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    Summary
    EudraCT Number:2014-005042-21
    Sponsor's Protocol Code Number:I4X-MC-JFCU
    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:2016-08-01
    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 number2014-005042-21
    A.3Full title of the trial
    A Single-Arm, Multicenter, Phase 1b Study with an Expansion Cohort to Evaluate Safety and Efficacy of Necitumumab in Combination with Abemaciclib in Treatment of Patients with Stage IV Non-Small Cell Lung Cancer (NSCLC)
    Estudio de fase 1b, multicéntrico, con un único grupo de tratamiento y una cohorte de expansión, en el que se evalúan la seguridad y la eficacia de necitumumab en combinación con abemaciclib en pacientes con cáncer de pulmón no microcítico (CPNM) en estadio IV
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    A medical research evaluating the safety and efficacy of two new medicines (Necitumumab and Abemaciclib), administered in combination in patients affected by a defined type of advanced lung cancer (Stage IV Non-Small-Cell Lung Cancer)
    A.4.1Sponsor's protocol code numberI4X-MC-JFCU
    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 SponsorLilly S.A.
    B.1.3.4CountrySpain
    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 supportEli Lilly and Company
    B.4.2CountryUnited States
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationLilly
    B.5.2Functional name of contact pointClinical Trial Registry Office
    B.5.3 Address:
    B.5.3.1Street AddressLilly Corporate Center, DC 1526
    B.5.3.2Town/ cityIndianapolis
    B.5.3.3Post code46285
    B.5.3.4CountryUnited States
    B.5.4Telephone number34916635327
    B.5.5Fax number34916633481
    B.5.6E-mailensayosclinicos@lilly.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 Yes
    D.2.1.1.1Trade name Portrazza
    D.2.1.1.2Name of the Marketing Authorisation holderEli Lilly Nederland B.V.
    D.2.1.2Country which granted the Marketing AuthorisationEuropean Union
    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 nameNecitumumab
    D.3.2Product code LY3012211
    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 INNNecitumumab
    D.3.9.1CAS number 906805-06-9
    D.3.9.3Other descriptive nameNECITUMUMAB
    D.3.9.4EV Substance CodeSUB33032
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number16
    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) No
    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 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 nameAbemaciclib
    D.3.2Product code LY2835219
    D.3.4Pharmaceutical form Capsule
    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 INNNot available
    D.3.9.1CAS number 1231929-97-7
    D.3.9.3Other descriptive nameLY2835219
    D.3.9.4EV Substance CodeSUB88440
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number50
    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
    Non Small Cell Lung Cancer
    cáncer de pulmón no microcítico
    E.1.1.1Medical condition in easily understood language
    Lung Cancer
    Cancer de Pulmon
    E.1.1.2Therapeutic area Diseases [C] - Cancer [C04]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 19.0
    E.1.2Level PT
    E.1.2Classification code 10061873
    E.1.2Term Non-small cell lung cancer
    E.1.2System Organ Class 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    E.1.3Condition being studied is a rare disease No
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    Part A: to determine the dose-limiting toxicity (DLT) of abemaciclib at doses up to 200 mg when combined with necitumumab 800 mg, in patients with Stage IV NSCLC as measured by the number of patients with a DLT in Cycle 1.

    Part B: to evaluate the efficacy of necitumumab in combination with abemaciclib in terms of PFS rate at 3 months in patients with Stage IV NSCLC.
    Parte A: Determinar las toxicidades limitantes de la dosis (TLD) de abemaciclib en dosis de hasta 200 mg, cuando se combina con 800 mg de necitumumab, en pacientes con CPNM en estadio IV, según el número de pacientes con una TLD en el ciclo 1.

