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    Summary
    EudraCT Number:2013-004011-41
    Sponsor's Protocol Code Number:1280.8
    National Competent Authority:Spain - AEMPS
    Clinical Trial Type:EEA CTA
    Trial Status:Completed
    Date on which this record was first entered in the EudraCT database:2015-06-01
    Trial results
    Index
    A. PROTOCOL INFORMATION
    B. SPONSOR INFORMATION
    C. APPLICANT IDENTIFICATION
    D. IMP IDENTIFICATION
    D.8 INFORMATION ON PLACEBO
    E. GENERAL INFORMATION ON THE TRIAL
    F. POPULATION OF TRIAL SUBJECTS
    G. INVESTIGATOR NETWORKS TO BE INVOLVED IN THE TRIAL
    N. REVIEW BY THE COMPETENT AUTHORITY OR ETHICS COMMITTEE IN THE COUNTRY CONCERNED
    P. END OF TRIAL
    Expand All   Collapse All
    A. Protocol Information
    A.1Member State ConcernedSpain - AEMPS
    A.2EudraCT number2013-004011-41
    A.3Full title of the trial
    A Phase Ib/II, Multicentre, Open Label, Randomized Study of BI 836845 in Combination With Enzalutamide, versus Enzalutamide alone, in Metastatic Castration-Resistant Prostate Cancer (CRPC) Following Disease Progression on Docetaxel-Based Chemotherapy and Abiraterone
    Ensayo clínico de fase Ib/II, multicéntrico, abierto y aleatorizado de BI 836845 en combinación con enzalutamida frente a enzalutamida en monoterapia, en cáncer de próstata metastásico resistente a la castración (CRPC) que haya progresado al tratamiento con quimioterapia basada en docetaxel y abiraterona
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    BI 836845 plus enzalutamide in castrate resistant prostate cancer (CRPC)
    BI 836845 más enzalutamida en cáncer de próstata resistente a la castración (CRPC)
    A.4.1Sponsor's protocol code number1280.8
    A.5.2US NCT (ClinicalTrials.gov registry) numberNCT02204072
    A.7Trial is part of a Paediatric Investigation Plan No
    A.8EMA Decision number of Paediatric Investigation Plan
    B. Sponsor Information
    B.Sponsor: 1
    B.1.1Name of SponsorBoehringer Ingelheim España, S.A.
    B.1.3.4CountrySpain
    B.3.1 and B.3.2Status of the sponsorCommercial
    B.4 Source(s) of Monetary or Material Support for the clinical trial:
    B.4.1Name of organisation providing supportBoehringer Ingelheim España, S.A.
    B.4.2CountrySpain
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationBoehringer Ingelheim
    B.5.2Functional name of contact pointQRPE PSC CT Information Disclosure
    B.5.3 Address:
    B.5.3.1Street AddressBinger Strasse 173
    B.5.3.2Town/ cityIngelheim am Rhein
    B.5.3.3Post code55216
    B.5.3.4CountryGermany
    B.5.4Telephone number+34934045100
    B.5.5Fax number+34934045580
    B.5.6E-mailclintriage.rdg@boehringer-ingelheim.com
    D. IMP Identification
    D.IMP: 1
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.2Product code BI 836845
    D.3.4Pharmaceutical form Concentrate for solution for injection/infusion
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPIntravenous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNNot yet assigned
    D.3.9.2Current sponsor codeBI 835845
    D.3.9.4EV Substance CodeSUB122634
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number10
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin No
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) Yes
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product Yes
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product Yes
    D.3.11.13.1Other medicinal product typeFully human monoclonal antibody (HumAb) og the IgG1 isotype
    D.IMP: 2
    D.1.2 and D.1.3IMP RoleComparator
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.1.1Trade name Xtandi 40 mg soft capsules
