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    The EU Clinical Trials Register currently displays   44335   clinical trials with a EudraCT protocol, of which   7366   are clinical trials conducted with subjects less than 18 years old.   The register also displays information on   18700   older paediatric trials (in scope of Article 45 of the Paediatric Regulation (EC) No 1901/2006).

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    Summary
    EudraCT Number:2014-003437-26
    Sponsor's Protocol Code Number:CO-1686-020
    National Competent Authority:Spain - AEMPS
    Clinical Trial Type:EEA CTA
    Trial Status:Completed
    Date on which this record was first entered in the EudraCT database:2015-02-23
    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 number2014-003437-26
    A.3Full title of the trial
    TIGER-3: A Phase 3, Open-Label, Multicenter, Randomized Study of Oral Rociletinib (CO-1686) Monotherapy Versus Single-agent Cytotoxic Chemotherapy in Patients with Mutant EGFR Non-small Cell Lung Cancer (NSCLC) after Failure of at Least 1 Previous EGFR-directed Tyrosine Kinase Inhibitor (TKI) and Platinum-doublet Chemotherapy
    TIGER-3: Estudio en fase III, abierto, multicéntrico, aleatorizado de rociletinib (CO-1686) por vía oral en monoterapia en comparación con quimioterapia citotóxica con un solo agente en pacientes con cáncer de pulmón no microcítico (CPNM) con EGFR mutante, tras el fracaso terapéutico previo de, al menos, 1 inhibidor de la tirosina quinasa (ITQ) dirigido al EGFR y una quimioterapia doble con platino
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    A Phase 3 clinical study to evaluate the safety and efficacy of the study medication Rociletinib compared to pemetrexed, gemcitabine, docetaxel, or paclitaxel in subjects with Non-Small Cell Lung Cancer
    Estudio en fase III para evaluar la seguridad y la eficacia de la medicación del estudio Rociletinib en comparación con pemetrexed, gemcitabina, docetaxel, o paclitaxel en pacientes con cáncer de pulmón no microcítico
    A.3.2Name or abbreviated title of the trial where available
    TIGER-3
    TIGER-3
    A.4.1Sponsor's protocol code numberCO-1686-020
    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 SponsorClovis Oncology, 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 supportClovis Oncology, Inc
    B.4.2CountryUnited States
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationClovis Oncology UK Ltd
    B.5.2Functional name of contact pointDr Lindsey Rolfe
    B.5.3 Address:
    B.5.3.1Street AddressSheraton House, Castle Park
    B.5.3.2Town/ cityCambridge
    B.5.3.3Post codeCB3 0AX
    B.5.3.4CountryUnited Kingdom
    B.5.4Telephone number+441223 370037
    B.5.6E-mailinfo@clovisoncology.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 nameRociletinib
    D.3.2Product code CO-1686
    D.3.4Pharmaceutical form Film-coated tablet
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNNA
    D.3.9.1CAS number 1446700-26-0
    D.3.9.2Current sponsor codeCO-1686
    D.3.9.3Other descriptive nameRociletinib
    D.3.9.4EV Substance CodeSUB126980
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number125
    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: 2
    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 nameRociletinib
    D.3.2Product code CO-1686
    D.3.4Pharmaceutical form Film-coated tablet
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNNA
    D.3.9.1CAS number 1446700-26-0
    D.3.9.2Current sponsor codeCO-1686
    D.3.9.3Other descriptive nameRociletinib
    D.3.9.4EV Substance CodeSUB126980
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number250
    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.2.5The 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/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number10
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin 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.2.5The 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 nameGemcitabine
    D.3.4Pharmaceutical form Powder 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 INNGEMCITABINE HYDROCHLORIDE
    D.3.9.1CAS number 95058-81-4
    D.3.9.4EV Substance CodeSUB02324MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number200
    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.2.5The 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 namePaclitaxel
    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 INNPACLITAXEL
    D.3.9.1CAS number 33069-62-4
    D.3.9.4EV Substance CodeSUB09583MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number6
    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.2.5The 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 namepemetrexed
    D.3.4Pharmaceutical form Powder for 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 INNPEMETREXED
    D.3.9.1CAS number 137281-23-3
    D.3.9.2Current sponsor codePEMETREXED
    D.3.9.4EV Substance CodeSUB09655MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number100
    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.2.5The 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/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number10
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.8 Information on Placebo
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    Patients with EGFR mutant Non-Small Cell Lung Cancer who have failed at least 1 previous EGFR-directed TKI and 1 line of platinum?containing doublet chemotherapy
    Pacientes con CPNM con EGFR mutante, tras el fracaso de, al menos, 1 ITQ previo dirigido contra el EGFR y, al menos, 1 línea de quimioterapia doble con platino.
