E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Locally advanced unresectable pancreatic adenocarcinoma |
Adenocarcinoma de páncreas irresecable localmente avanzado |
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E.1.1.1 | Medical condition in easily understood language |
Advanced Pancreatic Cancer |
Cáncer Pancreático avanzado. |
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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 | 16.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10033606 |
E.1.2 | Term | Pancreatic cancer non-resectable |
E.1.2 | System Organ Class | 100000004864 |
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E.1.3 | Condition being studied is a rare disease | Yes |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
The primary objective of the trial is to evaluate efficacy, as measured by overall survival (OS), of gemcitabine in combination with TH-302 compared to gemcitabine in combination with placebo in subjects with previously untreated locally advanced unresectable or metastatic pancreatic adenocarcinoma. |
El objetivo principal de este estudio es evaluar la eficacia, medida mediante la supervivencia global (SG) de la combinación de gemcitabina con TH-302 en comparación con la combinación de gemcitabina con placebo en pacientes con adenocarcinoma de páncreas irresecable localmente avanzado o metastático que no hayan recibido tratamiento con anterioridad. |
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E.2.2 | Secondary objectives of the trial |
To assess efficacy with resepct to: - progression free survival (PFS), and - objective response (OR) and disease control. To assess patient reported outcomes (PROs) with respect to quality of life (QoL) measured with EORTC QLQ-C30 (Version 3) and EQ-5D-5L, and pain measured by a Numerical Rating Scale (NRS). To investigate levels of carbohydrate antigen 19-9 (CA19-9), To assess the safety and tolerability of gemcitabine in combination with TH-302 compared with gemcitabine in combination with placebo. |
Evaluar la eficacia con respecto a: - la supervivencia sin progresión (SSP), y - la respuesta objetiva (RO) y el control de la enfermedad. Evaluar los resultados comunicados por el paciente (RCP) con respecto a la calidad de vida (CdV) medida con los cuestionarios QLQ-C30 (versión 3) de la EORTC y EQ-5D-5L, y al dolor medido con una escala de valoración numérica (EVN). Investigar la concentración del antígeno carbohidrato 19-9 (CA19-9). Evaluar la seguridad y tolerabilidad de la combinación de gemcitabina y TH-302 en comparación con la combinación de gemcitabina y placebo. |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
- At least 18 years of age. - Locally advanced unresectable or metastatic pancreatic ductal adenocarcinoma proven by histology or cytology and previously untreated with chemotherapy or systemic therapy - Measurable disease (at least one target lesion outside of previous radiation fields) or non-measurable disease by RECIST 1.1 criteria (see Appendix III). - Documentation of disease progression since any prior therapy. - Life expectancy of at least 3 months. - Acceptable liver function. - Acceptable renal function. - Acceptable hematologic status. - please see protocol for full list of inclusion criteria |
- Edad mínima de 18 años. -Adenocarcinoma ductal de páncreas irresecable localmente avanzado o metastático confirmado mediante estudio histológico o citológico, y no tratado con anterioridad con quimioterapia o un tratamiento sistémico. - Enfermedad medible (al menos una lesión objetivo fuera de los campos de radiación anteriores) o enfermedad no medible según los criterios RECIST 1.1 (v. el Anexo III). -Demostración de la progresión de la enfermedad desde la administración de cualquier tratamiento anterior. -Esperanza de vida mínima de 3 meses. - Función hepática aceptable - Función renal aceptable - Estado hematológico aceptable - Véase en protocolo, listado completo de criterios de inclusión. |
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E.4 | Principal exclusion criteria |
1. New York Heart Association (NYHA) Class III or IV congestive heart failure, myocardial infarction within 6 months prior to the date of randomization, unstable arrhythmia or symptomatic peripheral arterial vascular disease. 2. Symptomatic ischemic heart disease. 3. Known brain, leptomeningeal or epidural metastases (unless treated and well controlled for at least 3 months). 4. Previous malignancy other than pancreatic cancer in the last 5 years, except for adequately treated non-melanoma skin cancer or pre-invasive cancer of the cervix. 5. Severe chronic obstructive or other pulmonary disease with hypoxemia 6. Major surgery, other than diagnostic surgery, ?28 days prior to the date of randomization. Subject must have completely recovered from surgery. 7. Active, uncontrolled bacterial, viral, or fungal infections, requiring systemic therapy. 8. Treatment of pancreatic cancer with radiation therapy or surgery ?28 days prior to the date of randomization. 9. Prior therapy with a hypoxic cytotoxin. 10. Subjects who participated in an investigational drug or device trial ?28 days prior to Day 1 of the first cycle. 11. Known infection with HIV, or an active infection with hepatitis B or hepatitis C. 12. Subjects who have exhibited allergic reactions to a structural compound similar to TH-302 or the drug product excipients or to gemcitabine or its excipients. 13. Please see protocol for full list of exclusion criteria. |
