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    Summary
    EudraCT Number:2011-005533-39
    Sponsor's Protocol Code Number:Debio0932-201
    National Competent Authority:Spain - AEMPS
    Clinical Trial Type:EEA CTA
    Trial Status:Prematurely Ended
    Date on which this record was first entered in the EudraCT database:2012-02-22
    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 number2011-005533-39
    A.3Full title of the trial
    A Phase I-II evaluation of the safety and efficacy of the oral HSP90 inhibitor Debio 0932 in combination with standard of care in first- and second-line therapy of patients with Stage IIIb or IV Non-small Cell Lung Cancer - the HALO study (HSP90 inhibition And Lung cancer Outcomes)
    Estudio de fase I-II para evaluar la seguridad y la eficacia de Debio 0932, inhibidor oral de la HSP90, en combinación con el tratamiento de referencia en primera y segunda línea de pacientes con carcinoma de pulmón no microcítico en estadio IIIb o IV: Estudio HALO (HSP90 And Lung cancer Outcomes).
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    A clinical trial to study the safety and effectiveness of Debio 0932 in combination with standard of care in non-small cell lung cancer
    Un ensayo clínico para estudiar la seguridad y eficacia de Debio 0932 en combinación con el tratamiento habitual en cancer de pulmón no microcítico.
    A.3.2Name or abbreviated title of the trial where available
    HALO
    HALO
    A.4.1Sponsor's protocol code numberDebio0932-201
    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 SponsorDebiopharm SA
    B.1.3.4CountrySwitzerland
    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 supportDebiopharm SA
    B.4.2CountrySwitzerland
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationINC Research
    B.5.2Functional name of contact pointRegulatory Affairs Project Manager
    B.5.3 Address:
    B.5.3.1Street Address270 Wharfedale Road, Winnersh Triangle
    B.5.3.2Town/ cityWokingham, Berkshire
    B.5.3.3Post codeRG41 5TP
    B.5.3.4CountryUnited Kingdom
    B.5.4Telephone number+441189335 413
    B.5.5Fax number+441189335 399
    B.5.6E-mailSM_Regaffairs_eu_ap@incresearch.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 nameDebio 0932, 100mg tablet
    D.3.2Product code Debio 0932
    D.3.4Pharmaceutical form Tablet
    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.3.9.2Current sponsor codeDebio 0932
    D.3.9.3Other descriptive nameDebio 0932
    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 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 nameDebio 0932, 250 mg tablet
    D.3.2Product code Debio 0932
    D.3.4Pharmaceutical form Tablet
    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.3.9.2Current sponsor codeDebio 0932
    D.3.9.3Other descriptive nameDebio 0932
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number250
    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: 3
    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.2.5The 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 namecisplatin
    D.3.4Pharmaceutical form Concentrate for solution for infusion
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPIntravenous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNCISPLATIN
    D.3.9.1CAS number 15663-27-1
    D.3.9.4EV Substance CodeSUB07483MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typerange
    D.3.10.3Concentration number0.5 to 1
    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: 4
    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.2.5The 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 namePEMETREXED
    D.3.4Pharmaceutical form Powder for concentrate for solution for infusion
    D.3.4.1Specific paediatric formulation No
    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 150399-23-8
    D.3.9.3Other descriptive namePEMETREXED DISODIUM
    D.3.9.4EV Substance CodeSUB03669MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number100
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.9.1CAS number 150399-23-8
    D.3.9.3Other descriptive namePEMETREXED DISODIUM
    D.3.9.4EV Substance CodeSUB03669MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number500
    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: 5
    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.2.5The 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 namegemcitabine