    E.1.1.1Medical condition in easily understood language
    Third and later line Treatment of Patients with EGFR-Mutant Advanced Non-Small Cell Lung Cancer
    Tercera y siguiente linea de tratamiento de pacientes con CPNM avanzado con EGFR mutante
    E.1.1.2Therapeutic area Diseases [C] - Cancer [C04]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 18.0
    E.1.2Level LLT
    E.1.2Classification code 10029514
    E.1.2Term Non-small cell lung cancer NOS
    E.1.2System Organ Class 100000004864
    E.1.3Condition being studied is a rare disease No
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    To compare the anti-tumor efficacy of oral single-agent rociletinib, as measured by investigator assessment of the PFS, with that of single-agent cytotoxic chemotherapy in patients with EGFR-mutated, advanced/metastatic NSCLC after failure of at least 1 previous EGFR-directed TKI and at least 1 line of platinum-containing doublet chemotherapy
    Comparar la eficacia antitumoral de rociletinib por vía oral en monoterapia, medida según la evaluación del investigador de la supervivencia libre de progresión (SLP), con aquella de la quimioterapia citotóxica con un solo agente en pacientes con CPNM avanzado/metastásico con EGFR mutante, tras el fracaso de, al menos, 1 ITQ previo dirigido contra el EGFR y, al menos, 1 línea de quimioterapia doble con platino.
    E.2.2Secondary objectives of the trial
    ? To compare secondary measures of clinical efficacy (ORR, DR, DCR and OS) between patients randomized to rociletinib or single-agent cytotoxic chemotherapy
    ? To compare the safety and tolerability of rociletinib with that of single-agent cytotoxic chemotherapy
    ? To determine PK of rociletinib using population PK (POPPK) methods and explore correlations between PK, exposure, response, and/or safety findings in patients randomized to rociletinib
    ?Comparar las mediciones secundarias de la eficacia clínica (tasa de control de la enfermedad [TCE], duración de la respuesta [DR], tasa de respuesta objetiva [TRO] y SG) entre los pacientes aleatorizados al grupo de rociletinib o al grupo de quimioterapia citotóxica con un solo agente.
    ?Comparar la seguridad y tolerabilidad de rociletinib con las de la quimioterapia citotóxica con un solo agente.
    ?Determinar la farmacocinética (FC) de rociletinib usando métodos de FC poblacional (FCPOB) y explorar las correlaciones entre los hallazgos de FC, exposición, respuesta o seguridad en los pacientes aleatorizados al grupo de rociletinib.
    E.2.3Trial contains a sub-study Yes
    E.2.3.1Full title, date and version of each sub-study and their related objectives
    To explore tissue and blood-based biomarkers that may be predictive of response or primary resistance to rociletinib and investigate mechanisms of acquired resistance in the tissue and blood of patients who experience clinical progression during treatment with rociletinib
    Explorar los biomarcadores en tejidos y sangre que pueden predecir la respuesta o resistencia primaria a rociletinib e investigar los mecanismos de resistencia adquirida en el tejido y la sangre de los pacientes que sufren progresión clínica durante el tratamiento con rociletinib.
    E.3Principal inclusion criteria
    1. Histologically or cytologically confirmed metastatic or unresectable locally advanced NSCLC with radiological progression on the most recent therapy received
    2. Documented evidence of a tumor with 1 or more EGFR activating mutations excluding exon 20 insertion
    3. Disease progression confirmed by radiological assessment while receiving treatment with single-agent EGFR-TKI
    4. Multiple lines of prior treatment are permitted but patients must have received at least 1 line of treatment with an EGFR TKI and a platinum-containing doublet chemotherapy
    5. Have undergone a biopsy of either primary or metastatic tumor tissue within 60 days prior to start of treatment and have tissue available to send to sponsor laboratory or are able to undergo a biopsy during Screening and provide tissue to
    sponsor laboratory
    6. Measureable disease according to RECIST Version 1.1
    7. Life expectancy of at least 3 months
    8. ECOG performance status of 0 to 1
    9. Age ? 18 years (in certain territories, the minimum age requirement may be higher e.g., age ? 20 years in Japan and Taiwan; age ? 21 years in Singapore)
    10. Patients should have recovered to National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events (CTCAE) Grade ? 1 from any significant chemotherapy-related toxicities
    11. Adequate hematological and biological function, confirmed by local laboratory value se.g. Bone Marrow Function, Hepatic Function, Renal function and Electrolyte within normal range
    12. Written consent on an Institutional Review Board (IRB)/Independent Ethics Committee (IEC)-approved ICF before any study specific evaluation
    1.CPNM localmente avanzado irresecable o con metástasis, confirmado mediante histología o citología, con progresión radiológica en la terapia más reciente que se haya recibido.
