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    Summary
    EudraCT Number:2011-001230-42
    Sponsor's Protocol Code Number:CTKI258A2210
    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:2012-01-30
    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 number2011-001230-42
    A.3Full title of the trial
    A multicenter, randomized, double blind, placebo controlled, phase II trial evaluating the safety and efficacy of TKI258 combined with fulvestrant, in postmenopausal patients with HER2- and HR+ breast cancer that have evidence of disease progression on or after prior endocrine therapy
    Estudio fase II, multicéntrico, aleatorizado, doble ciego, controlado con placebo que evalúa la seguridad y la eficacia de TKI258 combinado con fulvestrant, en pacientes postmenopáusicas con cáncer de mama RH+ y HER2- con evidencia de progresión de la enfermedad durante o después de terapia endocrina previa
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    An exploratory clinical study to evaluate the safety and efficacy of the new medicine TKI258 together with fulvestrant (a currently used medicinal product in the treatment of advanced breast cancer) compared to fulvestrant alone in postmenopausal women with specific kind of advanced breast cancer which has progressed after prior hormonal therapy.
    Un estudio clínico exploratorio para evaluar la seguridad y la eficacia del nuevo medicamento TKI258 junto con fulvestrant (un producto actualmente en uso medicinal en el tratamiento del cáncer de mama avanzado) en comparación con fulvestrant solo en mujeres posmenopáusicas con tipo específico de cáncer de mama avanzado que ha progresado a terapia hormonal previa.
    A.4.1Sponsor's protocol code numberCTKI258A2210
    A.7Trial is part of a Paediatric Investigation Plan No
    A.8EMA Decision number of Paediatric Investigation Plan
    B. Sponsor Information
    B.Sponsor: 1
    B.1.1Name of SponsorNovartis Farmacéutica, 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 supportNovartis Farmacéutica, S.A.
    B.4.2CountrySpain
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationNovartis Farmacéutica, S.A.
    B.5.2Functional name of contact pointJavier Malpesa
    B.5.3 Address:
    B.5.3.1Street AddressGran Via de les Corts Catalanes, 764
    B.5.3.2Town/ cityBarcelona
    B.5.3.3Post code08080
    B.5.3.4CountrySpain
    B.5.4Telephone number0034933064464
    B.5.5Fax number0034933064290
    B.5.6E-maileecc.novartis@novartis.com
    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 nameDovitinib
    D.3.2Product code TKI258
    D.3.4Pharmaceutical form Capsule, hard
    D.3.4.1Specific paediatric formulation No
    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 INNDovitinib
    D.3.9.1CAS number 915769-50-5
    D.3.9.2Current sponsor codeTKI258
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number100
    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) No
    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 No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    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 No
    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 RoleComparator
    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 Faslodex sol inj 250 mg/5ml 1 syringe 5 ml
    D.2.1.1.2Name of the Marketing Authorisation holderAstra Zeneca UK ltd
    D.2.1.2Country which granted the Marketing AuthorisationSpain
    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 nameFaslodex
    D.3.2Product code Fulvestrant
    D.3.4Pharmaceutical form Solution for injection
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPIntramuscular use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNFULVESTRANT
    D.3.9.1CAS number 129453-61-8
    D.3.9.2Current sponsor codeFulvestrant
    D.3.9.4EV Substance CodeSUB13933MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number250 to mg
    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) No
    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 No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    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 No
    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
    D.8 Placebo: 1
    D.8.1Is a Placebo used in this Trial?Yes
    D.8.3Pharmaceutical form of the placeboCapsule, hard
    D.8.4Route of administration of the placeboOral use
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    Breast cancer, HER2 negative and HR positive, with evidence of disease progression after prior endocrine therapy
    Pacientes postmenopáusicas con cáncer de mama RH+ y HER2- con evidencia de progresión de la enfermedad durante o después de terapia endocrina previa
    E.1.1.1Medical condition in easily understood language
    Certain type of breast cancer which has progressed after prior hormonal treatment
    Determinado tipo de cancer de mama que ha progresado a un tratamiento hormonal previo.
    E.1.1.2Therapeutic area Diseases [C] - Cancer [C04]
    MedDRA Classification
    E.1.3Condition being studied is a rare disease No
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    To assess the treatment effect of TKI258 in combination with fulvestrant vs. fulvestrant plus placebo on Progression-Free Survival (PFS) per local investigator assessment in patients with HER2-, HR+, locally advanced or metatastic breast cancer (LA/mBC) that have evidence of disease progression on or after prior endocrine therapy for each of the 2 groups, namely, i) FGF pathway amplified and ii) regardless of FGF pathway amplification status.
    Objetivo primario: Evaluar el efecto del tratamiento de TKI258 en combinación con fulvestrant vs fulvestrant y placebo en la supervivencia libre de progresión (PFS) por la evaluación del investigador local en pacientes con HER2-, RH +, cáncer de mama localmente avanzado o metastático (LA / MBC) que tienen evidencia de progresión de la enfermedad durante o después de la terapia endocrina previa para cada uno de los dos grupos, i) vía FGF amplificada y ii) independientemente del estado amplificación de la vía FGF
    E.2.2Secondary objectives of the trial
    To evaluate TKI258 in combination with fulvestrant vs. fulvestrant plus placebo with respect to Overall Response Rate (ORR) in patients with HER2-, HR+, LA/mBC that have evidence of disease progression on or after prior endocrine therapy for each of the 2 groups, namely, i) FGF pathway amplified and ii) regardless of FGF pathway amplification status.