    D.3.2Product code L01BC05
    D.3.4Pharmaceutical form Powder for solution for infusion
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPIntravenous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNGEMCITABINE
    D.3.9.1CAS number 95058-81-4
    D.3.9.4EV Substance CodeSUB07892MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typerange
    D.3.10.3Concentration number200 to 2000
    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: 6
    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.2.5The 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 namedocetaxel
    D.3.2Product code L01CD 02
    D.3.4Pharmaceutical form Concentrate and solvent for solution for infusion
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPIntravenous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNDOCETAXEL
    D.3.9.1CAS number 114977-28-5
    D.3.9.4EV Substance CodeSUB12492MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typerange
    D.3.10.3Concentration number10 to 40
    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 placeboTablet
    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
    Non-small Cell Lung Cancer
    Cancer de pulmón no microcítico
    E.1.1.1Medical condition in easily understood language
    Non-small Cell Lung Cancer
    Cancer de pulmón no microcítico
    E.1.1.2Therapeutic area Diseases [C] - Cancer [C04]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 14.1
    E.1.2Level LLT
    E.1.2Classification code 10025054
    E.1.2Term Lung cancer non-small cell stage IIIB
    E.1.2System Organ Class 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 14.1
    E.1.2Level LLT
    E.1.2Classification code 10025055
    E.1.2Term Lung cancer non-small cell stage IV
    E.1.2System Organ Class 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    E.1.3Condition being studied is a rare disease No
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    Part A :To determine the MTD of Debio 0932 in combination with cisplatin/pemetrexed and cisplatin/gemcitabine in treatment-naïve patients with Stage IIIb or IV NSCLC and with docetaxel in previously treated patients with Stage IIIb or IV NSCLC.
    Part B : To compare the effect of adding Debio 0932 to combination chemotherapy with cisplatin/pemetrexed and cisplatin/gemcitabine on the rate of PFS at 6 months in first-line therapy of patients with Stage IIIb or IV NSCLC.
    Part C : To compare the effect of adding Debio 0932 to docetaxel on the change in tumour size in second-line therapy of patients with Stage IIIb or IV NSCLC.
    Parte A: Determinar la dosis máxima tolerada (DMT) de Debio 0932 en combinación con cisplatino/pemetrexed y cisplatino/gemcitabina en pacientes con CPNM en estadio IIIb o IV sin tratamiento previo y con docetaxel en pacientes con CPNM en estadio IIIb o IV tratados previamente.
    Parte B: Comparar el efecto de la adición de Debio 0932 a la quimioterapia de combinación con cisplatino/pemetrexed y cisplatino/gemcitabina sobre la tasa de SSP a los 6 meses en el tratamiento de primera línea de pacientes con CPNM en estadio IIIb o IV.
    Parte C: Comparar el efecto de la adición de Debio 0932 a docetaxel sobre el cambio del tamaño del tumor en el tratamiento de segunda línea de pacientes con CPNM en estadio IIIb o IV.
    E.2.2Secondary objectives of the trial
    Part A: Investigate for Debio 0932, in combination with cisplatin/pemetrexed, cisplatin/gemcitabine, and docetaxel:1. RD
    2. Safety;3. PK & potential for drug-drug interactions;4. Anti-tumour activity;5. PD biomarkers of activity
    Part B:Compare between treatment arms:1. Best overall response rate;2. Duration of objective response;3. Change in tumour size from baseline until 6 months;4. Overall survival;5. Incidence of new symptomatic brain metastases. Investigate for Debio 0932, in combination with cisplatin/pemetrexed and cisplatin/gemcitabine: 6. Safety; 7. PK and PD profile
    Part C: To compare between treatment arms:1. Best overall response rate; 2. Duration of objective response;3. PFS at 6 Months;4. Overall survival;5. Incidence of new symptomatic brain metastases. To investigate for Debio 0932, in combination with docetaxel: 6. Safety;7. PK and PD profile. Parts A, B & C:
    Pharmacogenomic, tumour pharmacogenetic, proteomic, & pharmacogenetic factors predictive of response.
    Ver resumen de protocol en español.