    Parte B: Evaluar la eficacia de necitumumab en combinación con abemaciclib,
    E.2.2Secondary objectives of the trial
    Part A:
    •to investigate the safety profile as assessed by clinical and laboratory significant events of necitumumab in combination with abemaciclib
    •to determine the overall response rate (ORR)
    •to determine pharmacokinetics (PK) of necitumumab and abemaciclib
    •to determine the immunogenicity of necitumumab
    Part B:
    To demonstrate the safety, efficacy and feasibility of necitumumab in combination with abemaciclib at the recommended dose by
    •to determine PFS
    •to determine ORR and disease control rate (DCR)
    •to estimate OS
    •to investigate the safety profile as assessed by clinical and laboratory significant events
    •to determine pharmacokinetics (PK) of necitumumab and abemaciclib
    •to determine the immunogenicity of necitumumab
    Parte A:
    • Investigar el perfil de seguridad de necitumumab cuando se administra en politerapia con abemaciclib, mediante la evaluación de los acontecimientos clínicos y analíticos significativos.
    • Determinar la tasa de respuestas objetivas (TRO).
    • Determinar la farmacocinética (FC) de necitumumab y abemaciclib.
    • Determinar la inmunogenicidad de necitumumab.
    Parte B: Demostrar la seguridad, la eficacia y la viabilidad de la administración de necitumumab en politerapia con abemaciclib, en la dosis recomendada, mediante:
    • La determinación de la SSP
    • La determinación de TRO y la tasa de control de la enfermedad (TCE)
    • La estimación de la supervivencia global (SG)
    • La investigación del perfil de seguridad de necitumumab cuando se administra en politerapia con abemaciclib, mediante la evaluación de los acontecimientos clínicos y analíticos significativos.
    • La determinación de la FC de necitumumab y abemaciclib
    • La determinación de la inmunogenicidad de necitumumab
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    Patients are eligible to be included in the study only if they meet all of the following criteria:
    [1]Histologically or cytologically confirmed NSCLC
    •Part A: NSCLC Stage IV (any type)
    •Part B: NSCLC Stage IV (squamous and nonsquamous)
    [2]Stage IV disease at the time of study entry (American Joint Committee on Cancer [AJCC] Staging Manual, 7th Edition [Edge et al. 2009])
    [3]Measurable disease at the time of study entry as defined by Response Evaluation Criteria in Solid Tumors Version 1.1 (RECIST 1.1) (Eisenhauer et al. 2009)
    [4]The patient must have progressed after platinum-based chemotherapy AND have received a maximum of 1 other prior chemotherapy for advanced and/or metastatic disease OR must be judged by the physician as ineligible for further standard second-line chemotherapy. Prior treatment with EGFR-TKI and ALK inhibitors is mandatory in patients whose tumor has EGFR-activating mutations or ALK translocations. Prior targeting agents and neoadjuvant/adjuvant therapies are permitted with the exception of CDK4/6-targeting agents or necitumumab.
    [5]The patient has tumor tissue available for biomarker analyses. The sample can be either 12 serially paraffin-embedded unstained tissue slides or a paraffin embedded tissue block.
    [6]The patient has given written informed consent prior to any study specific procedures. Written consent may also be provided by a legal representative.
    [7]The patient is 18 years or older if required by local law or regulations.
    [8]The patient has resolution to Grade ≤1 by the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE), Version 4.0, of all clinically significant toxic effects of prior chemotherapy, surgery, or radiotherapy (with the exception of alopecia).
    [9]The patient has an Eastern Cooperative Oncology Group performance status score of 0-1.
    [10]Have the following laboratory values:
    •hematologic: absolute neutrophil count 1.5 × 109/L, platelets 100 × 109/L, and hemoglobin 9 g/dL. T ransfusion of blood products (including platelets or red blood cells) or administration of colony stimulating factors (including G-CSF, GM-CSF or recombinant erythropoietin) within 4 weeks prior to Cycle 1 Day 1 are not allowed.
    •Serum albumin ≥25 g/L
    •hepatic: bilirubin 1.5 × the upper limit of normal (ULN), alkaline phosphatase (ALP), alanine aminotransferase (ALT) and aspartate transaminase (AST) 3.0 times ULN. For patients with hepatic metastases, ALT and AST equaling ≤5.0 times ULN are acceptable.
    •renal: serum creatinine 1.2 x ULN or calculated creatinine clearance >50 mL/min (per the Cockcroft-Gault formula as defined in Attachment 5) for patients with creatinine >1.2 x ULN.

