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    Summary
    EudraCT Number:2014-001749-26
    Sponsor's Protocol Code Number:MK-3475-040
    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:2014-10-03
    Trial results View 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 number2014-001749-26
    A.3Full title of the trial
    A Phase III Randomized Trial of MK-3475 (Pembrolizumab) versus Standard Treatment in Subjects with Recurrent or Metastatic Head and Neck Cancer
    Ensayo aleatorizado de fase III de MK-3475 (Pembrolizumab) frente al tratamiento convencional en sujetos con cáncer de cabeza y cuello recurrente o metastásico
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    Ph 3 Trial of MK-3475 (Pembrolizumab) vs Standard Treatment in Recurrent/Metastatic Head and Neck Cancer
    Fase III de MK-3475 (Pembrolizumab) vs al tratamiento convencional en cáncer de cabeza y cuello recurrente/metastásico
    A.3.2Name or abbreviated title of the trial where available
    Ph 3 Trial of MK-3475 (Pembrolizumab) vs Standard Treatment in Recurrent/Metastatic Head and Neck Ca
    FIII de MK-3475 (Pembrolizumab) vs al tra. convencional en cáncer de cabeza y cuello recurrente/meta
    A.4.1Sponsor's protocol code numberMK-3475-040
    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 SponsorMerck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc.
    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 supportSource of Monetary or Material Support Organisation Name: Merck Sharp & Dohme Corp, a subsidiary of Merck &Co Inc
    B.4.2CountryUnited States
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationMerck Sharp & Dohme de España S.A.
    B.5.2Functional name of contact pointInvestigación Clínica
    B.5.3 Address:
    B.5.3.1Street AddressC/ Josefa Valcárcel, 38
    B.5.3.2Town/ cityMadrid
    B.5.3.3Post code28027
    B.5.3.4CountrySpain
    B.5.4Telephone number+34913210600
    B.5.5Fax number+34913210590
    B.5.6E-mailensayos_clinicos@merck.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.3.1Product namePembrolizumab
    D.3.2Product code MK-3475; SCH900475; 1374853-91-4
    D.3.4Pharmaceutical form 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 INNPEMBROLIZUMAB
    D.3.9.1CAS number 1374853-91-4
    D.3.9.2Current sponsor codeMK-3475
    D.3.9.3Other descriptive nameAnti-PD-1 monoclonal antibody
    D.3.9.4EV Substance CodeSUB167136
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number25
    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) Yes
    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 No
    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 Methotrexate
    D.2.1.1.2Name of the Marketing Authorisation holderTEVA GmbH
    D.2.1.2Country which granted the Marketing AuthorisationGermany
    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 nameMethotrexate
    D.3.4Pharmaceutical form 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 INNMethotrexate
    D.3.9.1CAS number 59-05-2
    D.3.9.3Other descriptive nameMETHOTREXATE
    D.3.9.4EV Substance CodeSUB08856MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number25
    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.IMP: 3
    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 Methotrexate
    D.2.1.1.2Name of the Marketing Authorisation holderMedac (Germany)
    D.2.1.2Country which granted the Marketing AuthorisationGermany
    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 nameMethotrexate
    D.3.4Pharmaceutical form 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 INNMethotrexate
    D.3.9.1CAS number 59-05-2
    D.3.9.3Other descriptive nameMETHOTREXATE
    D.3.9.4EV Substance CodeSUB08856MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number25
    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.IMP: 4
    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 Methotrexate
    D.2.1.1.2Name of the Marketing Authorisation holderHospira (UK)
    D.2.1.2Country which granted the Marketing AuthorisationUnited Kingdom
    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 nameMethotrexate
    D.3.4Pharmaceutical form 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 INNMethotrexate
    D.3.9.1CAS number 59-05-2
    D.3.9.3Other descriptive nameMETHOTREXATE
    D.3.9.4EV Substance CodeSUB08856MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number25
    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.IMP: 5