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    Part A :
    1. Age ? 18 years;
    2. Diagnosis of NSCLC with confirmed squamous or non-squamous tumour histology, without known EGFR mutation;
    3. Archived tumour sample available;
    4. Advanced or metastatic disease (Stage IIIb or IV) ;
    5. Patients to be treated with cisplatin/gemcitabine or cisplatin/pemetrexed: No previous systemic treatment with chemotherapy, targeted therapy or investigational agents (except adjuvant therapy if > 6 months ago); Patients to be treated with docetaxel: ? 1 previous treatment with chemotherapy.
    6. Candidate for treatment with cisplatin/pemetrexed or cisplatin/gemcitabine or docetaxel as determined by the Investigator;
    7. Measurable disease by the RECIST criteria;
    8. ECOG performance score 0 - 1;
    9. Life expectancy ? 3 months;
    10. ANC ? 1 500/?L;
    11. Platelets ? 100 000/?L;
    12. Creatinine clearance ? 60 mL/minutes (Cockroft ? Gault formula);
    13. AST and ALT ? 2.5 x ULN; in case of documented liver metastases, AST and ALT ? 3.5 x ULN;
    14. If female, neither pregnant nor lactating;
    15. Women of child-bearing potential:
    a. Negative pregnancy test at screening;
    b. Agreement to use appropriate contraception methods from study entry to 6 months after the last day of treatment.
    16. Provide written informed consent;
    17. Ability to comply with study procedures.

    Part B :
    1. Age ? 18 years;
    2. Diagnosis of NSCLC with confirmed squamous or non-squamous tumour histology, without known EGFR mutation;
    3. Archived tumour sample available;
    4. Advanced or metastatic disease (Stage IIIb or IV) ;
    5. No previous systemic treatment with chemotherapy, targeted therapy or investigational agents (except adjuvant therapy if > 6 months ago) ;
    6. Candidate for treatment with cisplatin/pemetrexed or cisplatin/gemcitabine as determined by the Investigator;
    7. Measurable disease by the RECIST criteria;
    8. ECOG performance score 0 - 1;
    9. Life expectancy ? 3 months;
    10. Absolute neutrophil count ? 1 500/?L;
    11. Platelets ? 100 000/?L;
    12. Creatinine clearance ? 60 mL/minutes (Cockroft ? Gault formula);
    13. AST and ALT ? 2.5 x ULN; in case of documented liver metastases, AST and ALT ? 3.5 x ULN;
    14. If female, neither pregnant nor lactating;
    15. Women of child-bearing potential:
    a. Negative pregnancy test at screening;
    b. Agreement to use appropriate contraception methods from study entry to 6 months after the last day of treatment.
    16. Provide written informed consent;
    17. Ability to comply with study procedures.

    Part C :
    1. Age ? 18 years;
    2. Diagnosis of NSCLC with confirmed squamous or non-squamous tumour histology, without known EGFR mutation;
    3. Archived tumour sample available unless previous participant in Part B;
    4. Advanced or metastatic disease (Stage IIIb or IV) ;
    5. Previous participant of Part B of the study with PD under study treatment;
    6. New patients in case of futility of the interim analysis of Part B or in case of an insufficient number of patients enrolling from Part B: PD after dual chemotherapy with cisplatin/pemetrexed or cisplatin/gemcitabine.
    7. Candidate for treatment with docetaxel as determined by the Investigator;
    8. Measurable disease by the RECIST criteria;
    9. ECOG performance score 0 - 1;
    10. Life expectancy ? 3 months;
    11. Absolute neutrophil count ? 1 500/?L;
    12. Platelets ? 100 000/?L;
    13. Creatinine clearance ? 60 mL/minutes (Cockroft ? Gault formula);
    14. AST and ALT ? 2.5 x ULN; in case of documented liver metastases, AST and ALT ? 3.5 x ULN;
    15. If female, neither pregnant nor lactating;
    16. Women of child-bearing potential:
    a. Negative pregnancy test at screening;
    b. Agreement to use appropriate contraception methods from study entry to 6 months after the last day of treatment.
