E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
? Patients with a primary bone malignancy or soft-tissue sarcoma that has invaded a lower extremity bone that are undergoing surgical treatment to resect the tumor and functionally reconstruct the limb using a modular metallic and polyethylene endoprosthetic implant to replace the surgically resected bones and joints. ? Development of a surgical site infection according to the guidelines established by the Centers for Disease Control and Prevention (CDC) |
- Pacientes con tumor maligno óseo primario o sarcoma de tejidos blandos con invasión ósea de las extremidades inferiores sometidas a tratamiento quirúrgico para extirpación del tumor y reconstrucción funcional utilizando un implante endoprotésico metálico - Desarrollo de una infección del sitio quirúrgico de acuerdo con los criterios establecidos en la guía del Centro para el Control y la Prevención de Enfermedades (CDC) |
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E.1.1.1 | Medical condition in easily understood language |
? Patients with bone cancer of the leg that are undergoing surgery to remove the tumor and reconstruct the leg using a metal implant ? Development of a surgical site infection |
- Pacientes con cáncer de hueso de la pierna sometidos a cirugía para extirpar el tumor y reconstruir la pierna usando un implante de metal - Desarrollo de una infección del sitio quirúrgico |
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E.1.1.2 | Therapeutic area | Diseases [C] - Bacterial Infections and Mycoses [C01] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 18.1 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10064736 |
E.1.2 | Term | Antibiotic prophylaxis |
E.1.2 | System Organ Class | 10042613 - Surgical and medical procedures |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 18.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10056641 |
E.1.2 | Term | Post procedural site wound infection |
E.1.2 | System Organ Class | 100000004862 |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 18.1 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10068943 |
E.1.2 | Term | Limb reconstructive surgery |
E.1.2 | System Organ Class | 10042613 - Surgical and medical procedures |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 18.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10036894 |
E.1.2 | Term | Prophylactic antibiotic therapy |
E.1.2 | System Organ Class | 10042613 - Surgical and medical procedures |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 18.1 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10005978 |
E.1.2 | Term | Bone lesion excision |
E.1.2 | System Organ Class | 10042613 - Surgical and medical procedures |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 18.1 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10073235 |
E.1.2 | Term | Bone prosthesis insertion |
E.1.2 | System Organ Class | 10042613 - Surgical and medical procedures |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 18.1 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10006007 |
E.1.2 | Term | Bone sarcoma |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
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E.1.3 | Condition being studied is a rare disease | Yes |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To determine whether a 5-day regimen of post-operative prophylactic antibiotics in comparison to the standard 24-hour regimen decreases the rate of surgical site infections after limb salvage surgery within 1-year of follow-up. |
Determinar si el régimen antibiótico postoperatorio prolongado (5 días) disminuirá la tasa de infección en cirugía de tumores de los miembros inferiores, cuando se compara con un tratamiento antibiótico estándar a corto plazo (24 horas) |
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E.2.2 | Secondary objectives of the trial |
to evaluate whether the use of a 5-day regimen of post-operative prophylactic antibiotics in comparison to the standard 24-hour regimen in patients that are surgically treated for bone tumors of the lower extremity followed by limb reconstruction using an endoprostheses has an impact on (A) the development of antibiotic-related complications (such as gastrointestinal or fungal infections); (B) patient functional outcomes and quality of life; (C) the rate of re-operations; (D) the rate of oncologic recurrence and/or metastases; and (D) the rate of mortality after one year. |
