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    Summary
    EudraCT Number:2014-004708-30
    Sponsor's Protocol Code Number:DU176b-D-U311
    National Competent Authority:Czechia - SUKL
    Clinical Trial Type:EEA CTA
    Trial Status:Completed
    Date on which this record was first entered in the EudraCT database:2015-04-03
    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 ConcernedCzechia - SUKL
    A.2EudraCT number2014-004708-30
    A.3Full title of the trial
    A PHASE 3B, PROSPECTIVE, RANDOMIZED, OPEN-LABEL, BLIND EVALUATOR (PROBE) STUDY EVALUATING THE EFFICACY AND
    SAFETY OF (LMW) HEPARIN/EDOXABAN VERSUS DALTEPARIN IN VENOUS THROMBOEMBOLISM ASSOCIATED WITH CANCER

    Fáze 3b prospektivního, randomizovaného, otevřeného klinického hodnocení se zaslepeným přípravkem pro hodnotitele (PROBE) hodnotícího účinnost a bezpečnost nízkomolekulárního heparinu/edoxabanu v porovnání s dalteparinem u žilní tromboembolie spojené s rakovinou
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    Edoxaban/heparin versus dalteprin in cancer patients for prevention of thrombosis
    A.4.1Sponsor's protocol code numberDU176b-D-U311
    A.5.2US NCT (ClinicalTrials.gov registry) numberNCT02073682
    A.5.4Other Identifiers
    Name:IND numberNumber:63,266
    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 SponsorDaiichi Sankyo Development Ltd
    B.1.3.4CountryUnited Kingdom
    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 supportDaiichi Sankyo Development Ltd
    B.4.2CountryUnited Kingdom
    B.4.1Name of organisation providing supportDaiichi Sankyo Pharma Development
    B.4.2CountryUnited States
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationDaiichi Sankyo Development Ltd
    B.5.2Functional name of contact pointClinical Trial Information
    B.5.3 Address:
    B.5.3.1Street AddressChiltern Place, Chalfont Park
    B.5.3.2Town/ cityGerrards Cross, Buckinghamshire
    B.5.3.3Post codeSL9 0BG
    B.5.3.4CountryUnited Kingdom
    B.5.6E-maileuregaffairs@dsd-eu.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 nameedoxaban
    D.3.2Product code DU-176b
    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 INNedoxaban
    D.3.9.1CAS number 480449-71-6
    D.3.9.2Current sponsor codeDU-176b
    D.3.9.3Other descriptive nameEDOXABAN TOSYLATE
    D.3.9.4EV Substance CodeSUB35059
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number30
    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 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 Fragmin
    D.2.1.1.2Name of the Marketing Authorisation holderPfizer Limited
    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 nameDalteparin
    D.3.4Pharmaceutical form Solution for injection in pre-filled syringe
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPSubcutaneous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNdalteparin sodium
    D.3.9.3Other descriptive nameDALTEPARIN SODIUM
    D.3.9.4EV Substance CodeSUB11889MIG
    D.3.10 Strength
    D.3.10.1Concentration unit IU international unit(s)
    D.3.10.2Concentration typerange
    D.3.10.3Concentration number5000 to 18000
    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
    venous thromboembolism associated with cancer
    E.1.1.1Medical condition in easily understood language
    blood clot associated with cancer
    E.1.1.2Therapeutic area Diseases [C] - Cardiovascular Diseases [C14]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 18.1
    E.1.2Level LLT
    E.1.2Classification code 10066899
    E.1.2Term Venous thromboembolism
    E.1.2System Organ Class 100000004866
    E.1.3Condition being studied is a rare disease No
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    The primary objective is to demonstrate the non-inferiority of edoxaban
    (preceded by a short course a LMWH compared with dalteparin for the
    prevention of the combined outcome of recurrent venous
    thromboembolism (VTE) or major bleeding in subjects with VTE
    associated with cancer during a 12-month study period. If noninferiority
    is established, LMWH/edoxaban will be compared with
    dalteparin for superiority.
    E.2.2Secondary objectives of the trial
    To compare LMWH/edoxaban with dalteparin with regards to rates of:
    1. Recurrent VTE;
    2. Major bleeding;
    3. Clinically relevant non-major (CRNM) bleeding;
    4. Major + CRNM bleeding;
    5. All bleedings
    6. Event-free survival, defined as the proportion of subjects over time
    free of recurrent VTE, major bleeding events, and death;
    7. VTE-related death;
    8. Mortality from all causes;
    9. Recurrent deep vein thrombosis (DVT);
    10. Recurrent pulmonary embolism (PE);
    11. Healthcare resource utilization for potential recurrent VTE and bleed
    events.
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    Adult subjects presenting with VTE associated with cancer (other than basal-cell or squamous-cell carcinoma of the skin) for whom long-term treatment with LMWH is intended are eligible to participate in the study.