    17. Provide written informed consent;
    18. Ability to comply with study procedures.
    Parte A:
    1.Edad ? 18 años;
    2.Diagnóstico de CPNM con histología de tumor epidermoide o no epidermoide confirmado, sin mutación del RFCE conocida;
    3.Disponibilidad de muestra tumoral archivada;
    4.Enfermedad avanzada o metastásica (estadio IIIb o IV);
    5.Pacientes que serán tratados con cisplatino/gemcitabina o cisplatino/pemetrexed: Sin tratamiento sistémico previo con quimioterapia, terapia dirigida o agentes en investigación (con excepción del tratamiento adyuvante si se produjo hace más de 6 meses). Pacientes que serán tratados con docetaxel: Al menos un tratamiento previo con quimioterapia.
    6.Candidato para el tratamiento con cisplatino/pemetrexed o cisplatino/gemcitabina o docetaxel, a juicio del investigador;
    7.Enfermedad medible según los criterios RECIST;
    8.Estado funcional en la escala de ECOG 0-1;
    9.Esperanza de vida ? 3 meses;
    10.CAN ? 1 500/?l;
    11.Trombocitos ? 100 000/?l;
    12.Aclaramiento de creatinina ? 60 ml/min (fórmula de Cockroft - Gault);
    13.AST y ALT ? 2,5 x LSN, en el caso de metástasis hepática documentada, AST y ALT ? 3,5 x LSN;
    14.Si es mujer, ni embarazada ni madre lactante;
    15.Mujeres de edad fértil:
    a.Prueba de embarazo negativa en el momento de selección;
    b.Accede a utilizar métodos anticonceptivos adecuados desde la entrada en el estudio hasta 6 meses después del último día de tratamiento.
    16.Entrega del consentimiento informado por escrito;
    17.Capacidad para cumplir con los procedimientos del estudio.
    Parte B:
    1.Edad ? 18 años;
    2.Diagnóstico de CPNM con histología de tumor epidermoide o no epidermoide confirmado, sin mutación del RFCE conocida;
    3.Disponibilidad de muestra tumoral archivada;
    4.Enfermedad avanzada o metastásica (estadio IIIb o IV);
    5.Sin tratamiento sistémico previo con quimioterapia, terapia dirigida o agentes en investigación (con excepción del tratamiento adyuvante si se produjo hace más de 6 meses);
    6.Candidato para el tratamiento con cisplatino/pemetrexed o cisplatino/gemcitabina, a juicio del investigador;
    7.Enfermedad medible según los criterios RECIST;
    8.Estado funcional en la escala de ECOG 0-1;
    9.Esperanza de vida ? 3 meses;
    10.Cifra absoluta de neutrófilos ? 1 500/µl;
    11.Trombocitos ? 100 000/?l;
    12.Aclaramiento de creatinina ? 60 ml/min (fórmula de Cockroft - Gault);
    13.AST y ALT ? 2,5 x LSN, en el caso de metástasis hepática documentada, AST y ALT ? 3,5 x LSN;
    14.Si es mujer, ni embarazada ni madre lactante;
    15.Mujeres de edad fértil:
    a.Prueba de embarazo negativa en el momento de selección;
    b.Accede a utilizar métodos anticonceptivos adecuados desde la entrada en el estudio hasta 6 meses después del último día de tratamiento.
    16.Entrega del consentimiento informado por escrito;
    17.Capacidad para cumplir con los procedimientos del estudio.
