E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
solid tumors metastatic or relapsed, resistant/refractory to conventional therapy |
tumori solidi metastatici o recidivati, resistenti/refrattari alle terapie convenzionali |
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E.1.1.1 | Medical condition in easily understood language |
Solid tumors with no chances of cure |
Tumori solidi senza ulteriore possibilità di cura |
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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 | 20.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10006190 |
E.1.2 | Term | Breast cancer invasive NOS |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 25.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10033612 |
E.1.2 | Term | Pancreatic carcinoma NOS |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 21.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10038415 |
E.1.2 | Term | Renal cell carcinoma stage unspecified |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 21.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10017760 |
E.1.2 | Term | Gastric cancer NOS |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
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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 determine if engraftment can be achieved safely in patients with high-risk hematologic malignancies who undergo non-myeloablative transplant with peripheral stem cells from HLA-haploidentical donors. |
Determinare se l’attecchimento può essere raggiunto in maniera sicura in pazienti affetti da neoplasie ematologiche ad alto rischio che vengano sottoposti a trapianto non mieloablativo con cellule staminali periferiche da donatori HLA-apoloidentici familiari. |
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E.2.2 | Secondary objectives of the trial |
Reconstitution of lymphocytes and NK cells |
Ricostituzione dei linfociti e delle cellule Natural Killer (NK) |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
- Histologically or cytologically proven diagnosis of renal cell cancer, neurendocrine cancer, pancreatic cancer, rhinopharyngeal lymphoepithelioma, malignant melanoma, soft-tissue sarcoma, ovarian carcinoma, gastric carcinoma, germ cell tumors, breast cancer, colorectal cancer with evidence of unresectable, locally recurrent, or metastatic disease. Locally recurrent disease must not be amenable to resection or radiation therapy with curative intent - Recurrent/refractory disease after primary treatment and deemed not suitable for standard therapy. Metastatic disease not eligible for standard therapy-potentially curative or able to extend life expectancy.
- Prior treatment with chemotherapy as follows: receipt of adjuvant chemotherapy with RECIST defined disease progression documented during treatment or disease relapse within 6 months of last treatment, or receipt of chemotherapy in the first-line advanced disease setting with RECIST defined disease stable or progression documented during treatment, or, if the patient completed treatment with objective disease response, documented disease stable or progression after discontinuing treatment. Patients entering the study on the basis of this criterion may have also previously received neoadjuvant or adjuvant treatment with chemotherapy.
- Measurable disease as per RECIST. Measurable lesions that have been previously radiated will not be considered target lesions unless increase in size has been observed following completion of radiation therapy. - Male or female. - Patients age > 18 and < 70 years. - ECOG performance status 0-2. - Resolution of all acute toxic effects of prior therapy or surgical procedures to grade =1 (except alopecia).
- Life expectancy >3 months. - A fully HLA-identical or alternatively an HLA haploidentical related donor is available. - The definitions of minimum adequacy for organ function required prior to study entry are as follows: . Serum aspartate transaminase (AST) and serum alanine transaminase (ALT) =2.5 x upper limit of normal (ULN), or AST and ALT =5 x ULN if liver function abnormalities are due to underlying malignancy . Total serum bilirubin =1.5 x ULN . Absolute neutrophil count (ANC) =1500/µL . Platelets =100,000/µL . Haemoglobin =9.0 g/dL . Serum creatinine =1.5 x ULN - Signed and dated informed consent document indicating that the patient (or legally acceptable representative) has been informed of all the pertinent aspects of the trial prior to enrolment. - Willingness and ability to comply with scheduled visits, treatment plans, laboratory tests, and other study procedures. |
