E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
B-cell non-hodgkin's lymphoma (NHL) and diffuse large B-cell lymphoma (DLBCL) |
LINFOMA NO HODGKIN (LNH) DE LINFOMAS B Y LMDLB |
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E.1.1.1 | Medical condition in easily understood language |
Non-Hodgkin's Lymphoma |
Linfoma no Hodgkin |
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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 | 17.1 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10012821 |
E.1.2 | Term | Diffuse large B-cell lymphoma recurrent |
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 | 17.1 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10029601 |
E.1.2 | Term | Non-Hodgkin's lymphoma refractory |
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 | 17.1 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10012822 |
E.1.2 | Term | Diffuse large B-cell lymphoma refractory |
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 | 17.1 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10029547 |
E.1.2 | Term | Non-Hodgkin's lymphoma |
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 | 17.1 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10029600 |
E.1.2 | Term | Non-Hodgkin's lymphoma recurrent |
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 | 17.1 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10012818 |
E.1.2 | Term | Diffuse large B-cell lymphoma |
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 |
The primary objective of the Phase I portion of the study is: ? To estimate the maximum tolerated dosing schedule for GDC-0199 given in combination with R-CHOP or G-CHOP to patients with B-cell NHL, either previously untreated or relapsed/refractory after a maximum of one prior therapy The primary objectives of the Phase II portion of the study are: ? To assess the safety and tolerability of the combination of GDC-0199 and R-CHOP or G-CHOP administered to patients with previously untreated DLBCL ? To make a preliminary assessment of efficacy as measured by CR rate determined by PET/CT scan (see Appendix 2), of the combination of GDC-0199 and R-CHOP administered to patients with previously untreated DLBCL |
El objetivo principal de la parte de fase I del estudio es: ?Calcular la pauta posológica máxima tolerada para GDC-0199 administrado en combinación con R-CHOP o G-CHOP en pacientes con linfoma no Hodgkin (LNH) de linfocitos B, ya hubieran sido tratados previamente o sean recidivantes/resistentes tras un máximo de un tratamiento anterior Los objetivos principales de la parte de fase II del estudio son: ?Evaluar la seguridad y la tolerabilidad de la combinación de GDC-0199 más R-CHOP o G CHOP administrado en pacientes con linfoma macrocítico difuso de linfocitos B (LMDLB) sin tratamiento previo ?Realizar una evaluación preliminar de la eficacia medida por la tasa de respuesta completa (RC) determinada mediante exploración por tomografía por emisión de positrones/tomografía computarizada (TEP/TAC) de la combinación de GDC-0199 y R-CHOP administrado a pacientes con LMDLB no tratado previamente |
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E.2.2 | Secondary objectives of the trial |
The PK objectives of this study are: ? To characterize the PK of GDC-0199 when administered in combination with R-CHOP or G-CHOP in the relapsed/refractory or previously untreated setting ? To characterize the PK of rituximab, obinutuzumab, and CHOP components when administered in combination with GDC-0199 in relapsed/refractory or previously untreated B-cell NHL The activity objective of this study includes: ? To make a preliminary assessment of efficacy when GDC-0199 and R-CHOP are administered in combination to patients with previously untreated DLBCL, as measured by: ? OR rate ? CR rate as determined by CT scan ? Response duration ? PFS ? OS ? To make a preliminary assessment of efficacy when GDC-0199 and G-CHOP are administered in combination, as measured by OR, CR and PFS.
Please see section 2.2.3 of the protocol for additional explotatory objectives |
Los objetivos farmacocinéticos de este estudio son: ?Caracterizar la farmacocinética de GDC-0199 cuando se administra en combinación con R-CHOP o G-CHOP en contexto recidivante/resistente o sin tratamiento previo ?Caracterizar la farmacocinética de rituximab, obinutuzumab y los componentes de CHOP cuando se administra en combinación con GDC-0199 en LNH de linfocitos B recidivante/resistente o sin tratamiento previo Los objetivos secundarios para este estudio son: ?Realizar una evaluación preliminar de la eficacia cuando GDC-0199 y R-CHOP se administran en combinación a pacientes con LMDLB sin tratamiento previo, medida por: - Tasa de respuesta objetiva (RO) - Tasa de RC determinada por TAC - Duración de la respuesta - SSP - SG ?Realizar una evaluación preliminar de la eficacia cuando GDC-0199 y G-CHOP se administran en combinación, medida por la tasa de RO, la tasa de RC y la tasa de SSP Por favor, ver sección 2.2.3 del protocol para objtivos exploratorios adicionales |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
General Inclusion Criteria: - Patients, age >= 18 years - At least one bi-dimensionally measurable lesion defined as > 1.5 cm in its longest dimension - Ability and willingness to comply with the study protocol procedures - Confirmed availability of archival or freshly biopsied tumor tissue prior to study enrollment - ECOG performance status of 0, 1, or 2 - Adequate hematologic function - For female patients of childbearing potential and male patients with female partners of childbearing potential, agreement to use highly effective forms of contraception
Dose Escalation Portion of the Study: - Patients must have histologically confirmed B-cell non- Lymphoma (NHL) - Patients must have never received previous R-CHOP treatment - Any relapsed/refractory patients that are enrolled during the dose escalation should have received only a single previous treatment regimen
Expansion Portion of the Study: - Patients must have previously-untreated diffuse large, B-cell lymphoma - International prognostic index (IPI) score must be 2-5 |