    Parte C:
    1.Edad ? 18 años;
    2.Diagnóstico de CPNM con histología de tumor epidermoide o no epidermoide confirmado, sin mutación del RFCE conocida;
    3.Disponibilidad de muestra tumoral archivada, a menos que se trate de un participante previo en la Parte B;
    4.Enfermedad avanzada o metastásica (estadio IIIb o IV);
    5.Participante previo en la Parte B del estudio con enfermedad progresiva con el tratamiento del estudio;
    6.Nuevos pacientes en caso de falta de eficacia tras el análisis intermedio de la Parte B o en el caso de inscripción de un número insuficiente de pacientes desde la Parte B: Enfermedad progresiva después de la quimioterapia doble con cisplatino/pemetrexed o cisplatino/gemcitabina.
    7.Candidato para el tratamiento con docetaxel a juicio del investigador;
    8.Enfermedad medible según los criterios RECIST;
    9.Estado funcional en la escala de ECOG 0-1;
    10.Esperanza de vida ? 3 meses;
    11.Cifra absoluta de neutrófilos ? 1 500/µl;
    12.Trombocitos ? 100 000/?l;
    13.Aclaramiento de creatinina ? 60 ml/min (fórmula de Cockroft - Gault);
    14.AST y ALT ? 2,5 x LSN, en el caso de metástasis hepáticas documentada, AST y ALT ? 3,5 x LSN;
    15.Si es mujer, ni embarazada ni madre lactante;
    16.Mujeres de edad fértil:
    a.Prueba de embarazo negativa en el momento de selección;
    b.Accede a utilizar métodos anticonceptivos adecuados desde la entrada en el estudio hasta 6 meses después del último día de tratamiento.
    17.Entrega del consentimiento informado por escrito;
    18.Capacidad para cumplir con los procedimientos del estudio.
    E.4Principal exclusion criteria
    Part A :
    1. Unresolved toxicity from previous treatment;
    2. Symptomatic brain metastases;
    3. For patients on docetaxel: Serum bilirubin levels > ULN associated with serum ALP levels > 6 times ULN;
    4. Gastro-intestinal disorders that could affect drug absorption (including, but not limited to, major abdominal surgery, significant bowel obstruction, ulcerative colitis, Crohn?s disease);
    5. Concurrent treatment with any other systemic anti-cancer therapy;
    6. Concomitant treatment with any drug on the prohibited medication list (provided separately);
    7. Serious concomitant uncontrolled medical conditions.

    Part B :
    1. Unresolved toxicity from previous treatment;
    2. Symptomatic brain metastases;
    3. Gastro-intestinal disorders that could affect drug absorption (including, but not limited to, major abdominal surgery, significant bowel obstruction, ulcerative colitis, Crohn?s disease);
    4. Concurrent treatment with any other systemic anti-cancer therapy;
    5. Concomitant treatment with any drug on the prohibited medication list (provided separately);
    6. Serious concomitant uncontrolled medical conditions.

    Part C :
    1. Unresolved toxicity from previous treatment;
    2. Symptomatic brain metastases;
    3. Serum bilirubin levels > ULN associated with serum ALP levels > 6 times ULN;
    4. Gastro-intestinal disorders that could affect drug absorption (including, but not limited to, major abdominal surgery, significant bowel obstruction, ulcerative colitis, Crohn?s disease) ;
    5. Concurrent treatment with any other systemic anti-cancer therapy;
    6. Concomitant treatment with any drug on the prohibited medication list (provided separately);
    7. Serious concomitant uncontrolled medical conditions.
    Parte A:
    1.Toxicidad del tratamiento previo sin resolver;
    2.Metástasis cerebral sintomática;
    3.Para los pacientes con docetaxel: Niveles séricos de bilirrubina > LSN asociados con niveles séricos de fosfatasa alcalina > 6 veces el LSN;
    4.Trastornos gastrointestinales que puedan afectar a la absorción del fármaco (incluidos, entre otros, cirugía abdominal mayor, obstrucción intestinal significativa, colitis ulcerosa, enfermedad de Crohn);
    5.Tratamiento concomitante con cualquier otro tratamiento antineoplásico sistémico;
    6.Tratamiento concomitante con cualquier medicamento incluido en la lista de medicamentos prohibidos (facilitada por separado);
    7.Afecciones médicas concomitantes graves no controladas.
