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    EudraCT Number:2014-000934-53
    Sponsor's Protocol Code Number:104-13-302
    National Competent Authority:Spain - AEMPS
    Clinical Trial Type:EEA CTA
    Trial Status:Ongoing
    Date on which this record was first entered in the EudraCT database:2014-11-19
    Trial results
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    A. Protocol Information
    A.1Member State ConcernedSpain - AEMPS
    A.2EudraCT number2014-000934-53
    A.3Full title of the trial
    A Phase III, Randomized, Double Blind, Dummy-Controlled Study of ThermoDox® (Lyso-Thermosensitive Liposomal Doxorubicin-LTLD) in Hepatocellular Carcinoma (HCC) using standardized Radiofrequency Ablation (RFA) treatment time ≥ 45 minutes for solitary lesions ≥ 3 cm to ≤ 7 cm.
    Estudio de fase III, aleatorizado, doble ciego, controlado con simulación de ThermoDox® (doxorubicina liposomal liso-termosensible-LTLD) en carcinoma hepatocelular (HCC) utilizando un tiempo de tratamiento de ablación con radiofrecuencia estandarizado (RFA) ≥ 45 minutos para lesiones solitarias de ≥ 3 cm a ≤ 7 cm.
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    A clinical trial to evaluate efficacy for patients with primary liver cancer scheduled to be treated with Radiofrequency Ablation (RFA). This study will compare RFA plus an investigational drug of liposomal doxorubicin versus RFA without investigational drug.
    Ensayo clínico para evaluar la eficacia para los pacientes con cáncer de hígado primario programado para ser tratados con ablación por radiofrecuencia (RFA). Este estudio comparará RFA más un fármaco en investigación de la doxorubicina liposomal contra RFA sin fármaco en investigación.
    A.3.2Name or abbreviated title of the trial where available
    Optima Trial
    A.4.1Sponsor's protocol code number104-13-302
    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 SponsorCelsion Corporation
    B.1.3.4CountryUnited States
    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 supportCelsion Corporation
    B.4.2CountryUnited States
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationCelsion Corporation
    B.5.2Functional name of contact pointDirector, Clinical Operations
    B.5.3 Address:
    B.5.3.1Street Address997 Lenox Drive, Suite 100
    B.5.3.2Town/ cityLawrenceville, New Jersey
    B.5.3.3Post code08648
    B.5.3.4CountryUnited States
    B.5.4Telephone number+34914322630
    B.5.5Fax number+1609896-2200
    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 Yes
    D.2.5.1Orphan drug designation numberEU/3/10/833
    D.3 Description of the IMP
    D.3.1Product nameThermoDox®
    D.3.4Pharmaceutical form Concentrate for solution for 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 INNDoxorubicin hydrochloride (in heat-sensitive liposomes)
    D.3.9.1CAS number 25316-40-9
    D.3.9.3Other descriptive nameDOXORUBICIN HYDROCHLORIDE, Lyso-Thermosensitive Liposomal Doxorubicin (LTLD)
    D.3.9.4EV Substance CodeSUB01827MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number2
    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. cell therapy medicinal product No
    D. therapy medical product No
    D. Engineered Product No
    D. ATIMP (i.e. one involving a medical device) No
    D. 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
    D.8 Placebo: 1
    D.8.1Is a Placebo used in this Trial?Yes
    D.8.3Pharmaceutical form of the placeboSolution for infusion
    D.8.4Route of administration of the placeboIntravenous use
    D.8 Placebo: 2
    D.8.1Is a Placebo used in this Trial?Yes
    D.8.3Pharmaceutical form of the placeboSolution for infusion
    D.8.4Route of administration of the placeboIntravenous use
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    Hepatocellular Carcinoma (HCC)
    Carcinoma hepatocelular (HCC)
    E.1.1.1Medical condition in easily understood language
    Liver Cancer
    Cáncer de hígado
    E.1.1.2Therapeutic area Diseases [C] - Cancer [C04]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 17.1
    E.1.2Level PT
    E.1.2Classification code 10073071
    E.1.2Term Hepatocellular carcinoma
    E.1.2System Organ Class 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    E.1.3Condition being studied is a rare disease Yes
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    The primary objective is to compare overall survival (OS) between patients receiving RFA plus ThermoDox versus RFA alone, using a standardized Radiofrequency Ablation (sRFA) treatment dwell time ≥ 45 minutes.
