E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Metastatic uveal melanoma |
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E.1.1.1 | Medical condition in easily understood language |
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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 | 18.0 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10025654 |
E.1.2 | Term | Malignant melanoma of sites other than skin |
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 |
To assess the efficacy of selumetinib in combination with dacarbazine with placebo in combination with dacarbazine in terms of Progression Free Survival (PFS) |
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E.2.2 | Secondary objectives of the trial |
To assess the efficacy of selumetinib in combination with dacarbazine with placebo in combination dacarbazine by assessment of:
- Objective Response Rate (ORR)
- Duration of Response (DoR)
- Change in tumour size
To assess overall survival (OS) in patients taking selumetinib in combination with dacarbazine compared with those taking placebo in combination with dacarbazine
Assessment of AEs graded by common Terminology Criteria for Adverse Events (CTCAE) v4.0
Assessment of standard 12 lead ECGs
Assessment of standard vital signs (including blood pressure, pulse)
Assessment of lab parameters (clinical chemistry)
Assessment of lab parameters (haematology)
Assessment of lab parameters (urinalysis)
Assessment of Echocardiogram/multi gated Acquisition Scan (MUGA)
Ophthalmological assessment
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1.Clinical diagnosis of metastatic uveal melanoma
2.Written consent from female or male patients aged 18 years or older
3.Histological or cytological confirmation of melanoma who are suitable for treatment with dacarbazine chemotherapy
4.At least one lesion that can be accurately measured at baseline as ≥10 mm in the longest diameter (except lymph nodes which must have short axis ≥15 mm) with CT or MRI and which is suitable for accurate repeated measurements
- ECOG Performance Status 0-1
- Life expectancy >12 weeks
- Normal organ and marrow function
5.Patients should be able to swallow selumetinib/placebo capsules
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E.4 | Principal exclusion criteria |
1.Involvement in the planning and/or conduct of the study (applies to both AstraZeneca staff and/or staff at the study site)
2.Previous randomisation in the present study
3.Patients cannot have previously been treated with a systemic anti-cancer therapy. Patients can have had prior intra-hepatic therapy or non-systemic therapy
4.Having received any of the following within the specified timeframe:
-Any prior systemic anti-cancer therapy for the treatment of this current diagnosis
-An investigational drug within 30 days of starting treatment or within five half-lives of the compound (whichever is the most appropriate is at the discretion of the Investigator), or have not recovered from side effects of an investigational drug
-Any anti-cancer therapy which has not been cleared from the body by the time of starting study treatment
-Radiation therapy within 4 weeks prior to starting study treatment, or limited field of radiation for palliation within 7 days of the first dose of study treatment
-Major surgery within 4 weeks prior to entry into the study (excluding the placement of vascular access) which would prevent administration of study treatment
-Any prior investigational therapy comprising inhibitors of RAS, RAF or MEK at any time
-Previous treatment with dacarbazine.
5.Any unresolved toxicity >CTCAE grade 2 from previous anti-cancer therapy, excluding alopecia
6.History of allergic reactions attributed to compounds of similar chemical or biologic composition to selumetinib or dacarbazine
7.Symptomatic brain metastases or spinal cord compression (patients must be treated and stable off steroids and anti-convulsants for at least 1 month prior to entry into the study
8.Cardiac conditions as follows:
-Uncontrolled hypertension (BP ≥150/95 mmHg despite medical therapy)
-Acute coronary syndrome within 6 months prior to starting treatment
-Uncontrolled Angina - Canadian Cardiovascular Society grade II-IV despite medical therapy,
-Symptomatic heart failure (New York Heart Association [NYHA] Class II-IV,Prior or current cardiomyopathy
-Baseline LVEF <50% measured by echocardiography or MUGA. Appropriate correction to be used if a MUGA is performed
-Severe valvular heart disease
-Atrial fibrillation with a ventricular rate >100 bpm on ECG at rest
-QTcF >450 ms or other factors that increase the risk of QTc prolongation
9.Any evidence of severe or uncontrolled systemic disease, active infection, active bleeding diatheses or renal transplant, including any patient known to have hepatitis B, hepatitis C or human immunodeficiency virus (HIV)
10.Refractory nausea and vomiting, chronic gastrointestinal diseases (eg, inflammatory bowel disease), or significant bowel resection that would preclude adequate absorption
11.History of another primary malignancy within 5 years prior to starting study treatment, except for adequately treated basal or squamous cell carcinoma of the skin or cancer of the cervix in situ and the disease under study
12.Ophthalmologic conditions:
- Current or past history of central serous retinopathy
- Current or past history of retinal vein occlusion
- IOP >21 mmHg or uncontrolled glaucoma (irrespective of IOP)
13.Female patients who are breast-feeding a child
and male or female patients of reproductive potential who are not employing an effective method of birth control
14. Clinical judgement by the Investigator that the patient should not participate in the study. |
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E.5 End points |
E.5.1 | Primary end point(s) |
PFS by Blind Indepentdent Central Review (BICR) according to RECIST 1.1
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
PFS: Radiological scans performed from baseline then every 6 weeks thereafter until disease progression has been confirmed by BICR in accordance with RECIST 1.1,assessed up to 18 months
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E.5.2 | Secondary end point(s) |
ORR by central review of RECIST data
DoR by central review of RECIST data
Change in tumour size by central review of RECIST data
Efficacy in patients by assesment of OS
Assessment of the safety and tolerability of selumetinib by collection of AE reports
Determine safety and tolerability by assessment of 12 lead ECGs
Determine safety and tolerability by assessment of vital signs
Determine safety and tolerability by assessment of haematology results
Determine safety and tolerability by assessment of urinalysis results
Determine safety and tolerability by assessment of MUGA
Determine safety and tolerability by assessment by Ophthalmologic assessment |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
ORR: From baseline and at every 6 weeks, up to 18 months
DoR: From baseline and at every 6 weeks, up to 18 months
Change in tumour size: From baseline and at every 6 weeks, up to 18 months
OS: Post-progression patients assessed for survival every 8 weeks, up to 30 months
AEs: From baseline and at each study visit up to 30 months
ECGs: From baseline, up to 30 months
Vital signs: From baseline and at each study visit up to 30 months
Haematology: From baseline and at each study visit up to 30 months
Urinalysis: From baseline and at each study visit up to 30 months
MUGA: From baseline and every 12 weeks up to 30 months
Ophthalmologic: From baseline, up to 30 months |
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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 | Yes |
E.6.11 | Pharmacogenomic | Yes |
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) | 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 | 3 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 31 |
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 |
Belgium |
Canada |
Czech Republic |
Finland |
France |
Germany |
Israel |
Italy |
Netherlands |
Spain |
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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The end of the study will be defined as the point at which no patient
will be exposed to study related procedures and the last patient has
received the last dose of selumetinib plus 30 days of safety follow-up.
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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 | 0 |
E.8.9.1 | In the Member State concerned days | 0 |
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 | 0 |
E.8.9.2 | In all countries concerned by the trial days | 0 |