    D.2.1.1.2Name of the Marketing Authorisation holderAstellas Pharma Europe B.V.
    D.2.1.2Country which granted the Marketing AuthorisationEuropean Union
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameXtandi 40 mg soft capsules
    D.3.4Pharmaceutical form Capsule, soft
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNENZALUTAMIDE
    D.3.9.1CAS number 915087-33-1
    D.3.9.4EV Substance CodeSUB77412
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number40
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.8 Information on Placebo
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    Patients with metastatic castrate resistent prostate cancer (CRPC)
    Pacientes con cáncer de próstata metastásico resistente a la castración (CRPC)
    E.1.1.1Medical condition in easily understood language
    Patients with prostate cancer
    Pacientes con cáncer de próstata
    E.1.1.2Therapeutic area Diseases [C] - Cancer [C04]
    MedDRA Classification
    E.1.3Condition being studied is a rare disease No
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    To determine the safety and tolerability profile of enzalutamide in combination with BI 836845 and to evaluate the anti-tumour activity of the combination treatment, versus enzalutamide alone, in patients with CRPC.
    Determinar el perfil de seguridad y tolerabilidad de enzalutamida en combinación con BI 836845 y evaluar la actividad anti-tumoral del tratamiento de combinación, frente a enzalutamida sola, en pacientes con CRPC.
    E.2.2Secondary objectives of the trial
    To determine prostate serum antigen (PSA) response and progression in combination with anti-tumour activity, changes in circulating tumour cells (CTC), plus overall survival (in phase II only)
    Determinación de la respuesta del PSA y de la progresión junto con la actividad antineoplásica; cambios en las células tumorales circulantes (CTC); además de la determinación de la supervivencia global (solo en la fase II del estudio).
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1. The patient has histologically, or cytologically, confirmed adenocarcinoma of the prostate.
    2. Male patient aged ? 18 years old.
    3. Patients with radiographic evidence of metastatic prostate cancer (stage M1 or D2). Distant metastases evaluable by radionuclide bone scan, CT scan, or MRI within 28 days before the start of study treatment.
    4. Patients with a PSA ? 20 ng/mL.
    5. Patients with prior surgical or chemical castration with a serum testosterone of <50 ng/mL. If the method of castration is luteinizing hormone releasing level hormone (LHRH) agonists, the patient must be willing to continue the use of LHRH agonists during protocol treatment.
    6. Eastern Cooperative Oncology Group performance status (ECOG PS) 0, 1 or 2.
    7. Cardiac left ventricular function with resting ejection fraction >50% as determined by ECHO or MUGA.
    8. Absolute neutrophil count (ANC) ?1500/uL.
    9. Haemoglobin ?9 g/dL.
    10. Platelets ?100,000/uL.
    11. Bilirubin ? 1.5 times the upper limit of normal (ULN).
    12. Aspartate transaminase (AST) and alanine transaminase (ALT) ? 2.5 times the ULN (or ? 5 times the ULN if liver metastases are present).
    13. Creatinine ? 1.5 x ULN.
    14. International normalized ratio (INR) ? 1.4 and a partial thromboplastin time (PTT) ? 5 seconds above the ULN (unless on oral anticoagulant therapy). Patients receiving fulldose anticoagulation therapy are eligible provided they meet all other criteria, are on a stable dose of oral anticoagulant or low molecular weight heparin (except warfarin or
    coumarin-like anticoagulants, which are not permitted).
    15. Fasting plasma glucose < 8.9 mmol/L (< 160 mg/dL) and HbA1c < 8.0%.

