E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Non small-cell lung cancer (NSCLC) |
Carcinoma polmonare non a piccole cellule (Non Small Cell Lung Cancer – NSCLC) |
|
E.1.1.1 | Medical condition in easily understood language |
lung cancer |
Carcinoma polmonare |
|
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 | PT |
E.1.2 | Classification code | 10029522 |
E.1.2 | Term | Non-small cell lung cancer stage IV |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
|
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 14.1 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10029521 |
E.1.2 | Term | Non-small cell lung cancer stage IIIB |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
|
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 compare PFS in patients with advanced NSCLC whose tumors harbor EGFR activating mutations and have progressed on EGFR TKI treatment treated with AUY922 versus pemetrexed or docetaxel. |
Confrontare la sopravvivenza libera da progressione (Progression Free Survival - PFS) in pazienti, il cui tumore presenta mutazioni attivanti dell’EGFR e che sono progrediti durante il trattamento con EGFR TKI, trattati con AUY922 rispetto a pemetrexed o docetaxel, |
|
E.2.2 | Secondary objectives of the trial |
- To compare OS between the treatment arms. - To compare the Overall Response Rate (ORR) between the treatment
arms. - To compare the Disease Control Rate (DCR) duration between the treatment arms. - To compare Time to Progression (TTP) between the treatment arms. - To compare Duration of Response (DOR) between the treatment arms.
- To evaluate safety and tolerability of administering AUY922 in the treatment of NSCLC compared to pemetrexed or docetaxel. |
- Confrontare la sopravvivenza globale (Overall Survival - OS), il tasso di risposta globale (Overall Response Rate - ORR), il tasso di controllo di malattia (Disease Control Rate - DCR), il tempo alla progressione (Time To Progression - TTP) e la durata della risposta (Duration Of Response - DOR) tra i gruppi di trattamento. - Valutare la tossicità e la tollerabilità della somministrazione di AUY922 nel trattamento dell’NSCLC rispetto a pemetrexed o docetaxel. |
|
E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Patients with histologically or cytologically documented, locally advanced (stage IIIB who are not amenable to combined modality treatment) or recurrent or metastatic (Stage IV) non-small cell lung cancer.
2. Patients must have EGFR gene mutation in their tumors.
3. Patients must have documented clinical benefit (CR, PR, or patients with SD for 6 months or greater) on prior EGFR TKI (e.g. erlotinib or gefitinib) followed by documented
progression according to RECIST.
4. Patients must be 18 years or older and able to sign Informed Consent.
5. Patients must be suitable and willing to undergo mandatory baseline biopsy according to treating institution’s own guidelines and requirements for such procedure. No baseline biopsy is required for patients with known resistance mechanisms to EGFR TKI and available tumor material
6. WHO performance status of 0-1.
7. Measurable disease according to RECIST v.1.1 (Irradiated lesions can not be considered measurable unless they have clearly progressed since radiotherapy). |
•Pazienti con carcinoma polmonare non a piccole cellule, documentato istologicamente o citologicamente, localmente avanzato (stadio IIIB che non si possa sottoporre a una modalità combinata di trattamento) o ricorrente o metastatico (stadio IV).
•Pazienti con tumore che presenta mutazione genetica dell’EGFR.
•Pazienti con beneficio clinico documentato (CR, PR o SD per 6 mesi o più) durante il trattamento precedente con EGFR TKI (ad es. erlotinib o gefitinib) seguito da progressione documentata in base ai criteri RECIST.
•Pazienti di età uguale o superiore a 18 anni in grado di firmare il consenso informato.
•Pazienti idonei e disponibili a sottoporsi alla biopsia obbligatoria all’ingresso nello studio, in conformità alle linee guida proprie dell’ospedale di riferimento per il trattamento e ai requisiti per tale procedura. Non sono richieste biopsie all’ingresso nello studio per i pazienti con noti meccanismi di resistenza a EGFR TKI e materiale tumorale disponibile.
•Punteggio WHO Performance Status 0-1.
•Malattia misurabile secondo i criteri RECIST v. 1.1 (le lesioni irradiate non possono essere considerate misurabili a meno che non siano chiaramente progredite dalla radioterapia) |
|
E.4 | Principal exclusion criteria |
1. Patients who have received more than two prior lines of antineoplastic therapy for advanced disease. Chemotherapy administered as adjuvant treatment more than six months prior to study enrollment is not considered a prior line of therapy for purposes of
this study.