    Parte B:
    1.Toxicidad del tratamiento previo sin resolver;
    2.Metástasis cerebral sintomática;
    3.Trastornos gastrointestinales que puedan afectar a la absorción del fármaco (incluidos, entre otros, cirugía abdominal mayor, obstrucción intestinal significativa, colitis ulcerosa, enfermedad de Crohn);
    4.Tratamiento concomitante con cualquier otro tratamiento antineoplásico sistémico;
    5.Tratamiento concomitante con cualquier medicamento incluido en la lista de medicamentos prohibidos (facilitada por separado);
    6.Afecciones médicas concomitantes graves no controladas.
    Parte C:
    1.Toxicidad del tratamiento previo sin resolver;
    2.Metástasis cerebral sintomática;
    3.Niveles séricos de bilirrubina > LSN asociados con niveles séricos de fosfatasa alcalina > 6 veces el LSN;
    4.Trastornos gastrointestinales que puedan afectar a la absorción del fármaco (incluidos, entre otros, cirugía abdominal mayor, obstrucción intestinal significativa, colitis ulcerosa, enfermedad de Crohn);
    5.Tratamiento concomitante con cualquier otro tratamiento antineoplásico sistémico;
    6.Tratamiento concomitante con cualquier medicamento incluido en la lista de medicamentos prohibidos (facilitada por separado);
    7.Afecciones médicas concomitantes graves no controladas.
    E.5 End points
    E.5.1Primary end point(s)
    Part A : Occurrence of DLTs.

    Part B : Percentage of patients with PFS at 6 months.

    Part C : Change in tumour size from baseline until 6 months.
    Parte A: Aparición de la Toxicidad Limitante de Dosis (TLD).
    Parte B:Porcentaje de pacientes con SSP a los 6 meses.
    Parte C: Cambio del tamaño del tumor desde el inicio hasta los 6 meses.
    E.5.1.1Timepoint(s) of evaluation of this end point
    At end of each (Parts A, B and C) study treatment phase.
    Al final de cada fase (Parte A, B y C) de tratamiento en estudio.
    E.5.2Secondary end point(s)
    Part A :
    1. Change in vital signs and ECOG PS.
    2. Incidence of AEs and SAEs according to NCI-CTCAE criteria.
    3. Incidence of laboratory abnormalities according to NCI-CTCAE criteria.
    4. Incidence of treatment discontinuations due to AEs and SAEs.
    5. Pharmacokinetic parameters of Debio 0932 and its metabolite Debio 0932-MET1 in plasma at steady state alone (on Day 21) and in combination with cisplatin/pemetrexed, cisplatin/gemcitabine, and docetaxel (on Day 22): C0h, Cmax, tmax, AUC0-tlast, AUC0-?, Css av, FI, ?z, t1/2, CL/F, and Vz/F calculated for all patients using non-compartmental analysis.
    6. Pharmacokinetic parameters of cisplatin (total and unbound)/pemetrexed, cisplatin (total and unbound)/gemcitabine, and docetaxel in plasma after single infusion alone (on Day 1) and in combination with Debio 0932 at steady-state (on Day 22): Cmax, AUC0-tlast, AUC0-?, ?z, t1/2, MRT, CL, Vss, and Vz calculated for all patients using non-compartmental analysis.
    7. Best overall response, i.e., best response recorded from start of study treatment until study end.
    8. Exploration of pharmacodynamic biomarkers in plasma and PBMCs.
    9. Pharmacogenomic, tumour pharmacogenetic, proteomic, and pharmacogenetic factors predictive of response to Debio 0932.

    Part B :
    1. Best overall response, i.e. best response recorded from start of study treatment until study end.
    2. Duration of objective response.
    3. Change in tumour size from baseline until 6 months.
    4. Overall survival.
    5. In patients without brain metastases at baseline: incidence of new symptomatic brain metastases.
    6. Safety and tolerability (vital signs and ECOG PS, and AEs, SAEs, and laboratory abnormalities according to NCI-CTCAE criteria).