    Inclusion criteria only for patients entering phase Ib dose escalation and phase II:

    16. Patients who have disease progression during, or after, receiving docetaxel and have had at least 12 weeks of treatment and in the opinion of the investigator are unlikely to derive significant benefit from additional docetaxel-based therapy, or were intolerant to therapy with this agent.
    17. Patients who have disease progression during, or after, receiving abiraterone treatment in any setting.
    18. Patients must have progressive disease defined as at least one of the following:
    a. Progressive measurable disease: using conventional solid tumour criteria RECIST 1.1.
    b. Bone scan progression: at least two new lesions on bone scan, plus a rising PSA as described in c below.
    c. Increasing PSA level: at least two consecutive rising PSA values over a reference value (PSA #1) taken at least 1 week apart. A third PSA (PSA #3) is required to be greater than PSA #2; if not, a fourth PSA (PSA #4) is required
    to be greater than PSA #2.

    Inclusion criterion only for patients entering phase Ib expansion cohort:

    19. Patients must be receiving continuous enzalutamide treatment and show a rise in PSA level: at least two consecutive rising PSA values over a reference value (PSA #1) taken at least 1 week apart. A third PSA (PSA #3) is required to be greater than PSA #2; if not, a fourth PSA (PSA #4) is required to be greater than PSA #2.
    20. Archive tumour tissue is available prior to recruitment for pharmacogenomic tests.
    1. El paciente presenta una confirmación histológica o citológica de adenocarcinoma de próstata.
    2. Varones de ≥ 18 años de edad.
    3. Pacientes con signos radiográficos de cáncer de próstata metastásico (estadio M1 o D2). Metástasis a distancia evaluables mediante gammagrafía ósea, TC o RM en los 28 días previos al inicio del tratamiento del estudio.
    4. Pacientes con un nivel de PSA ≥ 20 ng/ml.
    5. Pacientes con castración quirúrgica o química previa con un nivel de testosterona sérica de < 50 ng/ml. Si el método de castración empleado son agonistas de la hormona liberadora de gonadotropinas (LHRH), el paciente debe estar dispuesto a continuar usando agonistas de LHRH durante el tratamiento del protocolo.
    6. Estado funcional del Eastern Cooperative Oncology Group (ECOG PS) de 0, 1 o 2.
    7. Función del ventrículo cardíaco izquierdo con fracción de eyección en reposo > 50 %, determinado mediante ECHO o MUGA.
    8. Recuento absoluto de neutrófilos (ANC) ≥ 1500/μl.
    9. Hemoglobina ≥ 9 g/dl.
    10. Plaquetas ≥ 100.000/μl.
    11. Bilirrubina ≤ 1,5 veces el límite superior de normalidad (ULN).
    12. Aspartato transaminasa (AST) y alanina transaminasa (ALT) ≤ 2,5 veces el ULN (o ≤ 5 veces el ULN si existen metástasis hepáticas).
    13. Creatinina ≤ 1,5 veces el ULN.
    14. Cociente internacional normalizado (INR) ≤ 1,4 y tiempo de tromboplastina parcial (PTT) ≤ 5 segundos superior al ULN (a menos que el paciente reciba tratamiento anticoagulante). Los pacientes que reciben tratamiento anticoagulante a dosis completa son elegibles siempre que cumplan todos los demás criterios, reciben una dosis estable de anticoagulante oral o heparina de bajo peso molecular (excepto warfarina o anticoagulantes cumarínicos, que no están permitidos).
    15. Glucosa plasmática en ayunas < 8,9 mmol/l (< 160 mg/dl) y HbA1c < 8,0 %.
    Criterios de inclusión solo para los pacientes que se incluyen en la fase Ib de escalado de dosis y en la fase II:
    16. Pacientes que presenten progresión de la enfermedad durante, o después, del tratamiento con docetaxel y que hayan recibido al menos 12 semanas de tratamiento y en los que, en opinión del investigador, existan pocas posibilidades de obtener un efecto beneficioso significativo del tratamiento adicional con docetaxel o que no toleraran el tratamiento con este fármaco.
    17. Pacientes que presenten progresión de la enfermedad durante, o después, del tratamiento con abiraterona en cualquier contexto.
    18. Los pacientes deben presentar progresión de la enfermedad definida como al menos una de las siguientes:
    a. Progresión de enfermedad medible: usando los criterios convencionales sobre tumores sólidos RECIST 1.1.
