E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
non-small cell lung cancer |
cáncer de pulmón de células no pequeñas |
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E.1.1.1 | Medical condition in easily understood language |
non-small cell lung cancer |
cáncer de pulmón de células no pequeñas |
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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 | 17.0 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10061873 |
E.1.2 | Term | Non-small cell lung cancer |
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 |
Phase Ib part: To estimate the MTD or RP2D of EGF816 in combination with INC280 Phase II part: To estimate the preliminary anti-tumor activity of EGF816 in combination with INC280 |
Parte de la fase Ib: Calcular la DMT o DRF2 de EGF816 en combinación con INC280 Parte de la fase II: Calcular la actividad antitumoral preliminar de EGF816 en combinación con INC280 |
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E.2.2 | Secondary objectives of the trial |
To characterize the safety, tolerability and pharmacokinetics of EGF816 in combination with INC280 To evaluate the preliminary anti-tumor activity of EGF816 in combination with INC280 |
Caracterizar la seguridad, tolerabilidad y farmacocinética de EGF816 en combinación con INC280 Evaluar la actividad antitumoral preliminar de EGF816 en combinación con INC280 |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
?Patients (male or female) ? 18 years of age. ? Patients with histologically documented, locally advanced or recurrent (stage IIIB who are not eligible for combined modality treatment) or metastatic (Stage IV) non-small cell lung cancer. ? Patients must have EGFR mutation L858R and/or ex19del. ? Presence of at least one measurable lesion according to RECIST v.1.1 ? ECOG performance status ?2 ? Phase Ib only: documented progression of disease according to RECIST v1.1 while on continuous treatment with EGFR TKI (e.g. erlotinib, gefitinib or afatinib, other EGFR TKIs may be allowed after discussion with Novartis). ? Phase II Group 1 only: Patients with acquired resistance to EGFR TKI treatment defined as documented clinical benefit (CR (any duration), PR (any duration), or SD for at least 6 months) on prior EGFR TKI therapy (e.g. erlotinib, gefitinib or afatinib, other EGFR TKIs may be allowed after discussion with Novartis) who subsequently demonstrated progression according to RECIST v1.1. ? Phase II Group 2 only: Advanced NSCLC patients who have not been previously treated with any therapy known to inhibit EGFR and harbor de novo T790M mutation |
? Pacientes (hombres o mujeres) ? 18 años de edad ? Pacientes con cáncer de pulmón de células no pequeñas localmente avanzado o recurrente (estadío IIIB que no sea apto para el tratamiento de modalidad combinada) o metastásico (estadío IV), histológicamente documentado. ? Pacientes con mutación en el EGFR L858R y/o ex19del ? Presencia de por lo menos una lesión medible según los RECIST v1.1, según el Suplemento 1. ? Estado funcional del ECOG ? 2 ? Sólo fase Ib: progresión documentada de enfermedad según los RECIST v1.1 mientras recibían tratamiento continuo con TKI del EGFR (por ejemplo, erlotinib, gefitinib o afatinib, otros TKIs del EGFR pueden permitirse tras discusión con Novartis). ? Sólo grupo 1 de la fase II: Pacientes con resistencia adquirida al tratamiento con TKI del EGFR, definida como beneficio clínico documentado (RC (cualquier duración), RP (cualquier duración) o EE durante por lo menos 6 meses) con terapia previa con TKI del EGFR (por ejemplo, erlotinib, gefitinib o afatinib, pueden permitirse otros TKIs del EGFR tras discusión con Novartis) que posteriormente demostraron progresión según los RECIST v.1.1. ? Sólo grupo 2 de la fase II: Pacientes con CPCNP avanzado que no hayan sido tratados previamente con ninguna terapia que se conozca que inhibe el EGFR y portadores de mutación T790M de novo. |
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E.4 | Principal exclusion criteria |