    To evaluate TKI258 in combination with fulvestrant vs. fulvestrant plus placebo with respect to Duration of Response (DOR) for each of the 2 groups, namely, i) FGF pathway amplified and ii) regardless of FGF pathway amplification status

    To evaluate TKI258 in combination with fulvestrant vs. fulvestrant plus placebo with respect to Overall Survival (OS) for each of the 2 groups, namely, i) FGF pathway amplified and ii) regardless of FGF pathway amplification status.

    And other secondary objectives as per study protocol
    -Evaluar TKI258 en combinación con fulvestrant vs fulvestrant y placebo con respecto a la tasa de respuesta global (ORR) en pacientes con HER2-, RH +, LA / MBC que tienen evidencia de progresión de la enfermedad durante o después de la terapia endocrina previa para cada uno de los 2 grupos, i) vía FGF amplificada y ii) independientemente del estado de amplificación de la via FGF.
    -Evaluar TKI258 en combinación con fulvestrant vs fulvestrant y placebo con respecto a la duración de la respuesta (DOR) para cada uno de los dos grupos, i) vía FGF amplificada y ii) independientemente del estado de amplificación de la via FGF
    -Evaluar TKI258 en combinación con fulvestrant vs fulvestrant y placebo con respecto a la supervivencia global (SG) para cada uno de los dos grupos, i) vía FGF amplificada y ii) independientemente del estado de amplificación de la via FGF
    -Otros objetivos secundarios.
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    Written informed consent obtained prior to any study procedures, including screening assessments

    Postmenopausal (? 18 years) women with HER2-, HR+ (ER+ and/or PgR+), locally advanced or metastatic breast cancer not amenable to curative treatment by surgery or radiotherapy. Postmenopausal status is defined either by:
    ? Age ? 55 years and one year or more of amenorrhea, or
    ? Age < 55 years and one year or more of amenorrhea in the absence of ovarian suppression, with an estradiol assay < 20 pg/mL, or
    ? Surgical menopause with bilateral oophorectomy. Note that it is not possible to assign menopause status to women who are receiving an LH-RH agonist or antagonist.

    Breast cancer that has progressed on or after prior endocrine therapy, with radiological evidence of recurrence or progression as follows:
    ? While on, or within 12 months of end of adjuvant treatment with any endocrine therapy (e.g., tamoxifen, exemestane, anastrozole, letrozole, etc.)
    ? While on, or within 1 month of end of any endocrine therapy treatment for LA/mBC

    Have measurable disease as per RECIST v1.1 (Appendix 1) or non-measurable lytic or mixed (lytic + blastic) bone lesions in the absence of measurable disease. Patients with only non-measurable lesions and no lytic or a mix of lytic and sclerotic bone metastasis (e.g. pleural effusion, ascites) are not eligible. Note: a) measurable lesions include lytic or mixed (lytic + blastic) bone lesions with an identifiable soft tissue component that meets the measurability criteria per RECIST v1.1, and; b) lesions in previously irradiated areas should not be considered measurable, unless they have clearly progressed since the radiotherapy

    Eastern Cooperative Oncology Group (ECOG) performance status that is not greater than 2 (i.e., either 0 or 1 or 2).