    b. Progresión determinada mediante gammagrafía ósea: al menos dos lesiones nuevas en la gammagrafía ósea, junto con un incremento de los niveles de PSA, según lo descrito en el apartado c siguiente.
    c. Aumento del nivel de PSA: al menos dos valores crecientes de PSA consecutivos con respecto al valor de referencia (PSA n.º 1) determinados con al menos una semana de diferencia. La tercera determinación del PSA (PSA n.º 3) deberá ser superior a la determinación n.º 2 del PSA; en caso que no sea así, se deberá realizar una cuarta determinación del PSA (PSA n.º 4) y esta debe ser superior a la determinación n.º 2 del PSA.
    Criterios de inclusión solo para los pacientes que se incluyen en la cohorte de expansión de fase Ib:
    19. Los pacientes deben estar recibiendo tratamiento continuo con enzalutamida y mostrar un aumento del nivel de PSA: al menos dos valores crecientes de PSA consecutivos con respecto al valor de referencia (PSA n.º 1) determinados con al menos una semana de diferencia. La tercera determinación del PSA (PSA n.º 3) deberá ser superior a la determinación n.º 2 del PSA; en caso que no sea así, se deberá realizar una cuarta determinación del PSA (PSA n.º 4) y esta debe ser superior a la determinación n.º 2 del PSA.
    20. Tejido tumoral de archivo disponible antes de la inclusión para análisis farmacogenómico.
    E.4Principal exclusion criteria
    1. Exclusion criterion 1 is not applicable for patients enrolled after protocol version 3 (or subsequent versions) are approved.
    2. Exclusion criterion 2 is not applicable for patients enrolled after protocol version 3 (or subsequent versions) are approved.
    3. Prior therapy with agents targeting IGF and/or IGFR pathway.
    4. Patients that have been treated with any of the following within 4 weeks of starting trial treatment: chemotherapy, immunotherapy, biological therapies, molecular targeted therapy, hormone therapy (except LHRH agonists), radiotherapy (except in case of localized radiotherapy for analgesic purpose or for lytic lesions at risk of fracture which can then be completed within 2 weeks prior to study treatment).
    5. Use of any investigational drug within 4 weeks before start of trial treatment or concomitantly with this trial.
    6. Patients that have been treated with strong CYP2C8 inhibitors, CYP2C8 inducers, within 2 weeks of starting the trial treatment.
    7. QTcF prolongation > 450 ms or QT prolongation deemed clinically relevant by the investigator (e.g., congenital long QT syndrome). The QTcF will be calculated as the mean of the 3 ECGs taken at screening.
    8. Patients with small cell or neuroendocrine tumours.
    9. Patients with known or suspected leptomeningeal metastases.
    10. Uncontrolled or poorly controlled hypertension.
    11. Patients with poorly controlled diabetes mellitus. Patients with a history of diabetes are allowed to participate, provided that their blood glucose is within normal range (fasting < 160 mg/dL or below ULN) and that they are on a stable dietary or therapeutic regimen for this condition.
    12. Known human immunodeficiency virus infection or acquired immunodeficiency syndrome-related illness.
    13. Patients with epilepsy, seizures, or predisposing factors for seizure as judged by the investigator.
    14. Patients unable to comply with the protocol as judged by the investigator.
    15. Active alcohol or active drug abuse as judged by the investigator.
    16. A history of allergy to human monoclonal antibodies.
    17. Patients who are sexually active and unwilling to use a medically acceptable method of contraception, e.g. condom plus spermicide use for participating males, plus another form of birth control such as implants, injectables, combined oral contraceptives, intrauterine devices for female partners, during the trial and for at least three months after end of active therapy. Men unwilling to agree to not donate sperm while on trial drug and up to 6 months following the last dose of trial drug.

    Exclusion criteria only for patients entering phase Ib dose escalation and phase II:

    18. Patients that have received prior enzalutamide in any setting will not be eligible.

    Exclusion criterion only for patients entering phase Ib expansion cohort:

    19. Patients that have received prior taxane-based chemotherapy or abiraterone in any setting will not be eligible for the expansion cohort.