    El objetivo principal consiste en comparar la supervivencia general (SG) entre pacientes que reciben RFA más ThermoDox frente a RFA solo, utilizando un tiempo de tratamiento de ablación con radiofrecuencia estandarizado (standarized Radiofrequency Ablation o sRFA) ≥ 45 minutos.
    E.2.2Secondary objectives of the trial
    The secondary objectives are to compare progression-free survival (PFS) and safety between patients receiving sRFA plus ThermoDox versus sRFA alone, using a standardized RFA treatment dwell time ≥ 45 minutes.
    Los objetivos secundarios consisten en comparar la supervivencia sin progresión (SSP) y la seguridad entre pacientes que reciben sRFA más ThermoDox frente a sRFA solo, utilizando un tiempo de tratamiento estandarizado de la RFA ≥ 45 minutos.
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    Subjects must fulfill all of the following inclusion criteria to be eligible to participate in the study.
    Subjects may be randomized without a biopsy if they meet American Association for the Study of Liver Disease (AASLD) criteria for the diagnosis of HCC (see Appendix 20.8). Subjects not meeting AASLD criteria for HCC will need a biopsy for confirming HCC prior to randomization.
    1. Male or female ≥ 18 years of age
    2. Diagnosed with a single HCC lesion ≥ 3.0 cm but ≤ 7.0 cm in maximum diameter based on diagnosis at screening.
    - Subjects meeting the AASLD criteria may be randomized without a biopsy, but will undergo a biopsy during the RFA procedure unless contraindicated or unattainable.
    - Subjects not meeting the AASLD criteria for HCC will need a biopsy to confirm HCC prior to randomization.
    3. Be an appropriate candidate for receiving RFA as a medically indicated treatment as evaluated by the following factors:
    - The position and accessibility of the target lesion allows for the safe administration of multiple ablation cycles or deployments to achieve a probe dwell time of ≥ 45 minutes.
    - Not a candidate for surgical resection according to the local guidelines for resection and in the Investigator´s judgment.
    4. Child-Pugh Class A without either current encephalopathy or ascites
    5. Left ventricular ejection fraction (LVEF) ≥ 50%
    6. ECOG performance status 0
    7. Willing to sign an informed consent form, indicating awareness of the investigational nature of this study that is in keeping with the policies of the institution.
    Los pacientes deben cumplir la totalidad de los siguientes criterios de inclusión para ser aptos para participar en el estudio:
    Se puede aleatorizar a los sujetos sin una biopsia si cumplen los criterios de la Asociación americana para el estudio de enfermedades hepáticas (AASLD) para el diagnóstico del HCC (véase el apéndice 20.8). Los sujetos que no cumplan los criterios de la AASLD para el HCC necesitarán una biopsia para confirmar el HCC antes de la aleatorización.
    1. Hombre o mujer ≥ 18 años de edad
    2. Tener un diagnóstico de una única lesión HCC ≥ 3,0 cm pero ≤ 7,0 cm de diámetro máximo basándose en el diagnóstico en la selección.
    - Se puede aleatorizar a los sujetos que cumplan los criterios de la AASLD sin una biopsia, pero se someterán a una biopsia durante el procedimiento de RFA, a menos que esté contraindicado o no se pueda realizar.
    - Los sujetos que no cumplan los criterios de la AASLD para el HCC necesitarán una biopsia para confirmar el HCC antes de la aleatorización.
    3. Ser un candidato apropiado para recibir RFA como tratamiento médicamente indicado según se evalúa mediante los siguientes factores: cumplan los criterios de la AASLD para el HCC necesitarán una biopsia para confirmar el HCC antes de la aleatorización.
    - la posición y accesibilidad de la lesión objetivo permite la administración segura de varios ciclos de ablación o despliegues para alcanzar un tiempo de tratamiento de la sonda de ≥ 45 minutos.
    - No es un candidato para resección quirúrgica según las directrices locales para resección y a juicio del investigador.