    7. Exploration of pharmacodynamic biomarkers in plasma and PBMCs.
    8. Pharmacogenomic, tumour pharmacogenetic, proteomic, and pharmacogenetic factors predictive of response to Debio 0932.
    9. If applicable, plasma PK parameters of Debio 0932 and its main metabolite Debio 0932-MET1 derived from a compartmental population PK data analysis (including covariates such as demographic characteristics and pharmacogenetics).

    Part C :
    1. Best overall response, i.e. best response recorded from start of study treatment until study end.
    2. Duration of objective response.
    3. Percentage of patients with PFS at 6 Months.
    4. Overall survival.
    5. In patients without brain metastases at baseline: incidence of new symptomatic brain metastases.
    6. Safety and tolerability (vital signs and ECOG PS, and AEs, SAEs and laboratory abnormalities according to NCI-CTCAE criteria).
    7. Exploration of pharmacodynamic biomarkers in plasma and PBMCs.
    8. Pharmacogenomic, tumour pharmacogenetic, proteomic, and pharmacogenetic factors predictive of response to Debio 0932.
    9. If applicable, plasma PK parameters of Debio 0932 and its main metabolite Debio 0932-MET1 derived from a compartmental population PK data analysis (including covariates such as demographic characteristics and pharmacogenetics)
    Parte A :
    1.Cambio en las constantes vitales y en el estado funcional en la escala de ECOG.
    2.Incidencia de acontecimientos adversos (AA) y acontecimientos adversos graves (AAG) de acuerdo con los criterios NCI-CTCAE.
    3.Incidencia de anomalías analíticas de acuerdo con los criterios NCI-CTCAE.
    4.Incidencia de abandonos del tratamiento debido a AA y AAG.
    5.Parámetros farmacocinéticos de Debio 0932 y de su metabolito Debio 0932-MET1 en el plasma en estado de equilibrio solo (el día 21) y en combinación con cisplatino/pemetrexed, cisplatino/gemcitabina y docetaxel (el día 22): C0h, Cmáx, tmáx, AUC0-tlast, AUC0-?, Css av, FI, ?z, t1/2, CL/F y Vz/F calculados para todos los pacientes mediante un análisis no compartimental.
    6.Parámetros farmacocinéticos de cisplatino (total y libre)/pemetrexed, cisplatino (total y libre)/gemcitabina y docetaxel en plasma después de una única infusión solo (el día 1) y en combinación con Debio 0932 en el estado de equilibrio (el día 22): Cmáx, AUC0-tlast, AUC0-?, ?z, t1/2, MRT, CL, Vss, y Vz calculados para todos los pacientes mediante un análisis no compartimental.
    7.Mejor respuesta global, es decir, la mejor respuesta registrada desde el inicio del tratamiento del estudio hasta el final del estudio.
    8.Exploración de biomarcadores farmacodinámicos en plasma y células mononucleares en sangre periférica (CMSP).
    9.Factores farmacogenómicos, farmacogenéticos tumorales, proteómicos y farmacogenéticos predictivos de la respuesta a Debio 0932.

    Parte B :
    1.Mejor respuesta global, es decir, la mejor respuesta registrada desde el inicio del tratamiento del estudio hasta el final del estudio.
    2.Duración de la respuesta objetiva.
    3.Cambio del tamaño del tumor desde el inicio hasta los 6 meses.
    4.Supervivencia global.
    5.En los pacientes sin metástasis cerebrales al inicio del estudio: incidencia de nuevas metástasis cerebrales sintomáticas.
