).
    5. Paciente con positividad conocida para virus de la inmunodeficiencia humana (VIH) o antígeno de superficie de la hepatitis B o con infección activa por hepatitis C.
    6. Limitación de la capacidad del paciente para cumplir con el tratamiento o el seguimiento definido en el protocolo.
    7. Medicamentos concomitantes que incluyen corticosteroides u otro tratamiento que sea o puede ser activo frente al mieloma, dentro de las dos semanas previas al día 1 del ciclo 1. Se permiten los corticosteroides como tratamiento concomitante, siempre que se administren a una dosis equivalente de prednisona de </=10 mg al día, como antieméticos o premedicación de hemoderivados.
    8. Tratamiento con cualquier producto en fase de investigación en el período de </=5 x semividas antes de la inclusión en el estudio o 30 días después del tratamiento (en caso de semivida desconocida).
    9. Contraindicación para el uso de corticosteroides (p. ej., antecedentes relevantes de alteraciones en el estado de ánimo asociadas a tratamiento previo basado en esteroides, úlcera péptica).
    10. Hipercalcemia sintomática relacionada con la enfermedad a pesar de un tratamiento médico óptimo.
    11. Enfermedades endocrinas no controladas (p. ej., diabetes mellitus, hipotiroidismo o hipertiroidismo que precisaron cambios relevantes de medicación dentro del último mes o ingreso hospitalario en los últimos tres meses).
    E.5 End points
    E.5.1Primary end point(s)
    Tratamiento, seguridad, eficacia, farmacocinética, farmacogenómica, dosis-respuesta.
    E.6 and E.7 Scope of the trial
    E.6Scope of the trial
    E.6.1Diagnosis No
    E.6.2Prophylaxis No
    E.6.3Therapy Yes
    E.6.4Safety Yes
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic Yes
    E.6.7Pharmacodynamic No
    E.6.8Bioequivalence No
    E.6.9Dose response Yes
    E.6.10Pharmacogenetic No
    E.6.11Pharmacogenomic Yes
    E.6.12Pharmacoeconomic No
    E.6.13Others No
    E.7Trial type and phase
    E.7.1Human pharmacology (Phase I) No
    E.7.1.1First administration to humans Information not present in EudraCT
    E.7.1.2Bioequivalence study Information not present in EudraCT
    E.7.1.3Other Information not present in EudraCT
    E.7.1.3.1Other trial type description
    E.7.2Therapeutic exploratory (Phase II) Yes
    E.7.3Therapeutic confirmatory (Phase III) No
    E.7.4Therapeutic use (Phase IV) No
    E.8 Design of the trial
    E.8.1Controlled No
    E.8.1.1Randomised Information not present in EudraCT
    E.8.1.2Open Information not present in EudraCT
    E.8.1.3Single blind Information not present in EudraCT
    E.8.1.4Double blind Information not present in EudraCT
    E.8.1.5Parallel group Information not present in EudraCT
    E.8.1.6Cross over Information not present in EudraCT
    E.8.1.7Other Information not present in EudraCT
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) Information not present in EudraCT
    E.8.2.2Placebo Information not present in EudraCT
    E.8.2.3Other Information not present in EudraCT
    E.8.3 The trial involves single site in the Member State concerned No
    E.8.4 The trial involves multiple sites in the Member State concerned Yes
    E.8.4.1Number of sites anticipated in Member State concerned4
    E.8.5The trial involves multiple Member States No
    E.8.6 Trial involving sites outside the EEA
    E.8.6.1Trial being conducted both within and outside the EEA No
    E.8.6.2Trial being conducted completely outside of the EEA Information not present in EudraCT
    E.8.7Trial has a data monitoring committee No
    E.8.8 Definition of the end of the trial and justification where it is not the last visit of the last subject undergoing the trial
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years3
    E.8.9.1In the Member State concerned months0
    E.8.9.1In the Member State concerned days0
    F. Population of Trial Subjects
    F.1 Age Range
    F.1.1Trial has subjects under 18 No
    F.1.1.1In Utero Information not present in EudraCT
    F.1.1.2Preterm newborn infants (up to gestational age < 37 weeks) Information not present in EudraCT
    F.1.1.3Newborns (0-27 days) Information not present in EudraCT
    F.1.1.4Infants and toddlers (28 days-23 months) Information not present in EudraCT
    F.1.1.5Children (2-11years) Information not present in EudraCT
    F.1.1.6Adolescents (12-17 years) Information not present in EudraCT
    F.1.2Adults (18-64 years) Yes
    F.1.3Elderly (>=65 years) Yes
    F.2 Gender
    F.2.1Female Yes
    F.2.2Male Yes
    F.3 Group of trial subjects
    F.3.1Healthy volunteers No
    F.3.2Patients Yes
    F.3.3Specific vulnerable populations Yes
    F.3.3.1Women of childbearing potential not using contraception No
    F.3.3.2Women of child-bearing potential using contraception Yes
    F.3.3.3Pregnant women No
    F.3.3.4Nursing women No
    F.3.3.5Emergency situation No
    F.3.3.6Subjects incapable of giving consent personally No
    F.3.3.7Others No
    F.4 Planned number of subjects to be included
    F.4.1In the member state55
    F.5 Plans for treatment or care after the subject has ended the participation in the trial (if it is different from the expected normal treatment of that condition)
    Los pacientes que abandonen el tratamiento sin progresión serán seguidos y tratados con el tratamiento habitual que el médico le asigne.
    G. Investigator Networks to be involved in the Trial
    N. Review by the Competent Authority or Ethics Committee in the country concerned
    N.Competent Authority Decision Authorised
    N.Date of Competent Authority Decision2010-02-08
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2010-01-15
    P. End of Trial
    P.End of Trial StatusCompleted
    P.Date of the global end of the trial2013-07-30
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