    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 Methotrexate
    D.2.1.1.2Name of the Marketing Authorisation holderAccord (UK)
    D.2.1.2Country which granted the Marketing AuthorisationUnited Kingdom
    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 nameMethotrexate
    D.3.4Pharmaceutical form 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 INNMethotrexate
    D.3.9.1CAS number 59-05-2
    D.3.9.3Other descriptive nameMETHOTREXATE
    D.3.9.4EV Substance CodeSUB08856MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number25
    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.IMP: 6
    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 Docetaxel
    D.2.1.1.2Name of the Marketing Authorisation holderActavis Group PTC ehf
    D.2.1.2Country which granted the Marketing AuthorisationIceland
    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 nameDocetaxel
    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 INNDocetaxel
    D.3.9.1CAS number 114977-28-5
    D.3.9.3Other descriptive nameDOCETAXEL
    D.3.9.4EV Substance CodeSUB12492MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg/l milligram(s)/litre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number20
    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.IMP: 7
    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 Cetuximab
    D.2.1.1.2Name of the Marketing Authorisation holderMerck KGaA
    D.2.1.2Country which granted the Marketing AuthorisationGermany
    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 nameCetuximab
    D.3.4Pharmaceutical form 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 INNCETUXIMAB
    D.3.9.1CAS number 205923-56-4
    D.3.9.3Other descriptive nameErbitux
    D.3.9.4EV Substance CodeSUB01178MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number5
    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) Yes
    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 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
    Recurrent or Metastatic Head and Neck Squamous Cell Carcinoma
    cáncer de cabeza y cuello recurrente o metastásico
    E.1.1.1Medical condition in easily understood language
    Advanced head and neck cancer
    cáncer de cabeza y cuello avanzado
    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
    (1) Objective: To compare the overall survival (OS) in subjects with recurrent or metastatic (R/M) head and neck squamous cell carcinoma (HNSCC) treated with pembrolizumab compared to standard treatment.
    (2) Objective: To compare progression-free survival (PFS) per RECIST 1.1 as assessed by independent radiology review in subjects with R/M HNSCC treated with pembrolizumab compared to standard treatment.
    (1)Objetivo: Comparar la supervivencia global (SG) en sujetos con carcinoma espinocelular de cabeza y cuello (CECC) recurrente o metastásico (R/M) tratados con pembrolizumab con la de sujetos que reciben el tratamiento convencional.
    (2)Objetivo: Comparar la supervivencia sin progresión (SSP) según los RECIST 1.1, evaluada en una revisión radiológica independiente, de sujetos con CECC R/M tratados con pembrolizumab con la de sujetos que reciben el tratamiento convencional.
    E.2.2Secondary objectives of the trial
    Evaluate safety and tolerability of pembrolizumab in subjects with R/M HNSCC
    Compare PFS per modified RECIST 1.1 by independent radiology review in subjects with R/M HNSCC treated with pembrolizumab compared to standard treatment
    Compare ORR per RECIST 1.1 by independent radiology review in subjects with R/M HNSCC treated with pembrolizumab compared to standard treatment
    Compare ORR per modified RECIST 1.1 by independent radiology review in subjects with R/M HNSCC treated with pembrolizumab compared to standard treatment
    Estimate PFS, OS, and ORR in a subgroup of PD-L1 positive R/M HNSCC subjects treated with pembrolizumab compared to standard treatment
    (Read the rest in the protocol)
    Evaluar el perfil de tolerabilidad y seguridad de pembrolizumab en sujetos con CECC R/M.
    Comparar la SSP según los RECIST 1.1 modificados, evaluada en una revisión radiológica independiente, de sujetos con CECC R/M tratados con pembrolizumab comparado con el tratamiento convencional.
    Comparar la tasa de respuesta global (TRO) según los RECIST 1.1, evaluada en una revisión radiológica independiente, en sujetos con CECC R/M tratados con pembrolizumab comparado con el tratamiento convencional.
