E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Metastatic or locally advanced squamous penile carcinoma |
Carcinoma epidermoide de pene metastásico o localmente avanzado |
|
E.1.1.1 | Medical condition in easily understood language |
Penile cancer |
Cáncer de pene |
|
E.1.1.2 | Therapeutic area | Diseases [C] - Cancer [C04] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 17.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10034318 |
E.1.2 | Term | Penile squamous cell carcinoma stage IV |
E.1.2 | System Organ Class | 100000004864 |
|
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 |
Evaluate response rate in terms of complete and partial response (RECIST criteria version 1.1) |
Evaluar la tasa de respuesta, en términos de respuesta completa y parcial, evaluada según los criterios RECIST versión 1.1 |
|
E.2.2 | Secondary objectives of the trial |
- Clinical benefit rate (complete and partial response and stable disease) evaluated according RECIST criteria version 1.1
- Progression free survival
- Response duration
- Overall survival
- Safety and tolerability profile |
- Tasa de beneficio clínico (respuesta completa y parcial y enfermedad estable), evaluada según los criterios RECIST versión 1.1
- Supervivencia libre de progresión
- Duración de la respuesta
- Supervivencia global
- Perfil de seguridad y tolerabilidad |
|
E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Written informed consent
2. Age >= 18 years
3. Histologically confirmed diagnosis of squamous cell carcinoma of the penis
4. Eastern Cooperative Oncology Group (ECOG) performance status of 0-1.
5. Measurable disease criteria according to RECIST criteria (version 1.1)
6. Progressive disease after treatment with cisplatin or carboplatin based chemotherapy. At least two cycles of chemotherapy had been administered either in neoadyuvant, adyuvant or metastatic setting.
7. Archived tumor tissue must be provided for all subjects for biomarker analysis before and/or during treatment with investigational product.
8. Adequate organ system function
- Haemoglobin >= 9.0 gr/dl (5.6 mmol/L) and stable in the previous 4 weeks to start study treatment
- Neutrophils >= 1.5 x 10*9/L
- Platelets >= 100 x 10*9/L
- Total bilirubin <= 1.5 x UNL
- AST/SGOT and ALT/SGPT <= 2.5 x UNL
9. Normal coagulation tests:
- Prothrombin time (PT) or international normalized ratio (INR) <= 1.2 X ULN
- Activated partial thromboplastin time (aPTT) <= 1.2 X ULN
10. Are able to swallow and retain oral tablets |
1. Consentimiento informado por escrito
2.Edad >= 18 años
3. Diagnóstico histológico confirmado de carcinoma de pene de células escamosas
4. ECOG PS 0-1
5. Enfermedad medible según los criterios RECIST versión 1.1 (Anexo 4)
6. Progresión de la enfermedad tras tratamiento con quimioterapia basada en cisplatino o carboplatino. Se deben haber administrado al menos dos ciclos de quimioterapia, ya sea en el ámbito neoadyuvante, adyuvante o metastásico
7. Disponibilidad de tejido tumoral para el análisis de biomarcadores antes y/o durante la administración del tratamiento en investigación.
8.Función hematológica, hepática y renal adecuadas:
- Hemoglobina >= 9.0 gr/dl (5.6 mmol/L) y estable en las 4 semanas previas al inicio del tratamiento
- Neutrófilos >= 1.5 x 10*9/L
- Plaquetas >= 100 x 10*9/L
- Bilirrubina total <= 1.5 x LSN
- AST/SGOT y ALT/SGPT <= 2.5 x LSN
- Creatinina <=1.5 x LSN (133 µmol/L). Si creatinina > 1.5 x LSN, el aclaramiento de creatinina deberá ser <= 30 mL/min calculado de acuerdo a la fórmula de Cockroft y Gault
- Ratio Proteína/Creatinina < 1 o proteína en orina (de 24h) <1g
9.Pruebas de coagulación normales:
- Tiempo de protrombina (PT) o cociente normalizado internacional (INR) <= 1.2 X LSN