    6.Seguridad y tolerabilidad (constantes vitales y estado funcional en la escala de ECOG y AA, AAG, y anomalías analíticas de acuerdo con los criterios NCI-CTCAE).
    7.Exploración de biomarcadores farmacodinámicos en plasma y CMSP.
    8.Factores farmacogenómicos, farmacogenéticos tumorales, proteómicos y farmacogenéticos predictivos de la respuesta a Debio 0932.
    9.Si procede, los parámetros farmacocinéticos en plasma de Debio 0932 y su principal metabolito Debio 0932-MET1 derivado de un análisis compartimental de los datos farmacocinéticos de la población (que incluya covariables como las características demográficas y farmacogenéticas).


    Parte C :
    1.Mejor respuesta global, es decir, la mejor respuesta registrada desde el inicio del tratamiento del estudio hasta el final del estudio.
    2.Duración de la respuesta objetiva.
    3.Porcentaje de pacientes con SSP a los 6 meses.
    4.Supervivencia global.
    5.En los pacientes sin metástasis cerebrales al inicio del estudio: incidencia de nuevas metástasis cerebrales sintomáticas.
    6.Seguridad y tolerabilidad (constantes vitales y estado funcional en la escala de ECOG y AA, AAG, y anomalías analíticas de acuerdo con los criterios NCI-CTCAE).
    7.Exploración de biomarcadores farmacodinámicos en plasma y CMSP.
    8.Factores farmacogenómicos, farmacogenéticos tumorales, proteómicos y farmacogenéticos predictivos de la respuesta a Debio 0932.
    9.Si procede, los parámetros farmacocinéticos en plasma de Debio 0932 y su principal metabolito Debio 0932-MET1 derivado de un análisis compartimental de los datos farmacocinéticos de la población (que incluya covariables como las características demográficas y farmacogenéticas).
    E.5.2.1Timepoint(s) of evaluation of this end point
    At end of each (Parts A, B and C) study treatment phase.
    Al final de cada fase (Parte A, B y C) de tratamiento en estudio.
    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 Yes
    E.6.8Bioequivalence No
    E.6.9Dose response No
    E.6.10Pharmacogenetic Yes
    E.6.11Pharmacogenomic Yes
    E.6.12Pharmacoeconomic No
    E.6.13Others No
    E.7Trial type and phase
    E.7.1Human pharmacology (Phase I) Yes
    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 No
    E.8.1.2Open Yes
    E.8.1.3Single blind No
    E.8.1.4Double blind No
    E.8.1.5Parallel group Yes
    E.8.1.6Cross over No
    E.8.1.7Other Yes
    E.8.1.7.1Other trial design description
    Open-label, non randomised, dose escalation
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) No
    E.8.2.2Placebo Yes
    E.8.2.3Other Yes
    E.8.2.3.1Comparator description
    Estudio de escalada de dosis para determinar la dosis máxima tolerable de Debio 0932
    Dose-escalation study to determine the maximum tolerated dose of Debio 0932
    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 concerned3
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA11
    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 No
    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
    Study will be considered as completed when all patients have withdrawn from the study (last visit of last subject in Part C of the study).
    El estudio se considerará completado cuando todos los pacientes hayan finalizado el estudio (última visita del último paciente en la parte C del estudio).
    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 months8
    E.8.9.1In the Member State concerned days15
    E.8.9.2In all countries concerned by the trial years2
    E.8.9.2In all countries concerned by the trial months8
    E.8.9.2In all countries concerned by the trial days15
    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: 30
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 30
    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 state10
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 60
    F.4.2.2In the whole clinical trial 60
    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)
    Patients who have ended the participation in the trial are to be treated and followed up according to accepted medical practice.
    Los pacientes que finalicen su participacion en el ensayo serán tratados y supervisados de acuerdo a la practica medica habitual.
    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 Decision2012-05-21
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2012-04-10
    P. End of Trial
    P.End of Trial StatusPrematurely Ended
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