    4. Child-Pugh Clase A sin encefalopatía actual o ascitis
    5. Fracción de eyección del ventrículo izquierdo (FEVI) ≥ 50 %
    6. Estado funcional 0 según ECOG
    7. Disposición para firmar un formulario de consentimiento informado, en el que se indique que se tiene conocimiento de la naturaleza experimental de este estudio que se ajusta a las políticas de la institución.
    E.4Principal exclusion criteria
    Subjects meeting any of the following criteria will be excluded from the study:
    1. Is scheduled for liver transplantation.
    2. Expected ablation volume > 30% of total liver volume or removal of 3 hepatic segments
    3. More than 1 lesion identified during baseline.
    4. Have previously received therapeutic treatment for HCC outside the study protocol or is expected to receive concomitant HCC treatment prior to PFS event.
    5. Have serious medical illnesses including, but not limited to, congestive heart failure, myocardial infarction or cerebral vascular accident within the last six months, or life threatening cardiac arrhythmias.
    6. Have previously received any anthracycline outside the protocol.
    7. Have extrahepatic metastasis.
    8. Have portal or hepatic vein tumor invasion/thrombosis.
    9. Have body temperature > 101ºF (38.3ºC) immediately prior to study treatment.
    10. Baseline laboratories (repeat lab tests are permitted to evaluate eligibility during the Screening Period. Lab results must be within protocol range prior to study treatment.)
    - Absolute neutrophil count < 1500/mm3
    - Platelet count < 75,000/mm3
    - Hgb < 10.0 g/dL (unless the hemoglobin value has been stable, the subject is cardiovascularly stable, asymptomatic and judged able to withstand the RFA procedure)
    Note: If clinically indicated, subjects may receive platelets or packed RBC transfusions and be re-evaluated after condition is treated.
    11. Baseline Chemistry
    - Serum creatinine ≥ 2.5 mg/dL or calculated creatinine clearance (CrCl) ≤ 25.0 mL/min.
    - Serum bilirubin > 3.0 mg/dL.
    - Serum albumin < 2.8 g/dL.
    12. Have any known allergic reactions to any of the drugs or liposomal components or intravenous imaging agents that prohibit the ability to complete the imaging requirements.
    13. Are pregnant or breast-feeding. In women of childbearing potential, a negative serum pregnancy test is required prior to study treatment.
    14. Women of childbearing potential and men who are not practicing an acceptable form of birth control (i.e. diaphragm, cervical cap, condom, surgical sterility or birth control pills. Women whose partner has or men who have undergone a vasectomy must use a second form of birth control).
    15. Have INR > 1.5 times the institution's upper normal limit (UNL), except in subjects, who are therapeutically anticoagulated for medical conditions unrelated to HCC such as atrial fibrillation. Subjects may be re-screened after condition is treated or anticoagulant is withheld.
    16. Have contraindications to receiving doxorubicin HCl.
    17. Are being treated with other investigational agents.
    18. Use of an investigational drug outside this study within 30 days or 5 half-lives, whichever is longer, preceding the first dose of study medication.
    19. Have other concurrent malignancy (subjects with treated squamous cell carcinoma of the skin or basal cell carcinoma of the skin may be included), evidence of extrahepatic cancer from their primary malignancy, or ongoing,
    medically significant active infection.
    20. HIV positive.
    21. NYHA class III or IV functional classification for heart failure.
    22. Evidence of hemachromatosis.
    Los sujetos que cumplan alguno de los criterios siguientes quedarán excluidos de este estudio:
    1. Esté programado para un trasplante de hígado. de los criterios siguientes quedarán excluidos de este estudio:
    2. Volumen de ablación esperado > 30 % del volumen total del hígado o extirpación de 3 segmentos hepáticos
    3. Más de 1 lesión identificada durante el período inicial
    4. Hayan recibido previamente tratamiento terapéutico para HCC fuera del protocolo del estudio o se espera que reciban tratamiento concomitante para HCC antes del acontecimiento de SSP.
    5. Tengan enfermedades médicas graves incluidas, sin limitarse a ellas, insuficiencia cardiaca congestiva, infarto de miocardio o accidente cerebrovascular dentro de los últimos seis meses o arritmias cardiacas potencialmente mortales.