    Additional exclusion criterion for patients undergoing tumour biopsy:

    20. For patients that are to undergo the tumour biopsy, a history of a hereditary bleeding disorder, or clinically relevant major bleeding event in the past 6 months, as judged by the investigator.

    After approval of protocol version 3 (or subsequent versions) the additional following exclusion criteria apply:

    For all patients:
    21. Previous or concomitant malignancies at any other site with the exception of the following:
    a.) benign basal cell carcinoma
    b.) benign low grade transitional cell carcinoma of the bladder
    c.) other effectively treated malignancy that has been in remission for more than 5 years and is considered to be cured

    Only for patients entering phase Ib dose escalation and phase II cohorts:
    22. Patients who have received more than 2 prior non-docetaxel-containing cytotoxic chemotherapy regimens for Metastatic Castration-Resistant Prostate Cancer (mCRPC).
    23. Patients who have received a taxane based treatment or abiraterone, within 4 weeks before start of study treatment.
    1. El criterio de exclusión 1 no se aplica a los pacientes incluidos después de la aprobación de la versión 3 del protocolo (o versiones posteriores).
    2. El criterio de exclusión 2 no se aplica a los pacientes incluidos después de la aprobación de la versión 3 del protocolo (o versiones posteriores).
    3. Tratamiento previo con agentes dirigidos a la vía IGF y/o IGFR.
    4. Pacientes que hayan recibido cualquiera de los siguientes tratamientos en las 4 semanas anteriores al inicio del tratamiento del estudio: quimioterapia, inmunoterapia, tratamientos biológicos, tratamiento molecular dirigido, tratamiento hormonal dirigido (excepto agonistas de LHRH), radioterapia (excepto en el caso de radioterapia localizada con fines analgésicos o por lesiones líticas en riesgo de fractura que pueda finalizarse en las 2 semanas previas al tratamiento del estudio).
    5. Uso de un fármaco experimental en las 4 semanas anteriores al inicio del tratamiento del estudio o de forma concomitante con este estudio.
    6. Pacientes que han recibido tratamiento con inhibidores potentes de CYP2C8, inductores de CYP2C8, en las 2 semanas anteriores al inicio el tratamiento del estudio.
    7. Prolongación del intervalo QTcF > 450 ms o prolongación del intervalo QT considerada clínicamente relevante por el investigador (p. ej., síndrome congénito de prolongación del intervalo QT). El intervalo QTcF se calculará como la media de los 3 ECG obtenidos en la selección.
    8. Pacientes con tumores neuroendocrinos o de células pequeñas.
    9. Pacientes con diagnóstico o sospecha de metástasis leptomeníngea.
    10. Hipertensión no controlada o controlada de forma deficiente.
    11. Pacientes con diabetes mellitus controlada de forma deficiente. Se permite la participación de los pacientes con antecedentes de diabetes, siempre que la glucemia se encuentre dentro del intervalo de la normalidad (en ayunas, < 160 mg/dl o inferior al ULN) y que mantengan una pauta dietética o terapéutica estable para la diabetes.
    12. Diagnóstico de infección relacionada con el virus de la inmunodeficiencia humana o enfermedad relacionada con el síndrome de inmunodeficiencia adquirida.
    13. Pacientes con epilepsia, convulsiones o factores de riesgo para padecer convulsiones, según el criterio del investigador.
    14. Pacientes que no sean capaces de cumplir el protocolo, según el criterio del investigador.
    15. Alcoholismo o drogadicción activos, según el criterio del investigador.
    16. Antecedentes de alergia a los anticuerpos monoclonales humanos.
    17. Los pacientes sexualmente activos y que no quieran utilizar un método anticonceptivo médicamente aceptable (p. ej., uso de preservativo más espermicida para los varones participantes, más otro método anticonceptivo, como implantes, anticonceptivos inyectables, anticonceptivos orales combinados, dispositivos intrauterinos, para las parejas de los participantes) durante el estudio y durante un mínimo de 3 meses después de la finalización del tratamiento activo. Los varones que no acepten no donar esperma durante el tratamiento con el fármaco del estudio y hasta 6 meses después de la última dosis del fármaco del estudio.
    Criterios de exclusión solo para los pacientes que se incluyen en la fase Ib de escalado de dosis y en la fase II:
    18. No podrán participar los pacientes que hayan recibido tratamiento previo con enzalutamida en cualquier contexto.
    Criterio de exclusión solo para los pacientes que se incluyen en la cohorte de expansión de fase Ib:
    19. No podrán participar en la cohorte de expansión aquellos pacientes que hayan recibido quimioterapia previa basada en taxanos o tratamiento con abiraterona en cualquier contexto.
    Criterio de exclusión adicional para los pacientes que se someten a la biopsia tumoral:
    20. Para los pacientes que se someten a la biopsia tumoral, antecedentes de episodio hemorrágico hereditario o episodio hemorrágico mayor importante en los últimos 6 meses, según el criterio del investigador.
    A partir de la aprobación de la versión 3 del protocolo (o versiones posteriores), también se aplican los siguientes criterios de exclusión adicionales:
    Para todos los pacientes:
    21. Neoplasias malignas previas o concomitantes en otra localización, a excepción de los siguientes casos:
    a.) Carcinoma basocelular benigno
    b.) Carcinoma benigno de células transicionales de la vejiga de grado bajo
    c.) Cualquier otra neoplasia maligna tratada de forma efectiva y en remisión durante más de 5 años y que se considere curada
    Solo para los pacientes que se incluyen en la Fase Ib de escalado de dosis y Fase II:
    22. Pacientes que hayan recibido más de dos pautas anteriores de quimioterapia citotóxica, sin docetaxel, para el cáncer de próstata metastásico resistente a la castración (mCRPC).
    23. Pacientes que hayan recibido un tratamiento basado en taxanos o abiraterona, en las 4 semanas anteriores al comienzo del tratamiento del estudio.
    E.5 End points
    E.5.1Primary end point(s)
    1: Number of patients with dose limiting toxicities (phase Ib escalation)