1.Insuficiencia cardíaca congestiva de clase III o IV según la NYHA (New York Heart Association), infarto de miocardio en los 6 meses anteriores a la fecha de la aleatorización, arritmia inestable o arteriopatía vascular periférica sintomática. 2.Cardiopatía isquémica sintomática. 3.Metástasis cerebrales, leptomeníngeas o epidurales conocidas (a menos que hayan recibido tratamiento y estén bien controladas durante al menos 3 meses). 4.Neoplasia maligna anterior, con excepción del cáncer de páncreas, en los últimos 5 años, salvo el cáncer de piel no melanómico o el carcinoma in situ del cuello uterino, debidamente tratados. 5.Neumopatía obstructiva crónica grave u otras enfermedades pulmonares que cursen con hipoxemia. 6.Operación quirúrgica mayor (excepto diagnóstica) ? 28 días antes de la fecha de la aleatorización. El paciente debe haberse recuperado por completo de la operación quirúrgica. 7.Infección bacteriana, vírica o micótica activa y no controlada que requiera tratamiento sistémico. 8.Tratamiento del cáncer de páncreas con radioterapia o cirugía ? 28 días anteriores a la fecha de la aleatorización. 9.Tratamiento anterior con una citotoxina hipóxica. 10.Pacientes que hayan participado en otro estudio clínico con algún fármaco o dispositivo en investigación ? 28 días antes del día 1 del primer ciclo. 11.Infección por el VIH diagnosticada o infección activa por el virus de la hepatitis B o C. 12.Pacientes que hayan presentado reacciones alérgicas a un compuesto estructural parecido a TH-302 o a los excipientes del fármaco en estudio, o a la gemcitabina o sus excipientes. 13. Véase protocolo para listado completo de criterios de exclusión. |
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E.5 End points |
E.5.1 | Primary end point(s) |
The primary endpoint is Overall Survival (OS) time. |
El criterio de valoración principal es el tiempo de Supervivencia Global (SG). |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
OS will be evaluated when 508 events (deaths) of randomized patients are reported. |
La SG se evaluará cuando se hayan comunicado 508 episodios (muertes) de pacientes aleatorizados. |
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E.5.2 | Secondary end point(s) |
- Progression-freee Survival (PFS) Time. - Best Overall Respose Rate according to Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1. - Disease control Rate according to Response Evaluation Criteria in solid Tumors (RECIST) version 1.1. - Quality of Life (QOL) EuroQuol-5D (EG-5D) Health Outcome questionnaire. - Pain intensitiy using a visual analogue scale (VAS). - Serum CA 19-9 response rate. - Number of participants with treatment-emergent adverse events (TEAE) graded according to National Cancer Institute Common Terminology Criteria for Adverse Eents (NCI CTCAE v.4.03). |
? Tiempo de supervivencia sin progresión ? Mejor tasa de respuesta global, según RECIST 1.1. ? Tasa de control de la enfermedad según (RECIST) version 1.1. ? Cuestionario de salud: EQ-5D-5L, cuestionario Calidad de Vida QLQ-C30, ? Escala de valoración numérica (EVN) de la intensidad del dolor ? Nivel de respuesta, serum CA19-9 ? Numero de participantes con acontecimientos adversos aparecidos durante el tratamiento (AAAT) en términos clasificados y graduados conforme a los Criterios de terminología comunes para acontecimientos adversos del National Cancer Institute (CTCAE del NCI, v. 4.03) |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
Secondary endpoints will be evaluated at the same timepoint as OS data is mature. |
Los criterios de valoración secundarios se evaluarán al mismo tiempo que los datos de supervivencia global estén disponibles- |
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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 | Yes |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | Yes |
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 | 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 | Yes |
E.8.2.3 | Other | Yes |
E.8.2.3.1 | Comparator description |
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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 | 125 |
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 |
European Union |
Austria |
Belgium |
Bulgaria |
Canada |
Czech Republic |
Finland |
France |
Germany |
Hungary |
Ireland |
Israel |
Italy |
Netherlands |
New Zealand |
Poland |
Romania |
Russian Federation |
Slovakia |
South Africa |
Spain |
Ukraine |
United Kingdom |
United States |
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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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Once the event-driven unblinding and final analysis is complete (unblinding and final analysis occurs after 508 events [deaths]), the Sponsor will initiate activities towards execution of an extension protocol, if appropriate, based on study outcomes, so that this Phase III study can be closed. |
Una vez terminados el proceso de desenmascaramiento motivado por algún episodio y el análisis final (el desenmascaramiento y el análisis final tendrán lugar después de que se produzcan 508 episodios [fallecimientos]), el promotor iniciará las actividades pertinentes destinadas a ejecutar un protocolo de ampliación, si procede, según los resultados del estudio, de manera que pueda cerrarse este estudio de fase III. |
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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 | |
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 |