Evaluar si el uso de un régimen de 5 días de antibióticos profilácticos después de la operación en comparación con el régimen estándar de 24 horas en los pacientes que son tratados quirúrgicamente por tumores óseos de la extremidad inferior, seguido de la reconstrucción del miembro utilizando una endoprótesis ,tiene un impacto en (A) el desarrollo de las complicaciones relacionadas con los antibióticos (como gastrointestinal o infecciones por hongos); (B) los resultados funcionales y calidad de vida de los pacientes; (C) la tasa de re-intervención; (D) la tasa de recurrencia y / o metástasis oncológica; y (D) la tasa de mortalidad después de un año. |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1) Males and females 12 years of age or older; 2) Primary bone malignancies or benign aggressive tumors of the lower extremity, or soft-tissue sarcomas which have invaded the bone; 3) Treatment by excision and endoprosthetic reconstruction*; and 4) Provision of informed consent |
1) Hombres y mujeres de 12 años de edad o más; 2) Tumores malignos o benignos agresivos primarios en los miembros inferiores o sarcomas de tejidos blandos, que han invadido el hueso; 3) Tratamiento por escisión y reconstrucción endoprotésica *; 4) Provisión del consentimiento informado. |
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E.4 | Principal exclusion criteria |
1) Current known Methicillin-Resistant Staphylococcus Aureus (MRSA), or Vancomycin Resistant Enterococcus (VRE) skin colonization*; 2) Documented anaphylaxis or angioedema to penicillin or the study antibiotic [cefazolin, or equivalent gram-positive coverage (i.e., cefuroxime)]; 3) Prior surgery within the surgical field of the affected limb (excluding a biopsy)**; 4) Prior local infection within the surgical field of the limb**; 5) Current known immunologically-deficient disease conditions (not including recent chemotherapy) ***; 6) Known renal insufficiency with estimated creatinine clearance (eGRF) of less than 54 mL/min for drug clearance; 7) Reconstruction to include a structural allograft (bone transplant); 8) Likely problems, in the judgement of the investigator, with maintaining follow-up; 9) Enrolled or previously randomized in a competing study; and 10) Patients who weigh less than or equal to 45kg**** |
1) Colonización* en la piel por MRSA (estafilococo resistente a Meticilina) o VRE (enterococo resistente a Vancomicina); 2) Anafilaxia documentada o angioedema a la Penicilina o a los antibióticos del estudio [Cefazolina, o la cobertura gram-positivos equivalente (Cefuroxima)]; 3) Cirugía previa en el miembro afectado (excluyendo una biopsia); 4) Infección local previa en el campo quirúrgico del miembro**; 5) Condiciones/enfermedades actuales, conocidas, que producen deficiencia inmunológica (excluyendo quimioterapia reciente)***; 6) Insuficiencia renal con depuración estimada de creatinina (EGRF) menor a 54 ml / min; 7) Reconstrucción que incluya la colocacion de un aloinjerto; 8) A juicio del Investigador, problemas con el seguimiento del estudio; 9) Enrolado en otro estudio clínico; 10) Los pacientes que pesan menos o igual a 45 kg. |
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E.5 End points |
E.5.1 | Primary end point(s) |
The development of a surgical site infection (SSI) |
tasa de infección en el sitio de la cirugía |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
within 12 months following the initial surgery |
en los 12 meses tras la cirugía |
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E.5.2 | Secondary end point(s) |
Functional outcomes, antibiotic-related complications, adverse events, serious adverse events, re-operations, complications of wound healing, tumor recurrence or metastasis, and mortality |
Resultados funcionales, complicaciones relacionadas con los antibióticos, acontecimientos adversos, acontecimientos adversos graves, re-intervenciones , complicaciones de la cicatrización de heridas, recurrencia del tumor o metástasis, y la mortalidad dentro del año de seguimiento |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
dentro del año de seguimiento |
dentro del año de seguimiento |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | Yes |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | No |
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 | No |
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) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | Yes |
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 | Yes |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 2 |
E.8.3 |
The trial involves single site in the Member State concerned
| Yes |
E.8.4 | The trial involves multiple sites in the Member State concerned | No |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 15 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
Argentina |
Australia |
Brazil |
Canada |
Israel |
South Africa |
United States |
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E.8.7 | Trial 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
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 5 |
E.8.9.1 | In the Member State concerned months | 0 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 8 |
E.8.9.2 | In all countries concerned by the trial months | 3 |
E.8.9.2 | In all countries concerned by the trial days | 0 |