Criterios de inclusión generales: ?Edad >= 18 años ?Al menos una lesión medible bidimensionalmente en exploraciones por TAC definida como 1,5 cm en su dimensión más larga ?Capacidad y disposición para cumplir con los procedimientos del protocolo del estudio ?Disponibilidad confirmada de tejido tumoral de archivo o recientemente biopsiado que cumpla con las especificaciones definidas en el protocolo antes de la inscripción en el estudio ?Estado general de 0, 1 o 2 del Grupo oncológico cooperativo del este (Eastern Cooperative Oncology Group, ECOG) ?Función hematológica adecuada
?Los pacientes deben tener LNH de linfocitos B confirmado histológicamente ?Los pacientes nunca deben haber recibido previamente tratamiento con R-CHOP ?Cualquier paciente en recaída/refractario que se haya inscrito durante el incremento de dosis debe haber recibido solo una pauta de tratamiento previa única. ?Para mujeres potencialmente fértiles y hombre con parejas pontencialmente fértiles, acuerdo de usar métodos anticonceptivos altamente eficaces. Criterios de inclusión aplicables a pacientes inscritos en la parte de fase II del estudio: ?Los pacientes deben tener un LMDLB sin tratamiento previo ?La puntuación del IPI debe ser 2?5 |
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E.4 | Principal exclusion criteria |
General Exclusion Criteria: - Contraindication to receive any of the individual components of CHOP, rituximab or obinutuzumab - Primary CNS lymphoma - Vaccination with live vaccines within 28 days prior to randomization - History of other malignancy that could affect compliance with the protocol or interpretation of results - Evidence of significant, concomitant disease or illness - Use of CYP3A inhibitors or inducers within 7 days of the first dose of GDC-0199 - Requires use of Warfarin - Recent major surgery - Women must not be pregnant or breastfeeding
Dose Escalation Portion of the Study: - Prior anthracycline therapy - Chemotherapy or other investigational therapy within 5 half-lives of a biologic agent with a minimum of 28 days prior to the start of Cycle 1 - histologically confirmed mantle cell lymphoma (MCL) or small lymphocytic lymphoma (SLL)
Expansion Portion of the Study: - Patients with transformed lymphoma - Prior therapy for non-hodgkin's lymphoma (NHL) - Current Grade > 1 peripheral neuropathy |
Criterios de exclusión generales: ?Contraindicación para recibir cualquiera de los componentes individuales de CHOP, rituximab u obinutuzumab ?Linfoma principal del SNC ?Vacunación con vacunas inactivadas dentro de los 28 días previos al tratamiento ?Antecedentes de otra neoplasia maligna que pudiera afectar al cumplimiento del protocolo o la interpretación de los resultados ?Evidencia de enfermedades concomitantes, significativas y no controladas ? Ha recibido Inhibidores del CYP3Al en el plazo de 7 días antes de la primera dosis de GDC-0199 ?Requiere el uso de warfarina ?Cirugía mayor reciente ?Mujeres embarazadas o en período de lactancia Parte de búsqueda de la dosis del estudio: ?Tratamiento previo con antraciclina ?Quimioterapia u otro tratamiento en investigación dentro de los 5 semividas de un agente biológico con un mínimo de 28 días antes del inicio del ciclo 1 Histológicamente confirmado linfoma del manto (LM) o linfoma linfocítico de células pequeñas (LLP) Parte de fase II del estudio: ?Pacientes con linfoma transformado ?Tratamiento anterior para el LNH ? Neuropatía periférica de grado > 1 actual |
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E.5 End points |
E.5.1 | Primary end point(s) |
1. Safety: Incidence of dose-limiting toxicities 2. Complete response (CR) defined by PET/CT scan and bone marrow examination |
1. Seguridad: Incidencia de la toxicidad limitante de la dosis 2. RC, definido mediante exploración TEP/TAC así como exploración de la médula ósea |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
1. Approximately 9 months 2. Approximately 9 months |
1. Aproximadamente 9 meses 2. Aproximadamente 9 meses |
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E.5.2 | Secondary end point(s) |
1. Pharmacokinetics: plasma concentration-time profile of GDC-0199 2. Objective response (partial or complete response) rate 3. Response duration, defined as time from first documented response until relapse or death 4. Incidence of adverse events 5. Progression-free survival 6. Overall survival 7. CR defined by CT scan and bone marrow examination 8. Relative dose intensity |
1. Farmacocinéticos: se derivará del perfil de concentración plasmática con el tiempo de GDC-0199 2. Tasa de respuesta objetiva (RO) 3. DR, que se define como la primera aparición de una respuesta documentada y objetiva hasta el momento de la recaída o muerte 4. Incidencia de efectos adversos 5. Supervivencia sin progresión 6. Supervivencia general 7. RC, definido mediante exploración por TAC y exploración de médula ósea 8. Intensidad de la dosis relativa |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
1. Approximately 9 months 2. Approximately 9 months 3. Approximately 1 year 4. Approximately 1 year 5. Approximately 1 year 6. Approximately 1 year 7. Approximately 9 months 8. Approximately 9 months |
1. Aproximadamente 9 months 2. Aproximadamente 9 months 3. Aproximadamente 1 year 4. Aproximadamente 1 year 5. Aproximadamente 1 year 6. Aproximadamente 1 year 7. Aproximadamente 9 months 8. Approximately 9 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 | 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 | Yes |
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) | Yes |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | Yes |
E.7.1.3.1 | Other trial type description |
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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 | 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) | 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 | 6 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 41 |
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 |
Australia |
Canada |
Czech Republic |
France |
Hungary |
Italy |
Netherlands |
Spain |
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 study will be defined as one year following initiation of treatment of the last patient enrolled |
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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 | 3 |
E.8.9.1 | In the Member State concerned months | 2 |
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 | 9 |
E.8.9.2 | In all countries concerned by the trial days | 0 |