? Phase Ib and Phase II Group 1 only: Patients who have received more than one prior line of EGFR TKI therapy ? Phase Ib and Phase II Group 1 only: Patients who have received more than three prior lines of antineoplastic therapy (including EGFR TKI) in the advanced setting. ? Phase II Group 2 only: Patients who have received more than two previous lines of antineoplastic therapies in advance setting. ? Phase II Group 2 only: Previous treatment with an investigational or marketed agent that inhibits EGFR. EGFR inhibitors include (but not limited to) erlotinib, gefitinib or other anti-EGFR or EGF monoclonal antibody therapy or dual TKI inhibitors. ? Previous treatment with a c-MET inhibitor or HGF-targeting therapy. ? Patients with brain metastases. ? Patients have out of range laboratory values defined as ? Absolute Neutrophil Count (ANC) <1.5 x 109/L ? Hemoglobin (Hb) <9 g/dL ? Platelets (PLT) <100 x 109/L ? Total bilirubin >1.5 x upper limit of normal (ULN). For patients with Gilbert?s syndrome total bilirubin >2.5 x ULN. ? AST and/or ALT >3 x ULN ? Patients with tumor involvement of the liver must have AST and/or ALT >5 x ULN ? Serum creatinine >1.5 x ULN ? Measured or calculated creatinine clearance ?45mL/min ? Asymptomatic serum amylase and lipase > Grade 2 ? Serum amylase or serum lipase CTCAE grade ? 1 with signs and/or symptoms suggesting pancreatitis or pancreatic injury |
? Sólo fase Ib y grupo 1 de la fase II: Pacientes que hayan recibido más de una línea previa de terapia con TKI del EGFR ? Sólo fase Ib y grupo 1 de la fase II: Pacientes que hayan recibido más de tres líneas previas de terapia antineoplásica (incluyendo TKI del EGFR) en el marco avanzado. ? Sólo grupo 2 de la fase II: Pacientes que hayan recibido más de dos líneas previas de terapias antineoplásicas en el marco avanzado. ? Sólo grupo 2 de la fase II: Tratamiento previo con un agente en investigación o comercializado que inhiba el EGFR. Los inhibidores del EGFR incluyen (pero no están limitados a) erlotinib, gefitinib u otro anticuerpo monoclonal anti-EGFR o EGF o terapia de anticuerpo monoclonal o inhibidores de TKI duales. ? Tratamiento previo con un inhibidor de c-MET o con terapia dirigida al HGF. - Pacientes con metástasis cerebrales. - Pacientes que presenten valores fuera del intervalo de laboratorio, definido como: - Recuento absoluto de neutrófilos (RAN) <1.5 x 109/L - Hemoglobina (Hgb) < 9 g/dL - Plaquetas (PLT) <100 x 109/L - Bilirrubina total > 1.5 x límite superior de normalidad (LSN). Para pacientes con síndrome de Gilbert, bilirrubina total > 2.5 x LSN. - AST y/o ALT > 3 x LSN. - Los pacientes con afectación tumoral hepática deberán presentar AST y/o ALT > 5 x LSN - Creatinina sérica > 1.5 x LSN - Aclaramiento de creatinina medido o calculado ? 45 mL/min - Amilasa y lipasa sérica asintomática > grado 2 - Amilasa sérica o lipasa sérica de grado ? 1 de los CTCAE con signos y/o síntomas que sugieran pancreatitis o lesión pancreática |
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E.5 End points |
E.5.1 | Primary end point(s) |
1-Phase Ib part: Incidence of DLTs 2-Phase II part: Objective response rate (ORR) per RECIST v1.1 |
1-Fase Ib parte: Incidencia de TLD 2-Fase II parte: tasa de respuesta objetiva (ORR) por RECIST v1.1 |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
1-First 28 days of treatment 2-Baseline, every 12 weeks |
1-Primeros 28 días de tratamiento 2-Desde el inicio, cada 12 semanas |
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E.5.2 | Secondary end point(s) |
Phase Ib/II parts: 1-Safety: AEs and SAEs 2-0Safety: hematology and chemistry values, vital signs and ECGs 3-Tolerability: Dose interruptions, reductions and dose intensity
Phase Ib part: 4- ORR, disease control rate (DCR), 5- PFS, duration of response 6- overall survival (OS) Phase II part: 7-DCR 8- PFS duration of response 9- OS Phase Ib/II parts: 10-Plasma concentration vs time profiles. Plasma PK parameters of EGF816 and INC280 |
Fase partes Ib / II: 1-Seguridad: AES y SAEs 2-Seguridad: valores hematológicos y de química, signos vitales y ECG 3-Tolerabilidad: interrupciones, reducciones de dosis y dosis de intensidad
