E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Advanced or metastatic predominantly transitional cell carcinoma of the urothelial tract. |
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E.1.1.1 | Medical condition in easily understood language |
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E.1.1.2 | Therapeutic area | Diseases [C] - Cancer [C04] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 15.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10046722 |
E.1.2 | Term | Urothelial carcinoma bladder stage IV |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
Progression-free survival rate (PFS-R) at 3 months after registration |
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E.2.2 | Secondary objectives of the trial |
- Overall response rate(ORR); duration of response; duration of stable disease - Response upgrade rate;disease control rate (DCR); duration of disease control - Progression free survival time (PFS); Time to treatment failure (TTF) - Overall survival time (OS) - Quality of life (EORTC QLQ-C30 questionnaire) - Safety and tolerability |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1) Patients aged ≥ 18 years 2) Histologically confirmed diagnosis of locally advanced or metastatic predominantly transitional cell carcinoma of the urothelium (TCCU) [urinary bladder, kidney, renal pelvis, or ureter]. Not amenable to definitive local/regional therapy. 3) Stable Disease, Partial Response or Complete Response as outcome of 1st line treatment with the gemcitabine-cisplatin combination for advanced/metastatic TCCU (confirmed or not). 4) Completion of 4 cycles of 1st line treatment with the gemcitabine-cisplatin combination for the chemo-naïve advanced/metastatic TCCU patient and no persistence of any adverse event > Grade 1 related to this treatment. 5) Last administration of gemcitabine and cisplatin (i.e. last day of administration of both compounds) ≤ 6 weeks before registration. 6) The patient must give written (personally signed and dated) informed consent before completing any study-related procedure which means any assessment or evaluation that would not be part of the routine medical care of the patient. 7) Women of childbearing potential must be using a medically accepted method of contraception (i.e. hormonal contraceptives, intrauterine devices) to avoid pregnancy during the 2 months preceding the start of study treatment, throughout the study period and for up to 3 months after the last dose of study treatment in such a manner that the risk of pregnancy is minimised. Women of childbearing potential must have a negative serum or urine pregnancy test within 72 hours prior to the start of study treatment. 8) Fertile men must be using an effective method of birth control, if their partners are women of childbearing potential, during the study period and up to 3 months after last administration of study medication. 9) ECOG performance status of 0 or 1 (patients aged ≥ 80 years with ECOG performance status 1 or ECOG performance status 0 and prior irradiation of the pelvic area are not eligible). 10) Estimated life expectancy of at least 3 months 11) Adequate haematological, renal and hepatic functions as evidenced by: - Absolute Neutrophil Count ≥ 1,500/mm³ (≥1.5 x 10^9/L) - Haemoglobin ≥ 9 g/dL - Platelet count ≥ 100,000/mm³ - Serum total bilirubin ≤1.5 x upper limit of normal (ULN) - Transaminases ≤ 2.5 x ULN [ ≤ 5 times ULN only in case of liver metastasis] - Alkaline phosphatase ≤ 5 x ULN -Calculated creatinine clearance (CrCL) (Cockroft-Gault): • ≥ 20 mL/min for age < 75 years • ≥ 40 mL/min for age ≥ 75 to < 80 years • > 60 mL/min for age ≥ 80 years
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E.4 | Principal exclusion criteria |
1) Patients aged < 18 years 2) Patients with predominantly non-TCCU (adenocarcinoma, squamous cell carcinoma or other). 3) Prior administration of any systemic anti-tumour therapy (other than Gemcitabine-cisplatin-combination) for treatment of TCCU. 4) Progressive Disease during or after 1st line treatment with the gemcitabine cisplatin combination for advanced/metastatic TCCU. 5) Known brain metastasis or leptomeningeal involvement (CT Scan/MRI not required to rule this out unless there is clinical suspicion of CNS disease). 6) Peripheral neuropathy ≥ Grade 2. 7) Any serious, concurrent illness or uncontrolled medical disorder including active infection requiring antibiotics within 2 weeks before registration, uncontrolled cardiac arrhythmia, unstable diabetes mellitus, uncontrolled hypercalcaemia, congestive heart failure, poorly controlled hypertension, unstable angina pectoris, or myocardial infarction within 6 months before registration. 8) Screening-electrocardiogram with any significant modifications suggesting a high risk of occurrence of an acute clinical event (such as angina pectoris, high risk arrhythmia, etc.). 9) Prior other malignancy. Note: Patients who have had another malignancy and who have been disease-free for at least 3 years or patients with a history of successfully treated basal cell carcinoma of the skin or in-situ cervix carcinoma or localised prostate cancer with limited risk of recurrence (pT ≤ 2b, Gleason score ≤ 7) that was incidentally discovered and did not lead to any other treatment apart from prostatectomy are eligible. 10) Known hypersensitivity to vinca alkaloids. 11) Prior radiation to ≥ 30% of the bone marrow or radiation not completed at least 28 days before registration or current persistence of any adverse event >Grade 1 related to this treatment. 12) Major surgery or trauma within 28 days before registration or presence of any major non-healing wound, fracture or ulcer. 13) Prior participation in an interventional clinical study investigating drugs within 30 days before registration, during the treatment period. 14) Current treatment with any potent CYP3A4-inhibitor or -inducer 15) Pregnant or lactating women or women with positive pregnancy test at screening. 16) Any serious and/or unstable pre-existing medical, psychiatric, psychological, familial, sociological, geographical or other condition that could interfere with the patient’s safety, provision of informed consent, or compliance with the study protocol. 17) Prisoners or persons who are compulsory detained (involuntary incarcerated). |
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E.5 End points |
E.5.1 | Primary end point(s) |
The primary endpoint is to determine the Progression-free survival rate (PFS-R) at 3 months after registration |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
3 months after registration |
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E.5.2 | Secondary end point(s) |
· Overall response rate(ORR); duration of response; duration of stable disease · Response upgrade rate;disease control rate (DCR); duration of disease control · Progression free survival time (PFS); Time to treatment failure (TTF) · Overall survival time (OS) · Quality of life (EORTC QLQ-C30 questionnaire) · Safety and tolerability |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | No |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | No |
E.8.1.1 | Randomised | Information not present in EudraCT |
E.8.1.2 | Open | Information not present in EudraCT |
E.8.1.3 | Single blind | Information not present in EudraCT |
E.8.1.4 | Double blind | Information not present in EudraCT |
E.8.1.5 | Parallel group | Information not present in EudraCT |
E.8.1.6 | Cross over | Information not present in EudraCT |
E.8.1.7 | Other | Information not present in EudraCT |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | Information not present in EudraCT |
E.8.2.2 | Placebo | Information not present in EudraCT |
E.8.2.3 | Other | 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.8.4.1 | Number of sites anticipated in Member State concerned | 3 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 20 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | No |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.7 | Trial 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
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The end of study is defined as at least 3 months after the last administration of Vinflunine in the last patient under study treatment. Survival information will be collected every 3 months until death or decision for study closure. |
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 3 |
E.8.9.1 | In the Member State concerned months | 7 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 3 |
E.8.9.2 | In all countries concerned by the trial months | 7 |
E.8.9.2 | In all countries concerned by the trial days | 0 |