    Comparar la TRO según los RECIST 1.1 modificados, evaluada en una revisión radiológica independiente, en sujetos con CECC R/M tratados con pembrolizumab comparado con el tratamiento convencional.
    Estimar la SSP, SG y TRO en un subgrupo de sujetos con CECC R/M positivo para PD-L1 tratados con pembrolizumab, en comparación con el tratamiento convencional.

    (Leer el resto en el protocolo)
    E.2.3Trial contains a sub-study Yes
    E.2.3.1Full title, date and version of each sub-study and their related objectives
    Merck will conduct Future Biomedical Research on DNA (blood and tumor) specimens collected during this clinical trial. Such research is for biomarker testing to address emergent questions not described elsewhere in the protocol (as part of the main trial) and will only be conducted on specimens from appropriately consented subjects. The objective of collecting specimens for Future Biomedical Research is to explore and identify biomarkers that inform the scientific understanding of diseases and/or their therapeutic treatments. The overarching goal is to use such information to develop safer, more effective drugs, and/or to ensure that subjects receive the correct dose of the correct drug at the correct time.
    Merck llevará a cabo investigaciones biomédicas futuras con las muestras obtenidas de forma sistemática y específica durante este ensayo clínico. Estas investigaciones tendrán por objeto el análisis de biomarcadores para abordar aspectos nuevos que no se describen en otras partes del protocolo (como parte del ensayo principal) y solo se llevarán a cabo en muestras de los pacientes que hayan otorgado el consentimiento correspondiente. El objetivo de la obtención de muestras para investigación biomédica futura consiste en estudiar e identificar
    biomarcadores que proporcionen información a los científicos sobre las enfermedades y sus tratamientos.
    El objetivo último es utilizar tal información para desarrollar vacunas y fármacos más seguros y eficaces o para garantizar que los pacientes reciban la dosis correcta del fármaco o la vacuna adecuados en el momento preciso
    E.3Principal inclusion criteria
    1.Be willing and able to provide written informed consent for the trial. The subject may also provide consent for Future Biomedical Research. However, the subject may participate in the main trial without participating in Future Biomedical Research.
    2. Be > 18 years of age on day of signing informed consent.
    3. Have histologically or cytologically-confirmed R/M HNSCC of the oral cavity, oropharynx, hypopharynx, and larynx that is considered incurable by local therapies. Subjects may not have any other primary tumor site (e.g. nasopharynx).
    4. Prior platinum failure as defined by:
    a. Disease progression after treatment with a platinum-containing regimen for recurrent/metastatic disease
    Note: Disease progression may occur at any time during or after a platinum-containing regimen (e.g. carboplatin or cisplatin) which was administered in either 1L or 2L in the recurrent/metastatic setting.
    b. Recurrence/progression within 6 months of prior multimodal therapy using platinum (e.g. locally advanced setting)
    5. Have results from local testing of HPV positivity for oropharyngeal cancer defined as p16 IHC testing using CINtec® p16 Histology assay and a 70% cutoff point.
    Note: HPV stratification in this trial will be performed using local testing of HPV status in patients with oropharynx cancer. Oral cavity, hypopharynx, and larynx cancer are not required to undergo HPV testing by p16 IHC as by convention assumed to be HPV negative.
    6. Have provided tissue for PD-L1 biomarker analysis from a newly obtained core or excisional biopsy. Repeat samples may be required if adequate tissue is not provided or for indeterminate results.
    Note: Patients for whom newly obtained samples cannot be obtained (e.g. inaccessible or patient safety concern) may submit an archived specimen only upon agreement from the Sponsor.
    Note: If emerging data indicate a high concordance in PD-L1 expression scores between newly obtained and archival samples, archived samples may be acceptable.
    7. Have measurable disease based on RECIST 1.1 as determined by the site. Tumor lesions situated in a previously irradiated area are considered measurable if progression has been demonstrated in such lesions.