- Tiempo parcial de tromboplastina activada <= 1.2 X LSN
10. Capaz de tragar y retener los comprimidos orales |
|
E.4 | Principal exclusion criteria |
1. Prior malignancy.
2. Central nervous system metastases at baseline, with the exception of those subjects who have previously-treated CNS metastases (surgery ± radiotherapy, radiosurgery, or gamma knife) and who meet both of the following criteria: a) are asymptomatic and b) have no requirement for steroids or enzyme-inducing anticonvulsants
3. Clinically significant gastrointestinal abnormalities that may increase the risk for gastrointestinal bleeding.
4. Clinically significant gastrointestinal abnormalities that may affect absorption of investigational product.
5. Corrected QT interval (QTc) > 480 msecs
6. History of any one or more of the following cardiovascular conditions within the past 6 months:
- Cardiac angioplasty or stenting
- Myocardial infarction
- Unstable angina
- Coronary artery bypass graft surgery
- Symptomatic peripheral vascular disease
- Class III or IV congestive heart failure, as defined by the New York Heart Association (NYHA)
7. Poorly controlled hypertension [defined as systolic blood pressure (SBP) of >= 140 mmHg or diastolic blood pressure (DBP) of >= 90mmHg].
8. History of cerebrovascular accident including transient ischemic attack (TIA), pulmonary embolism or untreated deep venous thrombosis (DVT) within the past 6 months.
Note: Subjects with recent DVT who have been treated with therapeutic anti-coagulating agents for at least 6 weeks are eligible
9. Major surgery or trauma within 28 days prior to first dose of investigational product and/or presence of any non-healing wound, fracture, or ulcer (procedures such as catheter placement not considered to be major surgery).
10. Evidence of active bleeding or bleeding diathesis.
11. Known endobronchial lesions and/or lesions infiltrating major pulmonary vessels that increase the risk of pulmonary hemorrhage
12. Recent hemoptysis (>= 1/2 teaspoon [2.5 mL]) of red blood within 8 weeks before first dose of study drug).
13. Any serious and/or unstable pre-existing medical, psychiatric, or other condition that could interfere with subjects safety, provision of informed consent, or compliance to study procedures.
14. Unable or unwilling to discontinue use of prohibited medications 14 days prior to the first dose of study drug and for the duration of the study.
15. Treatment with any of the following anti-cancer therapies:
- radiation therapy, surgery or tumor embolization within 14 days prior to the first dose of pazopanib OR
- chemotherapy, immunotherapy, biologic therapy, investigational therapy or hormonal therapy within 14 days prior to the first dose of Pazopanib
16. Administration of any non-oncologic investigational drug within 30 days prior to receiving the first dose of study treatment
17. Any ongoing toxicity from prior anti-cancer therapy that is >Grade 1 and/or that is progressing in severity, except alopecia.
18. Have a known immediate or delayed hypersensitivity reaction or idiosyncrasy to drugs chemically related to pazopanib or paclitaxel and/or excipients that contraindicates their participation.
19. Previous taxane or/and antiVEGF treatment would not allow patient to participate in the study. |
1. Enfermedad cancerosa previa.
2. Metástasis en el sistema nervioso central (SNC) al inicio del estudio, a excepción de aquellos sujetos que hayan tenido metástasis en el SNC previamente tratadas (cirugía ± radioterapia, radiocirugía o bisturí de rayos gamma) y que cumplan los siguientes criterios: a. paciente asintomático y b. paciente que no precisa en la actualidad tratamiento con esteroides ni medicación anticonvulsivante inductores enzimáticos.
3. Trastornos gastrointestinales clínicamente significativos que pueden aumentar el riesgo de sangrado gastrointestinal
4. Trastornos gastrointestinales clínicamente significativos que puedan afectar a la absorción del producto en investigación
5. Prolongación del intervalo QT corregido (QTc) > 480 milisegundos
6. Historia de al menos uno de los siguientes trastornos cardiovasculares dentro de los últimos 6 meses:
- Angioplastia o stent cardiaco
- Infarto agudo de miocardio
- Angina inestable
- Cirugía coronaria de bypass
- Enfermedad vascular periférica sintomática
- Insuficiencia cardíaca congestiva de clase III o IV, definida por la New York Heart Association (NYHA)
7. Hipertensión mal controlada [definida como presión arterial sistólica (PAS) >= 140 mmHg o presión arterial diastólica (PAD) >= 90 mmHg].