    6. Haya recibido previamente alguna antraciclina fuera del protocolo.
    7. Tengan metástasis extrahepática.
    8. Tengan invasión/trombosis tumoral venosa hepática o portal.
    9. Tenga una temperatura corporal > 101 ºF (38,3 ºC) inmediatamente antes del tratamiento del estudio.
    10. Pruebas analíticas en el momento inicial (se permite repetir las pruebas analíticas para evaluar la elegibilidad durante el período de selección. Los resultados de las pruebas analíticas deben estar dentro del rango del protocolo antes del tratamiento del estudio.)
    - Recuento absoluto de neutrófilos < 1500/mm3
    - Recuento plaquetario < 75 000/mm3
    - Hgb < 10,0 g/dl (a menos que el valor de hemoglobina haya sido estable, el sujeto sea cardiovascularmente estable, asintomático y se le juzgue estable para resistir el procedimiento de RFA)
    Nota: si está clínicamente indicado, los sujetos pueden recibir transfusiones de plaquetas o bolsas de GR y se les debe volver a evaluar una vez tratada la afección.
    11. Bioquímica inicial
    - Creatinina sérica ≥ 2,5 mg/dl o aclaramiento de creatinina calculado (AcCl) ≤ 25,0 ml/min.
    - Bilirrubina sérica > 3,0 mg/dl.
    - Albúmina sérica < 2,8 g/dl.
    12. Tengan alguna reacción alérgica conocida a cualquier de los fármacos o componentes liposomales o agentes intravenosos de diagnóstico por imagen que prohíban la capacidad de completar los requisitos de diagnóstico por imagen.
    13. Están embarazadas o en período de lactancia. En mujeres en edad fértil, se requiere una prueba de embarazo en suero negativa antes del tratamiento del estudio.
    14. Mujeres en edad fértil y hombres que no utilicen una forma aceptable de anticonceptivo (es decir, diafragma, capuchón cervical, preservativo, esterilización quirúrgica o píldoras anticonceptivas. Los hombres o las parejas varones de mujeres, los cuales se hayan sometido a una vasectomía, deben usar una segunda forma de anticonceptivo).
    15. Tengan un INR > 1,5 veces el límite superior de la normalidad (LSN) de la institución, excepto en sujetos que estén anticoagulados terapéuticamente para afecciones médicas no relacionadas con el HCC, como la fibrilación atrial. Se puede repetir la selección de los sujetos después de haber tratado la afección o de que se haya retirado el anticoagulante.
    16. Tengan contraindicaciones para recibir dexorubicina HCl.
    17. Estén siendo tratados con otros agentes en investigación.
    E.5 End points
    E.5.1Primary end point(s)
    Primary Endpoint: Survival
    All patients will be monitored for survival by recording their visits during routine follow up for response to treatment. The visits are scheduled to occur every four months from the first imaging study confirming complete ablation until month 25 or radiological progression, whichever comes first. If patients have not demonstrated radiological progression at month 25 then the imaging visit schedule is reduced to every six months until progression.
    Survival is confirmed at every imaging visit.
    Once radiological progression is confirmed then follow up for overall survival is required. Sites are required to confirm contact with the subject during either a clinic visit or a telephone contact every three months. It is expected that subject follow up will be about five years.
    Criterio de valoración principal: supervivencia
    Se supervisará la supervivencia en todos los pacientes registrando sus visitas durante el seguimiento de rutina para evaluar la respuesta al tratamiento. Las visitas están programadas para que tengan lugar cada cuatro meses desde el primer estudio de imagen que confirme la ablación completa hasta el mes 25 o progresión radiológica, lo que ocurra primero. Si los pacientes no han demostrado progresión radiológica en el mes 25, el calendario de visitas de imágenes puede reducirse a cada seis meses hasta la progresión. La supervivencia se confirma en cada visita de imágenes.
    Una vez confirmada la progresión radiológica, se requiere el seguimiento de la supervivencia general. Los centros deben confirmar el contacto con el sujeto durante una visita clínica o un contacto telefónico cada tres meses. Se espera que el seguimiento de los sujetos sea de unos cinco años.
    E.5.1.1Timepoint(s) of evaluation of this end point
    Overall Survival Evaluation at every imaging visit.
    Evaluación General de Supervivencia en cada visita de imágenes.