    8. Have a performance status of 0 or 1 on the ECOG Performance Scale.
    9. Demonstrate adequate organ function as defined in Table 1 of the protocol, all screening labs should be performed within 10 days of treatment initiation.
    10. Female subjects of childbearing potential should have a negative serum pregnancy test within 72 hours prior to receiving the first dose of study medication. A urine test can be considered if a serum test is not appropriate.
    11. Female subjects of childbearing potential should be willing to use 2 methods of birth control or be surgically sterile, or abstain from heterosexual activity for the course of the study through 120 days after the last dose of study medication (Reference Section 5.7.2). Subjects of childbearing potential are those who have not been surgically sterilized or have not been free from menses for > 1 year. Note: Abstinence is acceptable if this is the established and preferred contraception for the subject.
    12. Male subjects should agree to use an adequate method of contraception starting with the first dose of study therapy through 120 days after the last dose of study therapy.
    1.Estar dispuesto a otorgar su consentimiento informado por escrito para el ensayo y ser capaz de hacerlo. El sujeto también podrá otorgar su consentimiento para las investigaciones biomédicas futuras. No obstante, podrá participar en el ensayo principal sin necesidad de participar en investigaciones biomédicas futuras.
    2.Tener una edad mínima de 18 años el día de la firma del consentimiento informado.
    3.Tener carcinoma espinocelular de cabeza y cuello recurrente o metastásico, histológica o citológicamente confirmado, en cavidad oral, orofaringe, hipofaringe o laringe, que se considere incurable con tratamientos locales. Los sujetos no podrán tener otras localizaciones del tumor primario (p. ej., nasofaringe).
    4.Fracaso previo de una terapia con platino, definido como:
    a.Progresión de la enfermedad después de un tratamiento para la enfermedad recurrente metastásica con un régimen basado en platino.
    Nota: la progresión de la enfermedad puede haberse producido en cualquier momento durante o después del tratamiento con el régimen basado en platino (p. ej., carboplatino o cisplatino), administrado en 1L o 2L en el contexto recurrente/metastásico.
    b.Recidiva/progresión en los 6 meses siguientes a la terapia multimodal previa basada en platino (p. ej., contexto localmente avanzado).
    5.Disponer de los resultados de una prueba local de positividad para PVH del cáncer de orofaringe, definida como un análisis IHQ de p16 usando el ensayo CINtec® y un valor de corte del 70 %. Véase más información en la sección 7.1.2.7.
    Nota: en este ensayo se realizará una estratificación por estado de PVH usando un análisis local de PVH en pacientes con cáncer de orofaringe. En el caso de cáncer de cavidad oral, hipofaringe o laringe, no es necesario realizar las pruebas de PVH por HIQ de p16, puesto que por convención se supone que son negativos para PVH.
    6.Proporcionar tejido de una biopsia con aguja gruesa o escisional recién obtenida, para análisis de biomarcadores de PD-L1. Pueden necesitarse nuevas muestras si no se dispone de tejido suficiente o en caso de resultados indeterminados. Los resultados indeterminados tras varias muestras repetidas pueden considerarse como negativo para PD-L1.
    Nota: en los pacientes en los que no puedan obtenerse nuevas muestras (p. ej., inaccesibilidad o problemas de seguridad del paciente) podrán facilitar una muestra de archivo solo con la aprobación del promotor.
    Nota: si nuevos datos indicasen una alta concordancia de los valores de expresión de PD-L1 entre las muestras recién obtenidas y las de archivo, podrían aceptarse estas últimas.
    7.Tener enfermedad medible con arreglo a los RECIST 1.1, según la evaluación del centro. Las lesiones tumorales ubicadas en una zona previamente irradiada se consideran medibles siempre que se haya demostrado progresión en dichas lesiones.
    8.Tener un estado funcional de 0 o 1 en la escala del ECOG.
    9.Demostrar una función orgánica adecuada según se define en la Tabla 1 del protocolo; todos los análisis de selección deben practicarse en los 10 días anteriores al inicio del tratamiento.
