E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Unresectable Malignant Pleural Mesothelioma |
Mesotelioma pleural maligno irresecable |
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E.1.1.1 | Medical condition in easily understood language |
Cancer of the pleura (the lining covering the lungs) which cannot be treated by surgery |
Cáncer de la pleura (revestimiento de los pulmones) que no puede ser tratado con cirugía |
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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 | 18.1 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10059518 |
E.1.2 | Term | Pleural mesothelioma malignant |
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 | Yes |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
The primary objective of the randomised, parallel-controlled Phase II/III study is to evaluate the safety and efficacy in terms of progression-free survival of nintedanib + pemetrexed / cisplatin followed by nintedanib (arm A) versus placebo + pemetrexed / cisplatin followed by placebo (arm B), as first line treatment for patients with unresectable MPM. |
El objetivo principal del estudio de fase II/III aleatorizado, paralelo-controlado es evaluar la seguridad y eficacia en términos de supervivencia libre de progresión de nintedanib + pemetrexed/cisplatino seguido de nintedanib (brazo A) frente a placebo + pemetrexed/cisplatino seguido de placebo (brazo B), como primera línea tratamiento para los pacientes con MPM irresecable. |
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E.2.2 | Secondary objectives of the trial |
The key secondary objective is to evaluate OS in patients treated with the nintedanib regimen (arm A) versus the placebo regimen (arm B). Further secondary objectives are to evaluate the objective tumour response rate and to evaluate the disease control rate. Further objectives in this trial are to evaluate related measures of tumour response, to assess the percentage changes from baseline in forced vital capacity (FVC), to obtain information on quality of life (QoL), and to examine exposure to nintedanib in patients with unresectable MPM. In addition, biological specimens will be collected for the evaluation of molecular markers and possible correlation with treatment outcome |
El objetivo secundario clave es evaluar la SG en pacientes tratados con la pauta posológica de nintedanib (brazo A) frente a la pauta posológica de placebo (brazo B). Otros objetivos secundarios son evaluar la tasa de respuesta tumoral objetiva y la tasa de control de la enfermedad. Otros objetivos en este estudio son evaluar medidas relativas a la respuesta tumoral, evaluar el porcentaje de variación de la capacidad vital forzada (CVF) en comparación con el estado basal, obtener información sobre la calidad de vida (CdV), y analizar la exposición de nintedanib en pacientes con MPM irresecable. Además, se recogerán muestras biológicas para la evaluación de marcadores moleculares y la posible correlación con el resultado del tratamiento. |
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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 |
No individual trial protocols will be used for substudies. The following investigations are integrated in the protocol of the main study:
- Optional analysis of archived tumour tissue and serum derived biomarkers: the set of planned biomarkers is exploratory in nature and will be used as hypothesis-generating studies - Optional pharmacogenomic analysis: Genotyping of promoter variants in the mesothelin gene, analysis of polymorphisms in the genes encoding for VEGFR1 and VEGFR3 and DNA-banking |
No se utilizarán protocolos individuales del estudio para sub-estudios. Las siguientes investigaciones están integradas en el protocolo del estudio principal: - Análisis opcional del tejido tumoral de archivo y biomarcadores derivados de sérum: el conjunto de biomarcadores previstos es de carácter exploratorio y se utilizará como estudios generadores de hipótesis - Análisis opcional farmacogenómico: Genotipado de las variantes promotoras en el gen mesotelina, análisis de polimorfismos en los genes codificadores de VEGFR1 y VEGFR3 y banco de ADN. |
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E.3 | Principal inclusion criteria |
- Histologically confirmed MPM (subtype: epithelioid or biphasic) - Life expectancy of at least 3 months in the opinion of the investigator - ECOG score of 0 or 1 - Measurable disease according to modified RECIST criteria |
- MPM confirmado histológicamente (subtipo: epitelioide o bifásico) - Esperanza de vida de mínimo 3 meses en la opinión del investigador - Estado funcional de 0 o 1 según el Eastern Cooperative Oncology Group (ECOG). - Enfermedad medible según los Criterios de evaluación de la respuesta en tumores sólidos (RECIST) modificados |
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E.4 | Principal exclusion criteria |
- Previous systemic chemotherapy for MPM - Prior treatment with nintedanib or any other prior line of therapy - Patients with sarcomatoid subtype MPM - Radiotherapy (except extremities) within 3 months prior to baseline imaging - Patients that may be eligible for or being considered for radical resection or elective surgery during the course of the study. - Radical surgery within 4 weeks prior to randomisation - Active brain metastases (e.g. stable for < 4 weeks) - Therapeutic anticoagulation or anti-platelet therapy (except for low-dose therapy with acetylsalicylic acid < 325 mg per day) - Major injuries within the past 4 weeks prior to randomisation with incomplete wound healing - Other malignancies within 3 years prior to screening other than basal cell skin cancer or carcinoma in situ of the cervix |