    2: Maximum tolerated dose (phase Ib escalation)

    3: PSA response - defined as a decline in PSA value >50%, which is confirmed by a second value 3-4 weeks apart (phase Ib expansion)

    4: Radiological progression free survival - defined as time from randomisation to disease progression based on central review in bone based on PCWG2 or soft tissue based on modified RECIST 1.1 where applicable, or death (phase II)
    1. Número de pacientes con toxicidades limitadas por la dosis (escalado fase Ib)

    2. Dosis máxima tolerada (escalado fase Ib)

    3. Respuesta del PSA: definida como una reducción en el valor del PSA > 50 % confirmada con una segunda evaluación con de 3 a 4 semanas de diferencia(expansión fase Ib)

    4. Supervivencia libre de progresión (PFS) radiológica: definida como el periodo desde la aleatorización hasta que se observa progresión de la enfermedad en función de una revisión central o en el hueso, en función de los criterios PCWG2, o o el tejido blando, en función de los criterios RECIST 1.1. modificados cuando proceda, o muerte (fase II)
    E.5.1.1Timepoint(s) of evaluation of this end point
    1: 6 months

    2: 6 months

    3: Up to 3 years

    4: Up to 3 years
    1: 6 meses

    2: 6 meses

    3: Hasta 3 años

    4: Hasta 3 años
    E.5.2Secondary end point(s)
    1: Changes in circulating tumour cells (CTC) response - CTC reduction compared to baseline for at least one time point after treatment defined as CTC decline from 5 to <5 cells per 7.5ml blood (phase Ib expansion)

    2: Radiological progression free survival - defined as time from randomisation to disease progression based on central review in bone based on PCWG2 or soft tissue based on modified RECIST 1.1 where applicable, or death (phase Ib expansion)