    10.Las mujeres con capacidad de procrear deberán tener una prueba de embarazo en suero negativa en las 72 horas anteriores a la administración de la primera dosis de la medicación del estudio. Puede considerarse el uso de una prueba en orina si la prueba en suero no es conveniente.
    11.Las mujeres con capacidad de procrear deberán estar dispuestas a utilizar dos métodos anticonceptivos, estar esterilizadas quirúrgicamente o abstenerse de mantener relaciones heterosexuales durante todo el estudio y durante 120 días después de recibir la última dosis de medicación del estudio (véase la sección 5.7.2). Las mujeres con capacidad de procrear son las que no han sido esterilizadas quirúrgicamente o no llevan más de un año sin menstruación.
    Nota: la abstinencia es aceptable si es el método anticonceptivo establecido y preferido del sujeto.
    12.Los varones deberán aceptar utilizar un método anticonceptivo adecuado desde la administración de la primera dosis del tratamiento del estudio hasta 120 días después de la última.
    E.4Principal exclusion criteria
    1.Has disease that is suitable for local therapy administered with curative intent.
    2. Had progressive disease within three months of completion of curatively intended treatment for locoregionally advanced or metastatic HNSCC.
    3. Is currently participating in or has participated in a study of an investigational agent or using an investigational device within 4 weeks prior to the first dose of trial treatment.
    4. Was previously treated with 3 or more systemic regimens given for recurrent and/or metastatic disease.
    5. Patients previously treated or resistant to one of the 3 standard of care agents in this trial (i.e. docetaxel, methotrexate, or cetuximab) may not receive the same agent if randomized to the standard treatment arm (see Section 5.2 for details).
    6. Has a diagnosis of immunodeficiency or is receiving systemic steroid therapy or any other form of immunosuppressive therapy within 7 days prior to the first dose of trial treatment. The use of physiologic doses of corticosteroids may be approved after consultation with the Sponsor.
    7. Has had a prior anti-cancer monoclonal antibody (mAb) within 4 weeks prior to study Day 1 or who has not recovered (i.e., < or = to Grade 1 or at baseline) from adverse events due to agents administered more than 4 weeks earlier.
    8. Has had prior chemotherapy, targeted small molecule therapy, or radiation therapy within 2 weeks prior to study Day 1 or who has not recovered (i.e., < or = to Grade 1 or at baseline) from adverse events due to a previously administered agent.
    9. Has a known additional malignancy that is progressing or requires active treatment.
    10. Has known active central nervous system (CNS) metastases and/or carcinomatous meningitis. Subjects with previously treated brain metastases may participate provided they are stable (without evidence of progression by imaging for at least four weeks prior to the first dose of trial treatment and any neurologic symptoms have returned to baseline), have no evidence of new or enlarging brain metastases, and are not using steroids for at least 7 days prior to trial treatment. This exception does not include carcinomatous meningitis which is excluded regardless of clinical stability.
    11. Has an active autoimmune disease requiring systemic treatment within the past 3 months or a documented history of clinically severe autoimmune disease, or a syndrome that requires systemic steroids or immunosuppressive agents. Subjects with vitiligo diabetes Type I, or resolved childhood asthma/atopy would be an exception to this rule. Subjects that require intermittent use of bronchodilators, inhaled steroids, or local steroid injections would not be excluded from the study. Subjects with hypothyroidism stable on hormone replacement or Sjøgrens syndrome will not be excluded from the study.
    12. Has active, non-infectious pneumonitis;
    13. Has an active infection requiring systemic therapy.
    14. Has a history or current evidence of any condition, therapy, or laboratory abnormality that might confound the results of the trial, interfere with the subjects participation for the full duration of the trial, or is not in the best interest of the subject to participate, in the opinion of the treating investigator.
    15. Has a known psychiatric or substance abuse disorders that would interfere with co- operation with the requirements of the trial.