    Subjects must satisfy all of the following criteria to be included in the study:
    1. Male or female subjects with age ≥ 18 years or the otherwise legal lower age according to the country of residence;
    2. Confirmed symptomatic or unsuspected lower extremity proximal DVT (ie, popliteal, femoral, iliac or inferior vena cava (IVC) vein thrombosis), or confirmed symptomatic PE, or unsuspected PE of a segmental or larger pulmonary artery;
    3. Cancer (other than basal-cell or squamous-cell carcinoma of the skin), either active or diagnosed within 2 years prior to randomization. [Note: Diagnosis of cancer must be objectively documented];
    4. Intention for long-term treatment (at least 6 months) with parenteral LMWH;
    5. Able to provide written informed consent.
    E.4Principal exclusion criteria
    1. Thrombectomy, insertion of a caval filter, or use of a fibrinolytic agent
    to treat the current (index) episode of DVT and/or PE;
    2. More than 72 hours pre-treatment with therapeutic dosages of
    anticoagulant treatment (LMWH, unfractionated heparin, and
    fondaparinux per local labeling), oral direct anticoagulants or VKA prior
    to randomization to treat the current (index) episode;
    3. Treatment with therapeutic doses of an anticoagulant including
    dalteparin for an indication other than VTE prior to randomization;
    4. Active bleeding or any contraindication for treatment with
    LMWH/dalteparin or edoxaban;
    5. An Eastern Cooperative Oncology Group (ECOG) Performance Status of
    3 or 4 at the time of randomization (Appendix 17.6);
    6. Calculated CrCL < 30 mL/min;
    7. History of heparin associated thrombocytopenia;
    8. Acute hepatitis, chronic active hepatitis, liver cirrhosis;
    9. Hepatocelullar injury with concurrent transaminase (ALT/AST > 3 x
    ULN) and bilirubin (> 2 x ULN) elevations in the absence of a clinical
    explanation;
    10. Life expectancy < 3 months;
    11. Platelet count < 50,000/mL;
    12. Uncontrolled hypertension as judged by the Investigator (eg, systolic
    blood pressure (BP) > 170 mmHg or diastolic blood pressure > 100
    mmHg despite antihypertensive treatment);
    13. Women of childbearing potential without proper contraceptive
    measures, and women who are pregnant or breast feeding;
    Note: Childbearing potential without proper contraceptive measures (ie,
    a method of contraception with a failure rate < 1 % during the course of
    the study including the observational period). These methods of
    contraception according to the note for guidance on nonclinical safety
    studies for the conduct of human trials for pharmaceuticals
    (CPMP/ICH/286/95, modification) include consistent and correct use of
    hormone containing implants and injectables, combined oral
    contraceptives, hormone containing intrauterine devices, surgical
    sterilization, sexual abstinence, and vasectomy for the male partner).
    14. Chronic treatment with non-aspirin non-steroidal anti-inflammatory
    drugs (NSAIDs) including both cyclooxygenase-1 (COX-1) and
    cyclooxygenase-2
    (COX-2) inhibitors for ≥ 4 days/week anticipated to continue during the
    study;
    15. Treatment with aspirin in a dosage of more than 100 mg/per day or
    dual antiplatelet therapy (any 2 antiplatelet agents including aspirin plus
    any other oral or intravenous [IV] antiplatelet drug) anticipated to
    continue during the study;
    16. Treatment with the P-gp inhibitors ritonavir, nelfinavir, indinavir, or
    saquinavir anticipated to continue during the study;
    17. Systemic use of the P-gp inhibitors ketoconazole, itraconazole,
    erythromycin, azithromycin or clarithromycin at the time of
    randomization; subsequent use is permitted (with appropriate dose
    reduction of edoxaban);
    18. Subjects with any condition that as judged by the Investigator would
    place the subject at increased risk of harm if he/she participated in the
    study.
    E.5 End points
    E.5.1Primary end point(s)
    The primary study outcome is the composite of recurrent
    VTE, and major bleeding.
    Recurrent VTE is either:
    -symptomatic confirmed (new) DVT or (new) PE;
    -unsuspected (new) proximal DVT of the legs or unsuspected (new) PE located in segmental or more proximal arteries:
    Unsuspected DVT or PE are thrombi that are detected during imaging testing performed for other reasons (eg, computed tomography (CT) for cancer staging) and not for suspicion of DVT or PE.
    -fatal PE (including unexplained death for which PE cannot be ruled out).
    E.5.1.1Timepoint(s) of evaluation of this end point
    Month 12
    E.5.2Secondary end point(s)
    -Recurrent VTE;
    -Major bleeding;
    -CRNM bleeding;
    -Major + CRNM bleeding;
    - All bleeding
    -Event-free survival, defined as the proportion of subjects over time free of recurrent VTE, major bleeding events, and death;
    -VTE-related death;
    -Mortality from all causes;
    -Recurrent DVT;
    -Recurrent PE;
    -Healthcare resource utilization for potential
    recurrent VTE and bleed events.
    E.5.2.1Timepoint(s) of evaluation of this end point
    Month 12
    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 No
    E.6.7Pharmacodynamic No
    E.6.8Bioequivalence No
    E.6.9Dose response No
    E.6.10Pharmacogenetic No
    E.6.11Pharmacogenomic No
    E.6.12Pharmacoeconomic No
    E.6.13Others No
    E.7Trial type and phase
    E.7.1Human pharmacology (Phase I) No
    E.7.1.1First administration to humans No
    E.7.1.2Bioequivalence study No
    E.7.1.3Other No
    E.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 No
    E.8.1.7Other Yes
    E.8.1.7.1Other trial design description
    Blind evaluator (probe)
    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 concerned9
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA95
    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
    Austria
    Belgium
    Canada
    Czech Republic
    France
    Germany
    Hungary
    Italy
    Netherlands
    New Zealand
    Spain
    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
    Once 1000 subjects are randomized, a global End-of-Treatment (EOT) date will be established that ensures a minimum of 6 months of study treatment and follow-up for the final subject(s) randomized. All subjects will permanently discontinue study treatment on or before the EOT date.
    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 months6
    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 months6
    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: 380
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 620
    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 state90
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 614
    F.4.2.2In the whole clinical trial 1000
    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
    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 Decision2015-08-04
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2015-04-29
    P. End of Trial
    P.End of Trial StatusCompleted
    P.Date of the global end of the trial2017-09-15
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