    2.Evidencia documentada de un tumor con 1 o más mutaciones activadoras del EGFR, excluida la inserción del exón 20.
    3.Progresión de la enfermedad confirmada mediante evaluación radiológica mientras se recibía tratamiento con ITQ del EGFR en monoterapia (p. ej., erlotinib, gefitinib, afatinib o dacomitinib). El periodo de reposo farmacológico mínimo para el ITQ del EGFR en monoterapia es de 3 días o 5 semividas, lo que mejor corresponda, antes del inicio del tratamiento.
    4.Se permiten múltiples líneas de tratamiento previo y no hay un orden especificado de tratamiento, pero en el transcurso de su historial terapéutico, los pacientes deben haber recibido y tener una progresión de la enfermedad documentada mediante pruebas radiológicas después de: Al menos, 1 línea de tratamiento previo con un ITQ del EGFR en monoterapia Y una quimioterapia doble con platino
    5.Haberse sometido a una biopsia de tejido tumoral primario o metastásico en los 60 días previos al inicio del tratamiento y tener tejido disponible para enviar al laboratorio del promotor, o ser capaz de someterse a una biopsia durante la selección y proporcionar tejido al laboratorio del promotor.
    6.Enfermedad medible conforme a RECIST, versión 1.1.
    7.Esperanza de vida de al menos 3 meses.
    8.Estado funcional ECOG de 0 a 1.
    9.Edad ? 18 años (en determinados territorios, el requisito de edad mínima puede ser mayor, p. ej., edad ?20 años en Japón y Taiwán, edad ? 21 años en Singapur).
    10.Los pacientes deben haberse recuperado de efectos adversos importantes relacionados con la quimioterapia hasta un grado ? 1 según los Criterios terminológicos comunes para acontecimientos adversos (Common Terminology Criteria for Adverse Events, CTCAE) del Instituto Nacional del Cáncer (National Cancer Institute, NCI).
    11.Función hematológica y biológica adecuada, confirmada por los valores analíticos siguientes: Función de la médula ósea, Función hepática, Función renal, Electrolitos, en rango normal.
    12.Consentimiento informado en un FCI aprobado por el comité de ética de investigación clínica (CEIC) antes de realizar ninguna evaluación específica del estudio.
    E.4Principal exclusion criteria
    1. Any other malignancy associated with a high mortality risk within the next 5 years and for which the patients may be (but not necessarily) currently receiving treatment
    2. Known pre-existing interstitial lung disease
    3. Tumor small cell transformation by local assessment, irrespective of presence of T790M+ component
    4. Patients with leptomeningeal carcinomatosis are excluded.
    5. Patients who are currently receiving treatment with any medications that have the potential to prolong the QT interval and that treatment cannot be either discontinued or switched to a different medication (known to have no effect on QT) before starting protocol-specified treatment
    6. Prior treatment with rociletinib, or other drugs that target T790M+ mutant EGFR with sparing of WT-EGFR including but not limited to AZD9291, HM61713, and TAS-121
    7. Any contraindications for therapy with pemetrexed, paclitaxel, gemcitabine or docetaxel unless a contraindication with respect to one of these drugs will not affect the use of any of the others as a comparator to rociletinib
    8. Cardiac abnormalities or history
    9. Non-study related surgical procedures ? 7 days prior to randomization. In all cases, the patient must be sufficiently recovered and stable before treatment administration.
    10. Females who are pregnant or breastfeeding
    11. Refusal to use adequate contraception for fertile patients (females and males) while on treatment and for 6 months after the last dose of study treatment (rociletinib and chemotherapy irrespective of single cytotoxic agent used)
    12. Presence of any serious or unstable concomitant systemic disorder incompatible with the clinical study (e.g., substance abuse, uncontrolled intercurrent illness including active infection, arterial thrombosis, and symptomatic pulmonary embolism)
    13. Any other reason the investigator considers the patient should not participate in the study
    1.Cualquier otra neoplasia maligna asociada a un riesgo elevado de mortalidad en los siguientes 5 años y para la cual los pacientes podrían estar recibiendo (aunque no necesariamente) tratamiento en la actualidad.
    2.Neumopatía intersticial preexistente conocida.
    3.Transformación a tumor de células pequeñas mediante evaluación local, independientemente de la presencia del componente T790M+.
    4.Se excluye a los pacientes con carcinomatosis leptomeníngea.