    16. Is pregnant or breastfeeding, or expecting to conceive or father children within the projected duration of the trial, starting with the screening visit through 120 days after the last dose of trial treatment.
    17. Has received prior therapy with an anti-PD-1, anti-PD-L1, or anti-PD-L2 agent.
    18. Has a known history of Human Immunodeficiency Virus (HIV) (HIV 1/2 antibodies).
    19. Has known active Hepatitis B (e.g., HBsAg reactive) or Hepatitis C (e.g., HCV RNA [qualitative] is detected).
    20. Has received a live vaccine within 30 days of planned start of study therapy.
    21. Is or has an immediate family member (e.g., spouse, parent/legal guardian, sibling or child) who is investigational site or sponsor staff directly involved with this trial, unless prospective IRB approval (by chair or designee) is given allowing exception to this criterion for a specific subject.
    1.Padece una enfermedad susceptible de tratamiento local administrado con intención curativa
    2.Ha presentado progresión de la enfermedad en los 3 meses siguientes a la finalización de un tratamiento con intención curativa para el CECC local/regionalmente avanzado o metastásico
    3.Está participando o ha participado en un estudio de un fármaco o dispositivo en investigación en las 4 semanas anteriores a la administración de la primera dosis del tratamiento del ensayo
    4.Ha sido tratado previamente con 3 o más regímenes sistémicos para la enfermedad recurrente o metastásica
    5.Los pacientes tratados con uno de los 3 fármacos convencionales de referencia de este ensayo (docetaxel, metotrexato o cetuximab) en el contexto recurrente/metastásico, o resistentes a ellos en el contexto localmente avanzado, no podrán recibir el mismo fármaco si resultan asignados al grupo de tratamiento convencional (consulte los detalles en la sección 5.2).
    6.Tiene un diagnóstico de inmunodeficiencia o ha recibido corticoterapia sistémica o algún tipo de tratamiento inmunodepresor en los 7 días anteriores a la administración de la primera dosis del tratamiento del ensayo. El uso de dosis fisiológicas de corticosteroides podrá autorizarse previa consulta con el promotor.
    7.Ha recibido un anticuerpo monoclonal (mAb) antineoplásico previo en las 4 semanas anteriores al día 1 del estudio o no se ha recuperado (es decir, a un grado < o = a 1 o al valor basal) de los acontecimientos adversos provocados por los fármacos administrados más de 4 semanas antes.
    8.Ha recibido quimioterapia previa, un tratamiento dirigido con moléculas pequeñas o radioterapia en las 2 semanas anteriores al día 1 del estudio o no se ha recuperado (es decir, a un grado < o = a 1 o al valor basal) de los acontecimientos adversos provocados por un fármaco administrado anteriormente.
    9.Presenta otro tumor maligno conocido que esté en progresión o necesite tratamiento activo.
    10.Presenta metástasis activas en el sistema nervioso central (SNC) o meningitis carcinomatosa. Los sujetos con metástasis cerebrales tratadas con anterioridad podrán participar siempre que se encuentren estables (sin signos de progresión en los estudios de imagen durante al menos cuatro semanas antes de la primera dosis del tratamiento del ensayo y con regreso de todos los síntomas neurológicos a la situación basal), no presenten indicios de metástasis cerebrales nuevas o que estén aumentando de tamaño y no utilicen esteroides durante al menos 7 días antes de recibir la medicación del ensayo. Esta excepción no se refiere a la meningitis carcinomatosa, que está excluida con independencia de la estabilidad clínica.
    11.Tiene una enfermedad autoinmune activa que precisó tratamiento sistémico en los últimos 3 meses o una historia documentada de enfermedad autoinmune clínicamente intensa, o un síndrome que requiera corticosteroides sistémicos o inmunodepresores. Son excepciones a esta regla los sujetos con vitiligo, diabetes de tipo I o asma/atopia infantil resueltas. No se excluirá del estudio a los sujetos que necesiten un uso intermitente de broncodilatadores, esteroides inhalados o inyecciones locales de esteroides. Tampoco se excluirá del ensayo a los sujetos con hipotiroidismo que se encuentren estables con un tratamiento de sustitución hormonal o que presenten síndrome de Sjogren.
