E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
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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 | 14.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10006203 |
E.1.2 | Term | Breast cancer stage unspecified |
E.1.2 | System Organ Class | 100000004864 |
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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 |
To assess the efficacy of LA-EP2006 compared to Neulasta® with respect to the mean duration of severe neutropenia (DSN), defined as number of consecutive days with Grade 4 neutropenia (absolute neutrophil count [ANC] less than 0.5 x 10 9/L), during Cycle 1 of the neoadjuvant or adjuvant TAC regimen (Taxotere® [docetaxel 75 mg/m2] in combination with Adriamycin® [doxorubicin 50 mg/m2] and Cytoxan® [cyclophosphamide 500 mg/m2]) in breast cancer patients. |
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E.2.2 | Secondary objectives of the trial |
The secondary objectives are to further compare LA-EP2006 and Neulasta® with respect to the efficacy, safety, and immunogenicity of both products.
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
The patients must fulfill all of the following criteria to be eligible for admission to the study:
•Written informed consent before any assessment is performed
•Patients with histologically proven breast cancer, eligible for neoadjuvant or adjuvant TAC chemotherapy
•Women ≥ 18 years of age
•Estimated life expectancy of more than six months
•Eastern cooperative oncology group (ECOG) performance status ≤ 2
•Adequate bone marrow function on Cycle 1 Day 1 prior to chemotherapy administration:
•ANC ≥ 1.5 x 10 9/L
•Platelet count ≥ 100 x 10 9/L
•Hemoglobin ≥ 10 g/dL
•Total bilirubin not higher than the upper limit of normal (ULN), unless the patient has Gilbert`s syndrome
•Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) level ≤ 2 x ULN
•Liver-derived alkaline phosphatase level ≤ 3 x ULN
•Creatinine ≤ 1.5 x ULN
•For all women of childbearing potential: negative serum pregnancy test within seven days prior to randomization, and using a highly effective method of birth control |
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E.4 | Principal exclusion criteria |
The patients meeting any of the following exclusion criteria will not be enrolled in the study:
1. History of chronic myeloid leukemia or myelodysplastic syndrome
2. History or presence of sickle cell disease
3. Previous or concurrent malignancy except non-invasive non-melanomatous skin cancer, in situ carcinoma of the cervix, or other solid tumor treated curatively, and without evidence of recurrence for at least ten years prior to study entry
4. Any serious illness or medical condition that may interfere with safety, compliance, response to the products under investigation or chemotherapy and their evaluation such as:
• Active uncontrolled infection
• Clinically significant impairment of left ventricular ejection fraction
(LVEF measured within three month before study entry by
echocardiography or multiple-gated acquisition scan (MUGA) must be above the lower limit of normal for the respective center)
• Severe valvular heart disease, myocardial infarction, unstable angina pectoris, uncontrolled hypertension or uncontrolled arrhythmias within six months from study entry
• Significant neurologic or psychiatric disorders including psychotic
disorders, dementia or seizures that would prohibit the understanding and giving of informed consent
5. Concurrent or prior radiotherapy within four weeks of randomization
6. Concurrent or prior chemotherapy for breast cancer
7. Concurrent or prior anti-cancer treatment for breast cancer such as endocrine therapy, immunotherapy, monoclonal antibodies and/or biological therapy
8. Concurrent prophylactic antibiotics
9. Prior bone marrow or stem cell transplant
10. Previous therapy with any rhG-CSF product
11. Known hypersensitivity to E. coli proteins or any of the excipients used in the IMPs
12. Patient known to have HIV, Hepatitis B, Hepatitis C infection or who have positive serology for HIV, Hepatitis B or Hepatitis C at screening
13. Known active drug addiction, including alcoholism
14. Participation in any other clinical study using an IMP or device within three months before the screening visit.
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E.5 End points |
E.5.1 | Primary end point(s) |
• Mean duration of Grade 4 neutropenia, defined as the number of consecutive days in which the patient had an ANC < 0.5 × 10 9/L during Cycle 1 of chemotherapy |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
• Mean duration of Grade 4 neutropenia, defined as the number of consecutive days in which the patient had an ANC <0.5 x 10 9/L during Cycle 1 of chemotherapy |
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E.5.2 | Secondary end point(s) |
• Incidence of febrile neutropenia (FN), defined as oral temperature ≥ 38.3 °C while having an ANC < 0.5 x 10 9/L (both measured on the same day) by cycle and across all cycles
• Number of days of fever, defined as oral temperature ≥ 38.3 °C, for each cycle
• Depth of ANC nadir, defined as the patient`s lowest ANC in Cycle 1
• Time to ANC recovery, defined as the time in days from the chemotherapy administration until the patient`s ANC increased to ≥ 2 x 10 9/L after the nadir, in Cycle 1
• Frequency of infection by cycle and across all cycles
• Mortality due to infection
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
• Incidence of febrile neutropenia (FN), defined as oral temperature ≥ 38.3 °C while having an ANC < 0.5 x 10 9/L (both measured on the same day) by cycle and across all cycles
• Number of days of fever, defined as oral temperature ≥ 38.3 °C, for each cycle
• Depth of ANC nadir, defined as the patient`s lowest ANC in Cycle 1
• Time to ANC recovery, defined as the time in days from the chemotherapy administration until the patient`s ANC increased to ≥ 2 x 10 9/L after the nadir, in Cycle 1
• Frequency of infection by cycle and across all cycles
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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) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | Yes |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | Yes |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 2 |
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 | 45 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
Brazil |
Bulgaria |
India |
Mexico |
Poland |
Romania |
Russian Federation |
Turkey |
Ukraine |
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E.8.7 | Trial 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
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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 | 2 |
E.8.9.1 | In the Member State concerned months | 4 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 2 |
E.8.9.2 | In all countries concerned by the trial months | 4 |
E.8.9.2 | In all countries concerned by the trial days | 0 |