- Quimioterapia sistémica previa para MPM - Tratamiento previo con nintedanib u otra línea de terapia previa - Pacientes con subtipo MPM sarcomatoide - Radioterapia (excepto extremidades) en los 3 meses previos a la imagen en el estado basal - Pacientes que pueden ser elegibles o ser considerados para resección radical o cirugía electiva durante el curso del estudio. - Cirugía radical en las 4 semanas previas a la aleatorización - Metástasis cerebral activa (e.g. estable durante < 4 semanas) - Anticoagulación terapéutica o terapia anti-plaquetas (excepto terapia dosis baja con ácido acetilsalicílico < 325 mg por día) - Lesiones mayores en las últimas 4 semanas previas a la aleatorización con curación de la herida incompleta - Otras malignidades dentro de los 3 años previos a la exploración diferentes al cáncer de piel celular basal o carcinoma de cuello uterino in situ |
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E.5 End points |
E.5.1 | Primary end point(s) |
Progression free survival measured from the time of randomisation to the time of disease progression or death of any cause, whichever occurs earlier |
Supervivencia libre de progresión medida desde el momento de aleatorización hasta que se produzca progresión de la enfermedad o muerte por cualquier causa, cualquiera que ocurra antes |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
The observation period for PFS will continue until approximately 237 OS events have occurred for Phase III patients or until approximately 44 months has elapsed since the first Phase III patient was randomised
Planned timepoint: November 2018 |
El periodo de observación para SLP continuará hasta que hayan ocurrido aproximadamente 237 acontecimientos de supervivencia global (OS) para pacientes en fase III o hasta que hayan transcurrido 44 meses desde que el primer paciente en fase III fue aleatorizado.
Criterio de valoración programado: noviembre 2018 |
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E.5.2 | Secondary end point(s) |
- Overall survival measured from the time of randomisation to the time of death of any cause (key secondary endpoint) - Objective response according to modified RECIST analysed by objective response rate - Disease control according to modified RECIST analysed by disease control rate |
- Supervivencia global medida desde el momento de aleatorización hasta que se produzca la muerte por cualquier causa (criterio secundario de valoración clave) - Respuesta objetiva según los criterios RECIST modificados analizada por tasa de respuesta objetiva - Control de la enfermedad según los criterios RECIST modificados analizado por tasa de control de la enfermedad |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
At the time of PFS analysis (November 2018) and if patients are still ongoing or in follow-up at the time of the clinical trial report for PFS, the clinical trial database will be kept open to collect the additional data.
Final evaluation: November 2018 |
En el momento del análisis de la SLP (noviembre 2018) y si los pacientes están todavía en tratamiento o en seguimiento en el momento del informe del estudio clínico para SLP, la base de datos del estudio clínico se mantendrá abierta para recoger datos adicionales.
Evaluación final: noviembre 2018 |
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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 | Yes |
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 | Yes |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | Yes |
E.6.13.1 | Other scope of the trial description |
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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) | 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 | Yes |
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 | Yes |
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 | 64 |
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 |
Argentina |
Australia |
Austria |
Belgium |
Canada |
Chile |
Czech Republic |
Denmark |
Egypt |
France |
Germany |
Israel |
Italy |
Mexico |
Netherlands |
Norway |
Poland |
Portugal |
Russian Federation |
South Africa |
Spain |
Sweden |
Switzerland |
Turkey |
United Kingdom |
United States |
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E.8.7 | Trial 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
|
The trial will be considered completed 18 months after the last patient was randomised. The primary analysis of PFS will be conducted and reported when approximately 237 patients have progressed or died. However, it may also be performed with fewer events within approximately 44 months total trial duration. If patients are still ongoing or in follow-up at the time of the clinical trial report for PFS, the clinical trial database will be kept open to collect the additional data. |
El estudio se considerará finalizado 18 meses tras la aleatorización del último paciente. |
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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 | 10 |
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 |