    3: Overall survival - defined as the time from randomisation to death from any cause (phase II)

    4: Time to PSA progression - defined as the date that a 25% or greater increase in PSA, and an absolute increase of 2 ng/mL or more from the nadir, is documented, which is confirmed by a second value 3 or more weeks later (phase II)

    5: Maximum decline in PSA - compared to baseline that occurs at any point after treatment start (phase II)

    6: Percentage change in PSA - from baseline to week 12 of treatment (phase II)

    7: PSA response - defined as a decline in PSA value >50%, which is confirmed by a second value 3 to 4 weeks apart (phase II)

    8: Changes in circulating tumour cells (CTC) response - CTC reduction compared to baseline for at least one time point after treatment start assessed by CTC decline from, equal to, or more than, 5 to <5 cells per 7.5ml blood (phase II)

    9: Changes in circulating tumour cells (CTC) response-CTC reduction compared to baseline for at least one time point after treatment start assessed by maximum change in CTC counts compared to baseline that occurs at any point after treatment start (phase II)
    1: Cambios en la respuesta de las células tumorales circulantes (CTC): reducción de las CTC en comparación con el periodo basal en al menos un momento después del tratamiento, definida como una reducción de CTC de ≥ 5 a < 5 células por 7,5 ml de sangre (expansión fase Ib)

    2: Supervivencia libre de progresión (PFS) radiológica: definida como el tiempo desde el inicio del tratamiento hasta que se observa progresión de la enfermedad en función de la evaluación del investigador o en el hueso, en función de los criterios PCWG2, o o el tejido blando, en función de los criterios RECIST 1.1. modificados cuando proceda,o muerte (expansión fase Ib)

    3: Supervivencia global: definida como el tiempo desde la aleatorización hasta la muerte por cualquier causa (fase II)

    4: Tiempo hasta la progresión del PSA: definido como la fecha en la que se documenta un incremento del 25 % o mayor del PSA, y un incremento absoluto de 2 ng/ml o más con respecto al valor mínimo (confirmado con un segundo valor 3 semanas o más después) (fase II)

    5: Reducción máxima en el PSA: en comparación con el periodo basal que se produzca en cualquier momento después del inicio del tratamiento (fase II)

    6: Porcentaje de variación del PSA en la semana 12: desde el periodo hasta la semana 12 de tratamiento (fase II)

    7: Respuesta del PSA: definida como una reducción en el valor del PSA > 50 % (confirmada con una segunda evaluación con de 3 a 4 semanas de diferencia) (fase II)

    8: Cambios en la respuesta de las células tumorales circulantes (CTC): reducción de las CTC en comparación con el periodo basal en al menos un momento después del inicio del tratamiento, evaluado de forma independiente mediante la reducción de CTC de ≥ 5 a < 5 células por 7,5 ml de sangre (fase II)

    9: Cambios en la respuesta de las células tumorales circulantes (CTC): reducción de las CTC en comparación con el periodo basal en al menos un momento después del inicio del tratamiento, evaluado de forma independiente mediante el cambio máximo en la cifra de CTC en comparación con el periodo basal que se produzca en cualquier momento después del inicio del tratamiento (fase II)
    E.5.2.1Timepoint(s) of evaluation of this end point
    1: Up to 3 years