    Have the following laboratory values:
    a. Absolute neutrophil count (ANC) ? 1.5 x 109/L
    b. Platelets ? 100 x 109/L
    c. Hemoglobin (Hgb) > 9 g/dL
    d. Serum total bilirubin ? 1.5 x ULN
    e. ALT and AST ? 3.0 x ULN (with or without liver metastases)
    f. Serum creatinine ? 1.5 x ULN or Creatinine clearance by 24 hr urine is ? 30 mL/min
    OR: Serum creatinine >1.5 - 3 x ULN with calculated creatinine clearance (CrCl) is ? 30 mL/min using the Cockroft-Gault equation, per the formula provided here: CrCl = ([140-age (years)] x weight (kg) / [72 x serum Cr (mg/dL)]) x .85

    Have completely recovered from major effects of prior radiotherapy and from any drug-related adverse events (AEs) associated with previous treatments, excluding alopecia and grade 1 peripheral neuropathy according to the National Cancer Institute CTCAE, v. 4.03

    Provide archival (paraffin embedded tissue or a minimum of 20 unstained slides) or fresh tumor tissues from which the FGF pathway status can be determined by an Novartis designated laboratory
    -Los pacientes deben otorgar el consentimiento informado por escrito para participar en este estudio antes de realizar cualquier procedimiento del ensayo incluyendo pruebas de screening.
    -Mujeres postmenopáusicas (? 18 years) con HER2-, HR+ (ER+ y/o PgR+), con cancer de mama localmente avanzado o metastasico no candidatos a tratamiento con cirugía o radioterapia. El status post-menopausico se define como:
    -Edad? 55 años y con un año o mas de amenorrea
    -Edad? 55 años y con un año o mas de amenorrea en ausencia de supresión ovárica, con niveles de estradiol< 20 pg/mL
    -Menopausia quirúrgica con ooforectomía bilateral. No es posible considerar post-menopausica a una mujer que esta recibiendo un agonista o antagonista de LH-RH
    -Cáncer de mama que ha progresado tras o durante una terapia endocrina, con evidencia radiológica de recurrencia o progresión tras
    -Durante o en los 12 meses posteriores al fin de la terapia con tratamiento adyuvante con cualquier terapia endocrina (ej tamoxifen, exemestano, anastrozole, letrozole, etc)
    - Durante o en el mes posterior al fin de la terapia endocrina con LA/mBC.
    -Enfermedad medible por criterios RECIST v.1.1 (apendice 1) o lesiones óseas no medible líticas o ambas (lítica+blastica) en ausencia de enfermedad medible. Pacientes con solo lesiones no medibles y no líticas o mixtas líticas y escleróticas (ej.derrame pleural, ascitis) no son elegibles. Considerar: a) lesiones medibles incluyen lesiones óseas líticas o mixtas (líticas+blasticas) con componente tisular identificable que cumple con los criterios de medibilidad RECIST v.1.1 y b) Lesiones en aéreas previamente irradiadas no deben considerarse medibles, excepto si hay signos claros de progresión desde la radioterapia.
    - Valor de ECOG performance status no superior a 2 (ej 0, 1 o 2)
    - Con los siguientes valores de laboratorio:
    a. Recuento de Neutrofilos (ANC) ? 1.5 x 109/L
    b. Plaquetas ? 100 x 109/L
    c. Hemoglobina (Hgb) > 9 g/dL
    d. Bilirrubina total en suero ? 1.5 x ULN
    e. ALT y AST ? 3.0 x ULN (con o sin metastasis hepaticas)
    f. Creatinina sérica ? 1.5 x ULN or Aclaramiento de creatinina por analisis de orina de 24 hr ? 30 mL/min
    O: Creatinina sérica >1.5 - 3 x ULN con Aclaramiento de creatinina calculado (CrCl) ? 30 mL/min usando la fórmula de Cockroft-Gault equation,: CrCl = ([140-edad (años)] x peso (kg) / [72 x Cr sérica(mg/dL)]) x .85
    - Completamente recuperados de los efectos de radioterapia previa y sin efectos adversos relacionados con tratamientos previos, excluyendo la alopecia y la neuropatía periferica grado 1 de acuerdo con los CTCAE v. 4.03
    -Proporcionar una muestra de tumor archivado (bloque de tumor en parafina o 20 slides) o muestra de tumor fresca para investigar el status de la via FGF que será determinado por un laboratorio designado por Novartis.
    E.4Principal exclusion criteria
    Evidence of central nervous system (CNS) or leptomeningeal metastases. A brain CT scan or MRI is mandatory at screening prior to study entry

    HER2 over expression as depicted by local laboratory IHC 3+ or FISH testing.