Fase Ib parte: 4-ORR, tasa de control de la enfermedad (DCR), 5- PFS, duración de la respuesta 6- supervivencia global (OS) Fase II parte: 7-DCR 8- PFS, Duración de respuesta 9- OS Fase partes Ib / II: 10- Concentración de plasma vs perfiles de tiempo. Parámetros de PK de plasma de EGF816 y INC280 |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
Phase Ib/II parts: 1-From baseline until 30 days post study treatment 2-From baseline until end of treatment 3-From start of treatment until end of treatment
Phase Ib part: 4-Baseline, every 12 weeks 5-Start of treatment, every 12 weeks 6-Start of treatment until death, average 9 months
Phase II part: 7-Baseline, every 12 weeks 8-Start of treatment, every 12 weeks 9-Start of treatment until death, average 9 months Phase Ib/II parts: 10-First 4 cycles Phase Ib : full PK on Days 1, 2, 15 and 16 of Cycle 1, and Days 1 and 2 of Cycle 2, & Pre-dose blood PK samples will be collected on Day 8 of Cycle 1, Day 1 of Cycle 3 and Cycle 4 Phase II: full PK on Days 1, and 2 of Cycle 1 and Cycle 2 & pre-dose PK on Day 8 of Cycle 1, Day 1 of Cycle 3 and Cycle 4 |
Fase Ib/II:1-Desde inicio hasta 30 días después del tratamiento del estudio,2-Desde inicio hasta fin del tratamiento,3 Desde inicio del tratamiento hasta fin del mismo Fase Ib: 4-Desde inicio,cada 12 semanas,5-Inicio de tratamiento,cada 12 semanas ,6-inicio de tratamiento hasta muerte,promedio 9meses Fase II:7-Desde inicio,cada 12 semanas,8-Inicio de tratamiento,cada 12 semanas,9-inicio de tratamiento hasta muerte,promedio 9meses Fase Ib/II:10-Los primeros 4ciclos Fase Ib:PK completo en los días 1,2,15 y 16 del ciclo 1,y los días 1 y 2 de ciclo 2,& Pre-dosis muestras PK sangre será recogida en el día 8 de ciclo 1,el día 1 del ciclo 3 y ciclo 4 Fase II:PK completo en los días 1 y 2 de los ciclos 1 y 2 y antes de la dosis de PK en el día 8 de ciclo 1,el día 1 del ciclo 3 y 4 del ciclo |
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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 | 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 | No |
E.8.1.1 | Randomised | No |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | Information not present in EudraCT |
E.8.1.4 | Double blind | Information not present in EudraCT |
E.8.1.5 | Parallel group | Information not present in EudraCT |
E.8.1.6 | Cross over | Information not present in EudraCT |
E.8.1.7 | Other | Information not present in EudraCT |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | Information not present in EudraCT |
E.8.2.2 | Placebo | Information not present in EudraCT |
E.8.2.3 | Other | Information not present in EudraCT |
E.8.3 |
The trial involves single site in the Member State concerned
| Yes |
E.8.4 | The trial involves multiple sites in the Member State concerned | No |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 11 |
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 |
France |
Germany |
Hong Kong |
Italy |
Korea, Republic of |
Norway |
Singapore |
Spain |
Taiwan |
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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End of study will be upon completion of the follow up period of the last patient treated with EGF816 and INC280, or when the study is terminated early. Completion of the FU period is defined as once all patients have discontinued study treatment and have either been followed up for survival for at least 9 months after the start of study treatment, died or have been lost to follow up, whichever occurs first. |
El final del estudio tendrá lugar cuando finalice el periodo de FU del último paciente tratado con la combinación de EGF816 e INC280, o cuando el estudio finalice prematuramente. La finalización del periodo de FU se define cuando todos los pacientes hayan suspendido el tratamiento del estudio y se les haya controlado la supervivencia durante por lo menos 9 meses después del inicio del tratamiento del estudio, hayan muerto o se les haya perdido el seguimiento, lo que ocurra primero |
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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 | 6 |
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 | 6 |