2. Patients who have received any antineoplastic treatment between EGFR TKI discontinuation and study start.
3. Evidence of spinal cord compression or current evidence of CNS metastases. Screening CT/MRI of the brain is mandatory.
4. Patients who have received EGFR TKI (e.g. erlotinib, gefitinib) within ≤ 5 half-lives of the agent or active metabolites of the of starting the study. All associated toxicities (with
the exception of alopecia) should be resolved to baseline or less prior to treatment start.
5. Patients who received radiation therapy for management of local disease within four weeks (RT for palliative pain management is allowed). All associated toxicities (with the
exception of alopecia) should be resolved to grade 1 or less prior to treatment start.
6. Prior treatment with an HSP90 inhibitor |
•Pazienti che hanno ricevuto più di due precedenti linee di terapia per malattia avanzata. La chemioterapia somministrata come trattamento adiuvante più di sei mesi prima dell’arruolamento nello studio non è considerata una precedente linea di trattamento per lo scopo di questo studio.
•I pazienti non devono aver ricevuto un trattamento anti-neoplastico tra l’interruzione di EGFR TKI e l’inizio dello studio.
•Evidenza di compressione del midollo spinale o evidenza attuale di metastasi del sistema nervoso centrale. È obbligatoria una TAC/RMN cerebrale di screening.
•I pazienti non devono aver ricevuto l’agente o i metaboliti attivi per EGFR TKI (ad es. erlotinib, gefitinib) entro ≤ 5 emivite dall’inizio dello studio. Tutte le tossicità associate (ad eccezione di alopecia) devono essere risolte al basale o precedentemente prima dell’inizio del trattamento.
•I pazienti non devono essere stati sottoposti a radioterapia per la gestione della malattia locale nelle quattro settimane precedenti. Tutte le tossicità associate (ad eccezione di alopecia) devono essere risolte a grado 1 o meno prima dell’inizio del trattamento.
•Precedente trattamento con un inibitore HSP90. |
|
E.5 End points |
E.5.1 | Primary end point(s) |
Progression free survival (PFS) based on local investigator assessment
per RECIST 1.1 |
Sopravvivenza libera da progressione (Progression Free Survival - PFS) basata sulla valutazione dello sperimentatore del centro in accordo ai criteri RECIST 1.1. |
|
E.5.1.1 | Timepoint(s) of evaluation of this end point |
durarion of the treatment |
per tutta la durata del trattamento |
|
E.5.2 | Secondary end point(s) |
1. overall survival (OS)
2. overall response rate (ORR)
3. disease control rate (DCR)
4. time to progression (TTP)
5. duration of response (DOR), all above based on local investigator assessment per RECIST 1.1.
6. rate of adverse events (AEs)
7. rate of serious adverse events (SAEs) |
1. sopravvivenza globale (Overall Survival - OS)
2. tasso di risposta globale (Overall Response Rate - ORR)
3. tasso di controllo di malattia (Disease Control Rate - DCR).
4. tempo alla progressione (Time To Progression - TTP).
5. durata della risposta (Duration Of Response - DOR), basati sulla valutazione dello sperimentatore del centro secondo i criteri RECIST 1.1.
6. tasso di eventi avversi (Adverse Event – AE).
7. tasso di eventi avversi seri (Serious Adverse Event – SAE) |
|
E.5.2.1 | Timepoint(s) of evaluation of this end point |
1. from randomization to death
2-7. treatment duration |
1. dalla randomizzazione alla morte
2-7. per tutta la durata del trattamento |
|
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 | Yes |
E.6.13.1 | Other scope of the trial description |
compare efficacy of AUY922 versus pemetrexed or docetaxel |
Confrontare l'efficacia di AUY922 rispetto a pemetrexed e docetaxel |
|
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 | Yes |
E.8.1.1 | Randomised | Yes |
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) | 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 | 5 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 18 |
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 |
Hong Kong |
Israel |
Korea, Republic of |
Singapore |
Taiwan |
United States |
|
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
|
The study will continue until one year past last patient treatment
unless survival follow up period has already been completed. |
Lo studio continuerà fino a un anno dopo la data dell'ultimo trattamento dell'ultimo paziente a meno che il periodo di follow up per la sopravvivenza non sia già stato completato |
|
E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 0 |
E.8.9.1 | In the Member State concerned months | 30 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 0 |
E.8.9.2 | In all countries concerned by the trial months | 30 |
E.8.9.2 | In all countries concerned by the trial days | 0 |