    Previously treated with fulvestrant as a single agent or in combination with other therapies or FGFR inhibitors

    Have any contraindication for being treated with fulvestrant 500 mg as described in the local approved prescribing information

    Received more than one line of any prior hormonal therapy for LA/mBC. Any adjuvant/neo adjuvant therapy is allowed

    Received any chemotherapy for LA/mBC

    Concurrent use of any other approved or investigational anticancer agents, including hormonal agents

    Having participated in a prior investigational study within 30 days prior to enrollment or ? 5 half-lives of the investigational product, whichever is longer

    Received the last administration of anti-cancer targeted small molecule therapy (e.g. sunitinib, sorafenib, pazopanib, axitinib, everolimus, temsirolimus, radaforolimus) ? 2 weeks prior to starting study drug, or who have not recovered from the side effects of such therapy

    Received the last administration of an anti-cancer monoclonal antibody, immunotherapy, hormonal therapy, or chemotherapy (except nitrosoureas and mitomycin-C) ? 4 weeks prior to starting study drug or who have not recovered from the side effects of such therapy

    Received the last administration of nitrosourea or mitomycin-C ? 6 weeks prior to starting study drug, or who have not recovered from the side effects of such therapy

    Received radiotherapy ? 4 weeks prior to starting the study drug or who have not recovered from radiotherapy-related toxicities (palliative radiotherapy for bone lesions ? 2 weeks prior to starting study drug is allowed)

    Undergone major surgery (e.g., intra-thoracic, intra-abdominal or intra-pelvic) ? 4 weeks prior to starting study drug or who have not recovered from side effects of such surgery

    With a history of pulmonary embolism (PE), or untreated deep venous thrombosis (DVT) ? 6 months prior to starting study drug

    Impaired cardiac function or clinically significant cardiac diseases, including any of the following:
    ? History or presence of serious uncontrolled ventricular arrhythmias.
    ? Clinically significant resting bradycardia (< 50 beats /minute)
    ? LVEF assessed by 2-D echocardiogram (ECHO) < 50% or lower limit of normal (whichever is higher) or multiple gated acquisition scan (MUGA) < 45% or lower limit of normal (whichever is higher)
    ? Any of the following within 6 months prior to starting study drug: myocardial infarction, severe/unstable angina, coronary artery bypass graft, congestive heart failure, cerebrovascular accident, transient ischemic attack
    ? Uncontrolled hypertension defined by a SBP ? 160 mm Hg and/or DBP ? 100 mm Hg, with or without anti-hypertensive medication(s). Initiation or adjustment of antihypertensive medication(s) is allowed prior to study entry

    Currently receiving anti-platelet therapy of prasugrel or clopidogrel, or full dose anticoagulation treatment with therapeutic doses of warfarin. However, treatment with low doses of warfarin (e.g., ? 2 mg/day) or locally accepted low doses of acetylsalicylic acid (up to 100 mg daily) to prevent cardiovascular events or strokes is allowed

    Concurrent malignancy or malignancy within 3 years prior to study enrollment, with the exception of adequately treated basal cell carcinoma, squamous cell carcinoma or other non-melanomatous skin cancer, or in-situ carcinoma of the uterine cervix

    Bilateral diffuse lung lymphangitic carcinomatosis or other life-threatening visceral metastases requiring immediate cytotoxic therapy

    Impairment of gastrointestinal (GI) function or GI disease that may significantly alter the absorption of TKI258 (e.g. ulcerative diseases, uncontrolled nausea, vomiting, diarrhea, malabsorption syndrome, or had gastric or small bowel resection)