8. Historia de accidente cerebrovascular incluido ataque isquémico transitorio (AIT), embolismo pulmonar o trombosis venosa profunda no tratada (TVP) en los últimos 6 meses.
9. Cirugía mayor o traumatismo en los 28 días previos a la administración de la primera dosis del tratamiento del estudio y/o presencia de cualquier herida no cicatrizada, fractura o úlcera (procedimientos como la colocación de un catéter no se considera cirugía mayor).
10. Evidencia de hemorragia activa o diátesis hemorrágica.
11. Lesiones endobronquiales conocidas y/o lesiones que infiltran los vasos pulmonares mayores que aumentan el riesgo de hemorragia pulmonar.
12. Hemoptisis reciente (>= 1/2 cucharadita o 2,5 mL) de sangre roja en las 8 semanas previas a la administración de la primera dosis del fármaco del estudio).
13. Cualquier trastorno médico, psiquiátrico o de otro tipo que sea grave y/o inestable que pudiera interferir con la seguridad del paciente, la prestación del consentimiento informado, o el cumplimiento de los procedimientos del estudio.
14. El paciente no puede o no quiere dejar de utilizar medicación no permitida en el estudio durante al menos 14 días antes de la primera dosis del fármaco del estudio y durante la duración del estudio.
15. Tratamiento con cualquiera de las siguientes terapias contra el cáncer:
- Radioterapia, cirugía o embolización del tumor dentro de los 14 días previos a la primera dosis de pazopanib
- Quimioterapia, inmunoterapia, terapia biológica, fármacos en investigación o terapia hormonal dentro de los 14 días antes de la primera dosis de pazopanib
16. Administración de cualquier fármaco en investigación no oncológico dentro de los 30 días previos a recibir la primera dosis del tratamiento del estudio.
17. Presencia de cualquier toxicidad > Grado 1 y/o que está progresando en severidad relacionada con el tratamiento previo para el cáncer, excepto alopecia.
18. Hipersensibilidad inmediata o tardía conocida a pazopanib o paclitaxel y/o fármacos químicamente relacionados con pazopanib o paclitaxel y/o a alguno de los excipientes, que contraindique su participación.
19. Tratamiento previo con taxanos y/o antiVEGF. |
|
E.5 End points |
E.5.1 | Primary end point(s) |
Response rate in terms of complete and partial response (RECIST criteria version 1.1) |
Tasa de respuesta, en términos de respuesta completa y parcial, evaluada según los criterios RECIST versión 1.1 |
|
E.5.1.1 | Timepoint(s) of evaluation of this end point |
Every 8 weeks |
Cada 8 semanas |
|
E.5.2 | Secondary end point(s) |
- Clinical benefit rate (complete and partial response and stable disease) evaluated according RECIST criteria version 1.1
- Progression free survival
- Response duration
- Overall survival
- Safety and tolerability profile |
- Tasa de beneficio clínico (respuesta completa y parcial y enfermedad estable), evaluada según los criterios RECIST versión 1.1
- Supervivencia libre de progresión
- Duración de la respuesta
- Supervivencia global
- Perfil de seguridad y tolerabilidad |
|
E.5.2.1 | Timepoint(s) of evaluation of this end point |
- Every 8 weeks
- Every 8 weeks
- Every 8 weeks
- Every 8 weeks
- Every 4 weeks |
- Cada 8 semanas
- Cada 8 semanas
- Cada 8 semanas
- Cada 8 semanas
- Cada 4 semanas |
|
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 | No |
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 | Yes |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
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 | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | No |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | No |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 8 |
E.8.5 | The trial involves multiple Member States | No |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | No |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
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
|
LVLS |
Última visita del último paciente |
|
E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 1 |
E.8.9.1 | In the Member State concerned months | 6 |
E.8.9.1 | In the Member State concerned days | 0 |