    2: Up to 3 years

    3: Up to 3 years

    4: Up to 3 years

    5: Up to 3 years

    6: Up to 3 years

    7: Up to 3 years

    8: Up to 3 years

    9: Up to 3 years
    1: Hasta 3 años

    2: Hasta 3 años

    3: Hasta 3 años

    4: Hasta 3 años

    5: Hasta 3 años
    E.6 and E.7 Scope of the trial
    E.6Scope of the trial
    E.6.1Diagnosis No
    E.6.2Prophylaxis No
    E.6.3Therapy Yes
    E.6.4Safety Yes
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic Yes
    E.6.7Pharmacodynamic Yes
    E.6.8Bioequivalence No
    E.6.9Dose response Yes
    E.6.10Pharmacogenetic No
    E.6.11Pharmacogenomic Yes
    E.6.12Pharmacoeconomic No
    E.6.13Others No
    E.7Trial type and phase
    E.7.1Human pharmacology (Phase I) Yes
    E.7.1.1First administration to humans No
    E.7.1.2Bioequivalence study No
    E.7.1.3Other Yes
    E.7.1.3.1Other trial type description
    First in human to combine BI 836845 with enzalutamide to find a safe and tolerable dose
    E.7.2Therapeutic exploratory (Phase II) Yes
    E.7.3Therapeutic confirmatory (Phase III) No
    E.7.4Therapeutic use (Phase IV) No
    E.8 Design of the trial
    E.8.1Controlled Yes
    E.8.1.1Randomised Yes
    E.8.1.2Open Yes
    E.8.1.3Single blind No
    E.8.1.4Double blind No
    E.8.1.5Parallel group Yes
    E.8.1.6Cross over No
    E.8.1.7Other No
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) Yes
    E.8.2.2Placebo No
    E.8.2.3Other No
    E.8.2.4Number of treatment arms in the trial2
    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.8.4.1Number of sites anticipated in Member State concerned5
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA15
    E.8.6 Trial involving sites outside the EEA
    E.8.6.1Trial being conducted both within and outside the EEA Yes
    E.8.6.2Trial being conducted completely outside of the EEA No
    E.8.6.3If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned
    Hong Kong
    Korea, Republic of
    Singapore
    Taiwan
    United States
    E.8.7Trial 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 end when the last patient in both the phase Ib expansion and phase II trial has completed at least the last follow-up visit and an adequate number of overall survival events have been recorded while patients are still in the observation phase of the trial in phase II.
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years3
    E.8.9.1In the Member State concerned months
    E.8.9.1In the Member State concerned days
    E.8.9.2In all countries concerned by the trial years3
    E.8.9.2In all countries concerned by the trial months2
    E.8.9.2In all countries concerned by the trial days10
    F. Population of Trial Subjects
    F.1 Age Range
    F.1.1Trial has subjects under 18 No
    F.1.1Number of subjects for this age range: 0
    F.1.1.1In Utero No
    F.1.1.2Preterm newborn infants (up to gestational age < 37 weeks) No
    F.1.1.3Newborns (0-27 days) No
    F.1.1.4Infants and toddlers (28 days-23 months) No
    F.1.1.5Children (2-11years) No
    F.1.1.6Adolescents (12-17 years) No
    F.1.2Adults (18-64 years) Yes
    F.1.2.1Number of subjects for this age range: 120
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 32
    F.2 Gender
    F.2.1Female No
    F.2.2Male Yes
    F.3 Group of trial subjects
    F.3.1Healthy volunteers No
    F.3.2Patients Yes
    F.3.3Specific vulnerable populations No
    F.3.3.1Women of childbearing potential not using contraception No
    F.3.3.2Women of child-bearing potential using contraception No
    F.3.3.3Pregnant women No
    F.3.3.4Nursing women No
    F.3.3.5Emergency situation No
    F.3.3.6Subjects incapable of giving consent personally No
    F.3.3.7Others No
    F.4 Planned number of subjects to be included
    F.4.1In the member state25
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 102
    F.4.2.2In the whole clinical trial 152
    F.5 Plans for treatment or care after the subject has ended the participation in the trial (if it is different from the expected normal treatment of that condition)
    Patients will continue to receive treatment with BI 836845 and/or enzalutamide until disease progression, undue toxicities or discontinuation from the trial for any other reason.
    G. Investigator Networks to be involved in the Trial
    N. Review by the Competent Authority or Ethics Committee in the country concerned
    N.Competent Authority Decision Authorised
    N.Date of Competent Authority Decision2015-07-24
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2015-07-10
    P. End of Trial
    P.End of Trial StatusCompleted
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