    12.Tiene neumonitis no infecciosa activa.
    13.Presenta una infección activa con necesidad de tratamiento sistémico.
    14.Tiene antecedentes o datos actuales de cualquier trastorno, tratamiento o anomalía analítica que, en opinión del investigador, pueda confundir los resultados del ensayo, afectar a la participación del sujeto durante todo el ensayo o hacer que la participación no sea lo más conveniente para el sujeto.
    15.Presenta un trastorno psiquiátrico o por abuso de sustancias que pueda interferir en la colaboración con los requisitos del ensayo.
    16.Es una mujer embarazada o en período de lactancia o que tiene intención de concebir o engendrar un hijo durante el período previsto del ensayo, desde la visita de selección hasta 120 días después de la última dosis del tratamiento del ensayo.
    17.Ha recibido un tratamiento previo con un agente anti-PD-1, anti-PD-L1 o anti-PD-L2.
    18.Tiene antecedentes de infección por el virus de la inmunodeficiencia humana (VIH) (anticuerpos contra el VIH 1 o 2).
    19.Tiene hepatitis B activa demostrada (p. ej., reactividad HBsAg) o Hepatitis C demostrada (p. ej., detección [cualitativa] del ARN del VHC).
    20.Ha recibido una vacuna con microbios vivos en los 30 días anteriores al comienzo previsto del tratamiento del ensayo.
    21.Forma parte, o tiene un familiar directo (por ejemplo, cónyuge, padre/madre o tutor legal, hermano o hijo) que forma parte, del personal del centro del estudio o del promotor implicado directamente en este ensayo, salvo dictamen prospectivo del CEIC (presidente o persona designada) que autorice la excepción a este criterio para un paciente concreto.
    E.5 End points
    E.5.1Primary end point(s)
    To compare the overall survival (OS) in subjects with recurrent or metastatic (R/M) head and neck squamous cell carcinoma (HNSCC) treated with pembrolizumab compared to standard treatment.
    To compare progression-free survival (PFS) per RECIST 1.1 as assessed by independent radiology review in subjects with R/M HNSCC treated with pembrolizumab compared to standard treatment.
    Comparar la supervivencia global (SG) en sujetos con carcinoma espinocelular de cabeza y cuello (CECC) recurrente o metastásico (R/M) tratados con pembrolizumab con la de sujetos que reciben el tratamiento convencional.
    Comparar la supervivencia sin progresión (SSP) según los RECIST 1.1, evaluada en una revisión radiológica independiente, de sujetos con CECC R/M tratados con pembrolizumab con la de sujetos que reciben el tratamiento convencional.
    E.5.1.1Timepoint(s) of evaluation of this end point
    The final OS analysis will be conducted after ~351 deaths have occurred between the MK-3475 arm and the standard treatment arm, if the trial is not stopped early for efficacy or futility.
    The first planned PFS analysis will be conducted after enrollment is complete, ~232 PFS events are observed between MK 3475 arm and the standard treatment arm and at least 310 subjects have ?4 months of follow-up.
    El análisis final de la SG se realizará cuando se hayan producido aproximadamente 351 muertes entre el grupo de pembrolizumab y el grupo de tratamiento convencional, a no ser que el estudio finalice prematuramente por inutilidad o eficacia.
    El primer análisis de la SSP se efectuará cuando el reclutamiento se haya completado, se hayan observado aproximadamente 232 acontecimientos de SSP y al menos 310 sujetos hayan permanecido en seguimiento durante 4 meses como mínimo.
    E.5.2Secondary end point(s)
    To evaluate the safety and tolerability profile of pembrolizumab in subjects with R/M HNSCC.