    E.5.2Secondary end point(s)
    Secondary Endpoint: Progression Free Survival
    The protocol incorporates modified RECIST (mRECIST) developed for HCC clinical research as a basis to evaluate tumor response. The mRECIST enables assessment of overall response by taking into account target lesion response, and presence or absence of new lesions. A separate imaging manual and imaging training program has
    been developed for this study in order to ensure uniformity in imaging technique and imaging review in
    accordance with mRECIST.
    Criterio de valoración secundario: Supervivencia sin progresión
    El protocolo incorpora RECIST modificado (mRECIST) desarrollado para la investigación clínica de HCC como una base para evaluar la respuesta tumoral. El mRECIST permite evaluar la respuesta general teniendo en cuenta la respuesta de la lesión objetivo y la presencia o ausencia de nuevas lesiones. Se ha desarrollado un manual de imágenes y un programa de formación sobre imágenes independientes para este estudio con el fin de garantizar la uniformidad en la técnica de imágenes y la revisión de imágenes de conformidad con mRECIST.
    E.5.2.1Timepoint(s) of evaluation of this end point
    Progression Free Survival
    Supervivencia sin progresión
    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 No
    E.6.7Pharmacodynamic No
    E.6.8Bioequivalence No
    E.6.9Dose response No
    E.6.10Pharmacogenetic No
    E.6.11Pharmacogenomic No
    E.6.12Pharmacoeconomic No
    E.6.13Others No
    E.7Trial type and phase
    E.7.1Human pharmacology (Phase I) No
    E.7.1.1First administration to humans No
    E.7.1.2Bioequivalence study No
    E.7.1.3Other No
    E. trial type description
    E.7.2Therapeutic exploratory (Phase II) No
    E.7.3Therapeutic confirmatory (Phase III) Yes
    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 No
    E.8.1.3Single blind No
    E.8.1.4Double blind Yes
    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) No
    E.8.2.2Placebo Yes
    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 concerned4
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA20
    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
    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
    End of the trial is scheduled when Overall Survival Reports reach 197 events (deaths) observed. Overall Survival records the date of death from time of randomization.
    El final del estudio está programado cuando los informes generales de supervivencia alcanzan los 197 acontecimientos (muertes) observados. La Supervivencia global registra la fecha de la muerte desde el momento de la aleatorización.
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years6
    E.8.9.1In the Member State concerned months10
    E.8.9.1In the Member State concerned days0
    E.8.9.2In all countries concerned by the trial years6
    E.8.9.2In all countries concerned by the trial months10
    E.8.9.2In all countries concerned by the trial days0
    F. Population of Trial Subjects
    F.1 Age Range
    F.1.1Trial has subjects under 18 No
    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: 360
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 240
    F.2 Gender
    F.2.1Female Yes
    F.2.2Male Yes
    F.3 Group of trial subjects
    F.3.1Healthy volunteers No
    F.3.2Patients Yes
    F.3.3Specific vulnerable populations Yes
    F.3.3.1Women of childbearing potential not using contraception No
    F.3.3.2Women of child-bearing potential using contraception Yes
    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 80
    F.4.2.2In the whole clinical trial 600
    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)
    Following study treatment, subjects will undergo CT or MRI imaging scans (chest, abdomen, and pelvis) at months 1, 5, 9, 13, 17, 21, and 25 (+/- 2 weeks), then at 6-month intervals (+/- 2 weeks) until radiological progression is seen.
    Post-progression treatments will be reported and the subject will continue to be followed for OS.
    Please refer to protocol for further post treatment details
    Después del tratamiento del estudio, los sujetos se someterán a exploraciones de imágenes por TC o RM en los meses 1, 5, 9, 13, 17, 21 y 25 (+/- 2 semanas), luego a intervalos de 6 meses (+/- 2 semanas) hasta que se observe progresión radiológica.
    Los tratamientos posteriores a la progresión se notificarán y se seguirá haciendo un seguimiento al sujeto para la SG.
    Por favor, refiéranse al protocolo para más información sobre los tratamientos posteriores.
    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 Decision2014-12-22
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2014-12-04
    P. End of Trial
    P.End of Trial StatusOngoing
    As of 1.2.2020, the UK is no longer an EU Member State. However, EU law still applies to the UK during the transition period
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