    Cirrhosis, chronic active hepatitis or chronic persistent hepatitis

    Have Child-Pugh B or worse hepatic impairment

    Known history of human immunodeficiency virus (HIV) infection (HIV testing is not mandatory unless required by local regulations)

    Any concurrent severe and/or uncontrolled medical conditions which could compromise participation in the study or interfere with study results

    Unwilling or unable to comply with the protocol
    -Evidencia de metastasis en el sistema nervioso central (CNS) o metastasis leptomeningeas. Se requiere un TAC cerebral o RMN en el screening.
    - Sobreexpresión de HER2 según resultados de laboratorio local por IHC 3+ o test FISH
    - Previamente tratados con fulvestrant como agente único o en combinación con otras terapias o inhibidores FGFR
    - Pacientes contraindicados a poder ser tratados con fulvestrant 500 mg según la prescripción local aprobada.
    - Pacientes que hayan recibido mas de una línea de cualquier terapia hormonal para LA/mBC. Cualquier terapia adyuvante/neoadyuvante esta permitida.
    - Pacientes que hayan recibido cualquier quimioterapia para LA/mBC
    - Uso concurrente de cualquier otro agente anti cancerígeno en investigación, incluyendo agentes hormonales.
    - Pacientes que hayan participado previamente en un estudio de investigación durante los 30 días anteriores a la inclusión o ? 5 semividas del producto en investigación, el que sea mas largo.
    - Pacientes que hayan recibido la última administración de terapia dirigida de molecula pequeña (ej sunitinib, sorafenib, pazopanib, axitinib, everolimus, temsirolimus, radaforolimus) ? 2 semanas antes de empezar el fármaco del estudio o que no se hayan recuperado de los efectos de la terapia.
    - Pacientes que hayan recibido la última terapia con anticuerpos monoclonales, inmunoterapia, terapia hormonar o quimioterapia (excepto nitrosureas y mitomicina-C) ? 4 semanas antes de empezar el fármaco del estudio o que no se hayan recuperado de los efectos de la terapia.
    -Pacientes que hayan recibido la última administración de nitrosurea o mitomicina-C ? 6 semanas antes de empezar el fármaco del estudio o que no se hayan recuperado de los efectos de la terapia.
    -Pacientes que hayan recibido radioterapia ? semanas antes de empezar el fármaco del estudio o que no se hayan recuperado de los efectos tóxicos de la terapia (la radioterapia paliativa para las lesiones óseas esta permitida hasta ? 2 semanas antes de empezar el estudio)
    -Pacientes que hayan recibido cirugía (ej intratorácica, intra-abdominal o intra-pelvica) ? 4 semanas antes de empezar el estudio o que no se hayan recuperado de sus efectos
    -Pacientes con historial de tromboembolismo pulmonar (EP) o trombosis venosa no tratada ? 6 semanas antes de empezar el estudio
    Función cardíaca dañada o enfermedad cardíaca clínicamente significativa, incluyendo cualquiera de las siguientes;
    ? Historial o presencia de arritmias ventriculares no controladas.
    ? Braquicardia clínicamente significativa (< 50 latidos /minuto)
    ? LVEF evaluado con ecocardiograma 2D (ECHO) < 50% o por debajo del límite normal (el que sea mayor) o MUGA < 45% o por debajo del límite normal (el que sea mayor)
    ? Cualquiera de los siguientes en los 6 meses anteriores a inciar el ensayo: infarto de miocardio, angina severa/inestable, injerto bypass arterio coronario, fallo cardiaco, accidente cerebrovascular, ataque isquemico transitorio.
    ? Hipertensión arterial no controlada definida como SBP ? 160 mm Hg y/o DBP ? 100 mm Hg, con o sin medicación anti-hipertensiva. Se permite el ajuste o el inicio de medicación anti-hipertensiva antes de entrar en el estudio.
    -Pacientes que estén recibiendo terapia anti plaquetaria con prasugrel o clopidogrel, o dosis plenas de anticoagulantes con dosis terapeuticas de warfarina. Sin embargo, el tratamiento a bajas dosis de warfarina (ej. ? 2 mg/dia) o dosis bajas localmente aceptadas de ácido acetilsalicilico (mas de 100 mg diarios) para prevenir los eventos cardiovasculares or ataques.
    -Tumor maligno o malignidad concurrentes en los 3 años anteriores a entrar en el estudio, con la excepción del carcinoma de células basales tratado adecuadamente, carcinoma de células escamosas o de cancer de piel no melanomatoso o carcinoma in situ del cuello uterino
    - Linfagitis carcinomatosa bilateral difusa u otras metastasis viscerales potencialmente mortales que requieren un tratamiento citotóxico inmediato
    -Deterioro de la función gastrointestinal (GI) o enfermedad gastrointestinal que puede alterar significativamente la absorción de TKI258 (por ejemplo, enfermedades ulcerosas, náuseas descontroladas, vómitos, diarrea, síndrome de mala absorción, o que haya tenido una resección intestinal gástrica o del intestino delgado)
    - Cirrosis, hepatitis crónica activa o hepatitis crónica persistente
    - Pacientes que tengan Chilb-Pugh B o insuficiencia hepática grave.
    - Historia conocida del virus de la inmunodeficiencia humana (VIH) (la prueba del VIH no es obligatoria a no ser que sea requerida por las leyes locales)