    To compare PFS per modified RECIST 1.1 by blinded independent radiology review in subjects with R/M HNSCC treated with pembrolizumab compared to standard treatment.
    To compare overall response rate (ORR) per RECIST 1.1 by blinded independent radiology review in subjects with R/M HNSCC treated with pembrolizumab compared to standard treatment.
    To compare ORR per modified RECIST 1.1 by blinded independent radiology review in subjects with R/M HNSCC treated with pembrolizumab compared to standard treatment.
    To estimate PFS, OS, and ORR in a subgroup of PD-L1 positive R/M HNSCC subjects treated with pembrolizumab compared to standard treatment.
    To estimate response duration per RECIST 1.1 by blinded independent radiology review in subjects with R/M HNSCC treated with pembrolizumab compared to standard treatment.
    To estimate response duration per modified RECIST 1.1 by blinded independent radiology review in subjects with R/M HNSCC treated with pembrolizumab compared to standard treatment.
    Evaluar el perfil de tolerabilidad y seguridad de pembrolizumab en sujetos con CECC R/M.
    Comparar la SSP según los RECIST 1.1 modificados, evaluada en una revisión radiológica independiente, de sujetos con CECC R/M tratados con pembrolizumab comparado con el tratamiento convencional.
    Comparar la tasa de respuesta global (TRO) según los RECIST 1.1, evaluada en una revisión radiológica independiente, en sujetos con CECC R/M tratados con pembrolizumab comparado con el tratamiento convencional.
    Comparar la TRO según los RECIST 1.1 modificados, evaluada en una revisión radiológica independiente, en sujetos con CECC R/M tratados con pembrolizumab comparado con el tratamiento convencional.
    Estimar la SSP, SG y TRO en un subgrupo de sujetos con CECC R/M positivo para PD-L1 tratados con pembrolizumab, en comparación con el tratamiento convencional.
    Estimar la duración de la respuesta según los RECIST 1.1, evaluada en una revisión radiológica independiente, en sujetos con CECC R/M tratados con pembrolizumab, en comparación con el tratamiento convencional.
    Estimar la duración de la respuesta según los RECIST 1.1 modificados, evaluada en una revisión radiológica independiente, en sujetos con CECC R/M tratados con pembrolizumab, en comparación con el tratamiento convencional.
    E.5.2.1Timepoint(s) of evaluation of this end point
    15 April 2017
    15 de Abril de 2017
    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 No
    E.6.8Bioequivalence No
    E.6.9Dose response No
    E.6.10Pharmacogenetic Yes
    E.6.11Pharmacogenomic Yes
    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.7.1.3.1Other 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 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 concerned6
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA56
    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
    Belgium
    Canada
    France
    Germany
    Hungary
    Ireland
    Italy
    Korea, Republic of
    Lithuania
    Netherlands
    Poland
    Puerto Rico
    Russian Federation
    Spain
    Switzerland
    United Kingdom
    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 overall trial begins when the first subject signs the informed consent form. The overall trial ends when the last subject completes the last trial visit, discontinues from the trial or is lost to follow-up (i.e. the subject is unable to be contacted by the investigator).
    El ensayo en su conjunto comenzará en el momento en que el primer paciente firme el documento de consentimiento informado. El ensayo en su conjunto finalizará cuando el último paciente complete la última visita del ensayo, se retire del ensayo o se pierda para el seguimiento (es decir, cuando el investigador no pueda ponerse en contacto con el paciente).
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years2
    E.8.9.1In the Member State concerned months1
    E.8.9.1In the Member State concerned days0
    E.8.9.2In all countries concerned by the trial years2
    E.8.9.2In all countries concerned by the trial months0
    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: 326
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 140
    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 state30
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 310
    F.4.2.2In the whole clinical trial 466
    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)
    None
    Ninguno
    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 Decision2014-12-01
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2014-11-06
    P. End of Trial
    P.End of Trial StatusCompleted
    P.Date of the global end of the trial2022-08-15
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