E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Malignant Pleural Mesothelioma |
Mesotelioma pleurico maligno |
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E.1.1.1 | Medical condition in easily understood language |
Cancer of the lung lining (pleura) named mesothelioma |
Tumore della membrana dei polmoni (pleura) del tipo mesotelioma |
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E.1.1.2 | Therapeutic area | Diseases [C] - Cancer [C04] |
MedDRA Classification |
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 activity of trabectedin in patients with epithelial MPM relapsing after treatment with pemetrexed plus platinum-based drugs
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Valutare l’attività di trabectedina in pazienti con MPM di tipo epitelioide in ricaduta dopo trattamento con pemetrexed e derivati del platino.
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E.2.2 | Secondary objectives of the trial |
To assess the activity of trabectedin in patients with biphasic or sarcomatoid either as first line treatment or following a previous course of platinum derivates and pemetrexed. To assess the tolerability and safety of trabectedin treatment. To explore the activity of trabectedin with respect to some biological features of MPM
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Valutare l’attività di trabectedina in pazienti con MPM di tipo sarcomatose o bifasico, sia come trattamento di prima linea, o in seguito a precedente terapia a base di pemetrexed e platino derivati. Valutare la tollerabilità e la sicurezza d’impiego di trabectedina Studiare gli effetti di trabectedina su alcuni marker biologici del mesotelioma pleurico maligno. |
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E.2.3 | Trial contains a sub-study | Yes |
E.2.3.1 | Full title, date and version of each sub-study and their related objectives |
Full title: ATREUS trial. A phase II study on the activity of Trabecteding in pretreated epithelioid or biphasic/sarcomatoid malignant pleural mesothelioma (MPM) - Biological sub-study Version: 2 (21/12/2012) Objectives: To explore the potential value of miRs determination in mesothelioma patients, particularly in relation to the treatment with trabectedin. To evaluate miRs profiles in plasma of all mesothelioma patients participating the phase II study, collecting samples before trabectedin treatment
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Titolo: Studio ATREUS. Studio di fase II sull'attività della trabectedina in pazienti con mesotelioma pleurico maligno di tipo tepitelioide pretrattato o con tipo sarcomatoide/misto - sottostudio biologico Versione: 2 (del 21/12/2012) Obiettivi: Esplorare il valore potenziale della deteminazione dei profili miR in pazienti affetti da mesotelioma, in particolare in relazione al trattamento con trabectedina. Valutare i profili miR nel plasma di tutti i pazienti partecipanti allo studio di fase II, attraverso la raccolta di campioni plasmatici prima del trattamento con trabectedina.
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E.3 | Principal inclusion criteria |
Cytological or histological diagnosis of unresectable MPM; age >18 years; Performance status 0-2 (ECOG); measurable disease (CT-PET); normal bone marrow reserve; adequate liver and renal function; not more than one previous chemotherapy course (of pemetrexed plus platinum derivative); previous chemotherapy course concluded at least 3 weeks prior to recruitment; atients must have recovered from toxicities of prior treatment (grade ≤ 1), life expectancy >3 months; written informed consent; negative pregnancy test. Patients who have received palliative radiation are eligible if <30% of bone marrow was irradiated and normal hematological function was completely regained. |
Diagnosi citologica o istologica di mesotelioma pleurico maligno inoperabile; età >18 anni; Performance status 0-2 (ECOG); malattia misurabile mediante TAC o PET; riserva midollare conservata; funzioni epatiche e renali adeguate; non più di un trattamento precedente (a base di pemetrexed e derivati del platino); distanza di almeno tre settimane dall’ultimo ciclo di terapia concluso; pieno recupero da eventuali tossicità del precedente trattamento (grado ≤1); spettanza di vita >3 mesi; consenso informato scritto; se applicabile, test gravidanza negativo. I pazienti che hanno ricevuto radioterapia palliativa sono eleggibili se è stata irradiata una porzione del midollo <30% e le condizioni ematologiche sono nella norma. |
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E.4 | Principal exclusion criteria |
Radiotherapy with curative intent to thoracic wall (concomitant with or prior to chemotherapy); adjuvant chemotherapy; severe concomitant illness; uncompensated diabetes mellitus or other condition absolutely contra-indicating dexamethasone (20 mg, used as pre-medication); enrollment in other trials; pregnant or breast-feeding women; prior exposure to trabectedin; history of other malignancies (except basal cell carcinoma or cervical carcinoma in situ, adequately treated), unless in remission for 5 years or more and judged of negligible potential of relapse; active viral hepatitis or chronic liver disease; unstable cardiac condition, including congestive heart failure or angina pectoris, myocardial infarction within one year before enrolment, uncontrolled arterial hypertension or arrhythmias; Active major infection; other serious concomitant illnesses; Brain / leptomeningeal involvement. |
Radioterapia con intento curativo della parete toracica (in concomitanza o in precedenza alla chemioterapia); chemioterapia adiuvante; patologie concomitanti gravi; diabete mellito scompensato o qualsiasi altra controindicazione all’impiego di desametasone (usato alla dose di 20 mg come pre-medicazione); partecipazione in altri studi di ricerca; gravidanza o allattamento; precedente assunzione di trabectedina; presenza di altre patologie neoplastiche (ad eccezione di basalioma o carcinoma della cervice uterina in situ, adeguatamente trattati), a meno che non siano in remissione da almeno cinque anni e giudicate di trascurabile potenziale di recidiva; epatite virale attiva o epatopatia cronica; cardiopatia instabile compresi: scompenso cardiaco, angina pectoris, infarto miocardico nell’anno precedente all’arruolamento, ipertensione incontrollata o aritmie; infezioni maggiori attive; altre patologie concomitanti gravi; interessamento cerebrale a/o meningeo. |
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E.5 End points |
E.5.1 | Primary end point(s) |
Progression Free Survival (PFS) |
Sopravvivenza libera da progressione (PFS) |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
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E.5.2 | Secondary end point(s) |
Progression free survival (PFS), objective response rate overall survival (OS). Safety will be evaluated based on reported AEs, clinical laboratory assessments, vital signs and physical examinations. Adverse events will be encoded using the Medical Dictionary for Regulatory Activities (MedDRA) and graded using NCI-CTCAE ver 4. .
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Sopravvivenza libera da progressione (PFS), tasso di risposta oggettiva, sopravvivenza (OS). La sicurezza della trabectedina sarà valutata a partire dai report di eventi avversi, esame obiettivo e di laboratorio. Gli eventi avversi saranno codificati usando il Medical Dictionary for Regulatory Activities (MedDRA) e classificati usando il sistema NCI-CTCAE versione 4.
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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 | Yes |
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 | No |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | No |
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) | No |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | No |
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 | 5 |
E.8.5 | The trial involves multiple Member States | No |
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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LVLS |
Ultima visita ultimo soggetto arruolato (LVLS) |
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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 | |
E.8.9.1 | In the Member State concerned months | |
E.8.9.1 | In the Member State concerned days | |