    - Cualquier condición médica grave concurrentes y / o fuera de control que pudiera comprometer la participación en el estudio o interferir con los resultados del estudio

    -Incapacidad den cumplir con el protocolo.
    E.5 End points
    E.5.1Primary end point(s)
    Progression-Free Survival (PFS).

    PFS is defined as date of randomization to the date of the first radiologically documented disease progression or death due to any cause per local investigator assessment as defined in Appendix 1 (RECIST 1.1).
    Supervivencia libre de progresión (PFS)

    PFS se define como la fecha de randomización hasta la fecha de la progresión de la enfermedad radiológicamente documentada o muerte por cualquier causa por la evaluación del investigador tal como se define en el Apéndice 1 (RECIST 1,1).
    E.5.1.1Timepoint(s) of evaluation of this end point
    This is an event driven trial and events will be monitored contineously. After at least 80 PFS events have occurred -including at least 50 events in patinets with FGF amplified breast cancer- data evaluation will take place. This is expected approximately 2 years after trial initiation nad is therfore projected for April 2014
    Este es un ensayo orientado a observar los acontecimientos adversos y los eventos serán monitoreados continuamente. Después de que al menos 80 eventos de SLP se hayan producido, incluyendo al menos 50 eventos en pacientes con cancer de mama con FGF amplificado, se llevará a cabo la evaluación de los datos. Ello se espera aproximadamente 2 años después del inicio, aproximadamente en abril de 2014
    E.5.2Secondary end point(s)
    Overall Response Rate (ORR)
    ORR is defined as percentage of patients with a best overall response of CR or PR as defined in Appendix 1 (RECIST 1.1).

    Duration Of Response (DOR)
    DOR is defined as time from the date of the first documented response (CR or PR) to the date of the first documented PD or death due to disease as defined in Appendix 1 (RECIST 1.1). If a patient does not have a progression event, DOR will be censored on the date of the last adequate tumor assessment.

    Overall Survival (OS)
    OS is defined as time from date of randomization to the date of death from any cause. If a patient is not known to have died at the date of analysis cut-off, the OS will be censored at the last date of contact.
    Tasa de respuesta global (ORR)
    Se define como el porcentaje de pacientes con una mejor respuesta general de RC o RP tal como se define en el Apéndice 1 (RECIST 1,1).

    Duración de la respuesta (DOR)
    Se define como el tiempo desde la fecha de la primera respuesta documentada (RC o RP ) a la fecha de la primera PD documentada o la muerte debido a una enfermedad tal como se define en el Apéndice 1 (RECIST 1,1). Si un paciente no tiene un evento de progresión, DOR será determinado en la última fecha de la evaluación del tumor.