tumori del rene a cellule chiare, tumori neuroendocrini, tumori del pancreas, linfoepiteliomi del rinofaringe, melanomi, sarcomi dei tessuti molli, tumori ovarici, tumori gastrici, tumori a cellule germinali, tumori della mammella, tumori del colon-retto con evidenza di malattia non resecabile, localmente avanzata o metastatica. Il quadro di recidiva locale non deve essere candidabile a chirurgia o radioterapia. - Malattia recidivata/refrattaria dopo il trattamento di prima linea e ritenuta non candidabile ad una terapia standard. Malattia metastatica non elegibile ad una terapia convenzionale potenzialmente curativa o capace di aumentare l’aspettativa di vita - Malattia stabile o in progressione, misurabile in accordo ai criteri RECIST. - Maschi o femmine dai 18 ai 70 anni di età. - ECOG performance status 0-2. - Risoluzione di tutti gli effetti collaterali di una precedente terapia o procedura chirurgica ad un grado < 1 (eccetto l’alopecia). - Aspettativa di vita superiore a 3 mesi. - Presenza di donatore familiare HLA-identico o Aploidentico - Presenza di una funzionalità d’organo adeguata, secondo i seguenti criteri: - Aspartato transaminasi (AST) and alanina transaminasi (ALT) = 2.5X limiti superiori alla norma (UNL) o = 5X ULN se l’anormalità della funzionalità epatica è dovuta al tumore - Bilirubina serica =1.5X ULN - Albumina serica =3.0 g/dL - Conta assoluta dei neutrofili (ANC) =1500/µL - Piastrine =100,000/µL - Emoglobina =9.0 g/dL - Creatinina Serica =1.5 x ULN - Consenso informato datato e firmato, con paziente che acconsente alle visite previste, ad eseguire i test di laboratorio e tutte le procedure previste dallo studio. |
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E.4 | Principal exclusion criteria |
- Uncontrolled CNS involvement with disease - Fertile men or women unwilling to use contraceptive techniques during and for 12 months following treatment - Females who are pregnant - Organ dysfunction defined as follows: ¿ Cardiac ejection fraction <30% or uncontrolled cardiac failure ¿ Pulmonary: DLCO <40% predicted ¿ Liver: elevation of bilirubin to > 1.5 x ULN and/or transaminases >5x the upper limit of normal ¿ Renal: Serum creatinine >1.5 x ULN - ECOG performance status >2 - Patients with poorly controlled hypertension on multiple antihypertensives - Documented fungal disease that is progressive despite treatment - Viral infections: HIV positive patients. Hepatitis B and C positive patients will be evaluated on a case by case basis - Psychiatric disorders or psychosocial problems which in the opinion of the primary physician or Principal Investigator would place the patient at unacceptable risk from this regimen. - Patients may not be receiving any other investigational agents. - History of allergic reactions attributed to compounds of similar chemical or biologic composition to agents used in the study. - Any previous or current malignancy at other sites, with the exception of adequately treated cone-biopsied in situ carcinoma of the cervix and adequately treated basal or squamous cell carcinoma of the skin. |
- Coinvolgimento del sistema nervoso centrale con malattia refrattaria alla terapia intratecale - Presenza di infezioni attive severe - Karnofsky score = 60% - Pazienti con funzionalità cardiaca, epatica o polmonare compromessa ( Frazione di eiezione ventricolare sinistra minore del 35%; Valore di diffusione alveolo-capillare < 40% od ossigenoterapia continua; alterazione della funzionalità epatica , con bilirubina =3 mg/dl e/o transaminasi >4x il limite superiore di normalità; Insufficienza renale con clearance della creatinina <50 cc/min (su urine delle 24 ore) - Pazienti HIV positivi - Stato di gravidanza o puerperio - Pazienti fertili che non sono intenzionati ad utilizzare metodi contraccettivi per i 12 mesi successivi al trattamento - Aspettativa di vita per ragioni diverse dalla malattia < 3 mesi - Altre terapie sperimentali concomitanti |
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E.5 End points |
E.5.1 | Primary end point(s) |
- Donor engraftment at day +84 (efficacy) - Incidence and severity of GVHD (safety) - Non-relapse-related mortality at day +200 (safety) |
- Valutazione dell’attecchimento al giorno +84 - Incidenza e severità della GVHD - Mortalità non correlata alla recidiva al giorno +200 |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
day +84 for the engraftment and day +200 for non-relapse-related mortality |
giorno +84 per l’attecchimento e giorno +200 per la mortalità non dovuta alla recidiva |
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E.5.2 | Secondary end point(s) |
Reconstitution of lymphocytes and NK cells |
Ricostituzione linfocitaria e delle cellule NK |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
every 2 weeks from transplant for 3 months |
ogni 2 settimane per 3 mesi dal trapianto |
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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) | 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 | No |
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.8.2.4 | Number of treatment arms in the trial | 1 |
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 | 2 |
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 | Information not present in EudraCT |
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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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 5 |
E.8.9.1 | In the Member State concerned months | 0 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 5 |
E.8.9.2 | In all countries concerned by the trial months | 0 |
E.8.9.2 | In all countries concerned by the trial days | 0 |