    5.Pacientes que estén recibiendo actualmente tratamiento con cualquier medicamento que tenga el potencial de prolongar el intervalo QT y que dicho tratamiento no pueda suspenderse o cambiarse a otro medicamento (que se sepa no tiene efecto sobre el intervalo QT) antes de iniciar el tratamiento especificado en el protocolo
    6.Tratamiento previo con rociletinib u otros fármacos que actúen sobre el EGFR mutante T790M+ y que no afecten al EGFR-WT como, por ejemplo, AZD9291, HM61713 y TAS-121.
    7.Contraindicaciones para el tratamiento con pemetrexed, paclitaxel, gemcitabina o docetaxel, a menos que una contraindicación relacionada con uno de estos fármacos no afecte al uso de cualquiera de los otros como comparador de rociletinib.
    8.Anomalías o antecedentes cardíacos
    9.Procedimientos quirúrgicos no relacionados con el estudio ? 7 días antes de la aleatorización. En todos los casos, el paciente debe haberse recuperado lo suficiente y estar suficientemente estable antes de la administración del tratamiento.
    10.Mujeres embarazadas o en periodo de lactancia.
    11.Negativa a usar anticonceptivos adecuados en el caso de pacientes fértiles (hombres y mujeres) durante el tratamiento y los 6 meses siguientes a la administración de la última dosis del tratamiento del estudio (rociletinib y quimioterapia independientemente del agente citotóxico empleado).
    12.Presencia de algún trastorno sistémico concomitante grave o inestable, incompatible con el estudio clínico (por ejemplo, drogadicción, enfermedad intercurrente no controlada, como diabetes no controlada, infección activa, trombosis arterial y embolia pulmonar sintomática).
    13.Cualquier otra razón por la que el investigador considere que el paciente no debe participar en el estudio.
    E.5 End points
    E.5.1Primary end point(s)
    Progression-free survival (PFS) according to RECIST Version 1.1 as determined by investigator assessment (invPFS)
    ?SLP conforme a RECIST versión 1.1?, según se determine mediante la evaluación del investigador (SLPinv).
    E.5.1.1Timepoint(s) of evaluation of this end point
    From start of treatment until it is clear that no further clinical benefit can be achieved.
    Desde el inicio del tratamiento hasta que esté claro que no se puede alcanzar más beneficio clínico
    E.5.2Secondary end point(s)
    ? ORR, DR, and DCR according to RECIST Version 1.1 as determined by investigator assessment
    ? OS
    ? Treatment-emergent AEs, laboratory abnormalities, and ECG abnormalities
    ? Plasma PK parameters for rociletinib based on sparse sampling
    ?TRO, DR y TCE conforme a RECIST versión 1.1, según se determinen mediante la evaluación del investigador.
    ?SG.
    ?Acontecimientos adversos (AA) surgidos durante el tratamiento, anomalías de laboratorio y anomalías en el electrocardiograma (ECG).
    ?Parámetros FC en plasma para rociletinib basados en muestreo disperso.
    E.5.2.1Timepoint(s) of evaluation of this end point
    From start of treatment until it is clear that no further clinical benefit can be achieved.
    Desde el inicio del tratamiento hasta que esté claro que no se puede alcanzar más beneficio clínico
    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 No
    E.6.4Safety Yes
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic Yes
    E.6.7Pharmacodynamic Yes
    E.6.8Bioequivalence No
    E.6.9Dose response No
    E.6.10Pharmacogenetic Yes
    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.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 No
    E.8.1.6Cross over Yes
    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 Yes
    E.8.2.3.1Comparator description
    pemetrexed, gemcitabine, docetaxel, or paclitaxel
    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 concerned7
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA50
    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
    Australia
    France
    Germany
    Italy
    Korea, Republic of
    Netherlands
    Spain
    Taiwan
    United Kingdom
    United States
    E.8.7Trial 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
    The trial will be completed when all enrolled patients have discontinued treatment in this protocol and completed the End-of-Treatment follow-up Visit.
    El ensayo estára completado cuando todos los pacientes incluidos hayan discontinuado el tratamiento en este protocolo y hayan completado la visita de seguimiento del fin del tratamiento
    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 days
    E.8.9.2In all countries concerned by the trial years2
    E.8.9.2In all countries concerned by the trial months6
    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: 175
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 425
    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 state53
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 250
    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)
    After the End of treatment the patients will return to their normal SOC medication.
    G. Investigator Networks to be involved in the Trial
    N. Review by the Competent Authority or Ethics Committee in the country concerned
    N.Competent Authority Decision Authorised
    N.Date of Competent Authority Decision2015-04-30
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2015-04-10
    P. End of Trial
    P.End of Trial StatusCompleted
    P.Date of the global end of the trial2018-03-29
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