    La supervivencia global (SG)
    Se define como el tiempo desde la fecha de randomización hasta la fecha de muerte por cualquier causa. Si un paciente no se sabe que han muerto en la fecha de análisis de corte, el tiempo será determinado en la última fecha de contacto.
    E.5.2.1Timepoint(s) of evaluation of this end point
    This is an event driven trial and events, duration of response etc. will be monitored contineously (see E.5.1.1)
    Este es un ensayo orientado a observar los eventos y acontecimientos, la duración de respuesta, etc serán monitoreados continuamente (ver E.5.1.1)
    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 No
    E.6.7Pharmacodynamic Yes
    E.6.8Bioequivalence No
    E.6.9Dose response No
    E.6.10Pharmacogenetic No
    E.6.11Pharmacogenomic No
    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 No
    E.7.1.2Bioequivalence study No
    E.7.1.3Other No
    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 Yes
    E.8.1.1Randomised Yes
    E.8.1.2Open No
    E.8.1.3Single blind No
    E.8.1.4Double blind Yes
    E.8.1.5Parallel group Yes
    E.8.1.6Cross over No
    E.8.1.7Other No
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) No
    E.8.2.2Placebo Yes
    E.8.2.3Other No
    E.8.2.4Number of treatment arms in the trial2
    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 concerned2
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA27
    E.8.6 Trial involving sites outside the EEA
    E.8.6.1Trial being conducted both within and outside the EEA Yes
    E.8.6.2Trial being conducted completely outside of the EEA No
    E.8.6.3If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned
    Argentina
    Brazil
    Egypt
    Israel
    Peru
    Russian Federation
    South Africa
    Taiwan
    United States
    E.8.7Trial has a data monitoring committee Yes
    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
    It will be established prior to the randomization of the first patient. In addition to the ongoing safety review during the study, the DMC will also review the interim analysis
    that will include evaluation for futility and key safety data. Additional safety analyses may be performed
    at the discretion of the DMC. Details regarding the constitution of the DMC and its specific roles will be
    detailed in the DMC charter prior to the randomization of the first patient.
    Se establecerá antes de la aleatorización de los pacientes. Además de la revisión de seguridad en curso durante el estudio, la DMC también revisará el análisis intermedio que incluirá una evaluación de la inutilidad y los datos clave de seguridad. Análisis adicionales de seguridad se pueden realizar
    a discreción de la DMC. Los detalles relativos a la constitución de la DMC y sus funciones específicas se
    se detallan en la carta de DMC antes de la aleatorización de los pacientes.
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years2
    E.8.9.1In the Member State concerned months6
    E.8.9.1In the Member State concerned days0
    E.8.9.2In all countries concerned by the trial years2
    E.8.9.2In all countries concerned by the trial months6
    E.8.9.2In all countries concerned by the trial days0
    F. Population of Trial Subjects
    F.1 Age Range
    F.1.1Trial has subjects under 18 No
    F.1.1.1In Utero No
    F.1.1.2Preterm newborn infants (up to gestational age < 37 weeks) No
    F.1.1.3Newborns (0-27 days) No
    F.1.1.4Infants and toddlers (28 days-23 months) No
    F.1.1.5Children (2-11years) No
    F.1.1.6Adolescents (12-17 years) No
    F.1.2Adults (18-64 years) Yes
    F.1.2.1Number of subjects for this age range: 150
    F.1.3Elderly (>=65 years) No
    F.2 Gender
    F.2.1Female Yes
    F.2.2Male No
    F.3 Group of trial subjects
    F.3.1Healthy volunteers No
    F.3.2Patients Yes
    F.3.3Specific vulnerable populations No
    F.3.3.1Women of childbearing potential not using contraception Information not present in EudraCT
    F.3.3.2Women of child-bearing potential using contraception No
    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 Information not present in EudraCT
    F.4 Planned number of subjects to be included
    F.4.1In the member state10
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 78
    F.4.2.2In the whole clinical trial 150
    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)
    All patients must be followed for 30 days after the last dose of study treatment for safety assessment (AEs and/or SAEs).
    In addition, all new anticancer therapies given after the last dose of the study drug, until disease progression, death, lost to follow-up, or withdrawal of consent will be recorded in the electronic Case Report Forms (eCRFs).
    Todos los pacientes deben ser seguidos durante 30 días después de la última dosis del tratamiento del estudio para la evaluación de la seguridad (efectos adversos y / o reacciones adversas graves).
    Además, todas las nuevas terapias contra el cáncer administradas después de la última dosis del fármaco en estudio, hasta la progresión de la enfermedad, muerte, pérdida de seguimiento, o la retirada del consentimiento se registrarán en los cuadernos de recogida de datos electrónicos (eCRFs).
    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 Decision2012-03-27
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2012-03-09
    P. End of Trial
    P.End of Trial StatusCompleted
    P.Date of the global end of the trial2015-01-13
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    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
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