    [11]are men who are sterile (including vasectomy confirmed by post-vasectomy semen analysis) or who agree to use a reliable method of birth control and to not donate sperm during the study (and for at least 12 weeks following the last dose of necitumumab and abemaciclib or country requirements, whichever is longer) OR
    [12]are women who are either: (a) not of child-bearing potential due to surgical sterilization (at least 6 weeks following surgical bilateral oophorectomy with or without hysterectomy or tubal ligation) confirmed by medical history or menopause; or (b) of child-bearing potential who have a negative serum pregnancy test within 14 days prior to study enrollment and agree to use a highly effective method of birth control during the study and for 6 months after the last dose of study drug(s) (oral hormonal contraception alone is not considered highly effective and must be used in combination with a barrier method).
    [13]Are able to swallow oral medications.
    [14]Have an estimated life expectancy of at least 12 weeks.
    Los pacientes se considerarán idóneos para participar en el estudio únicamente si cumplen todos los criterios que se detallan a continuación:
    [1] CPNM confirmado histológica o citológicamente.
    •Parte A: CPNM en estadio IV (cualquier tipo).
    •Parte B: CPNM en estadio IV (escamoso y no escamoso)
    [2] Cáncer en estadio IV en el momento de inclusión en el estudio (de acuerdo con el Manual de estadificación del American Joint Committee on Cancer [AJCC], 7ª edición) [Edge et al. 2009]).
    [3] Cáncer mensurable en el momento de inclusión en el estudio, de acuerdo con los Criterios de evaluación de la respuesta en tumores sólidos, versión 1.1 (RECIST 1.1) (Eisenhauer et al. 2009).
    [4] El paciente deberá haber presentado progresión de la enfermedad tras un tratamiento quimioterápico basado en platino Y haber recibido como máximo otro tratamiento quimioterápico previo diferente para tratar el cáncer metastásico o avanzado O, de acuerdo con el criterio del médico, no deberá considerarse idóneo para recibir otro tratamiento quimioterápico de segunda línea de referencia. Los pacientes que presenten mutaciones activadoras del EGFR o translocaciones de la cinasa de linfoma anaplásico (ALK) deben haber recibido tratamiento previo con un inhibidor de la actividad tirosina cinasa del receptor EGFR e inhibidores de la ALK. Se permite la administración previa de fármacos dirigidos y de tratamientos en neoadyuvancia/adyuvancia, salvo fármacos dirigidos a la CDK4 o a la CDK6, o necitumumab
    [5] Disponer de tejido tumoral para el análisis de biomarcadores, o 12 cortes de tejido seriados sin teñir e incluidos en parafina o un bloque de tejido incluido en parafina.
    [6] Haber proporcionado el consentimiento informado por escrito, previamente a la realización de cualquier procedimiento específico del estudio. El representante legal del paciente también podrá proporcionar el consentimiento por escrito.
    [7] Tener 18 años o más, si así lo estipulan la legislación y las normativas locales.
    [8] Todos los efectos tóxicos clínicamente significativos (con la excepción de loscasos de alopecia) de los tratamientos previos (quimioterapia, intervenciones quirúrgicas o radioterapia) deben haberse resuelto a un grado ≤ 1, de acuerdo con los Criterios terminológicos comunes para los acontecimientos adversos (NCI-CTCAE), versión 4.0.
    [9] Presentar una categoría funcional del Eastern Cooperative Oncology Group de 0-1.
    [10] Presentar los siguientes valores analíticos:
    • Hematológicos: Recuento absoluto de neutrófilos ≥ 1,5 × 109/l; plaquetas ≥ 100 × 109/l y hemoglobina ≥ 9 g/dl. No se permite la transfusión de hemoderivados (entre otros, plaquetas o eritrocitos) ni la administración de factores estimulantes de colonias (entre otros, G-CSF, GM-CSF o eritropoyetina recombinante) en el transcurso de las 4 semanas anteriores al día 1 del ciclo 1. • Concentración sérica de albúmina ≥ 25 g/l
    • Hepáticos: Bilirrubina ≤1,5 veces el límite superior de la normalidad (LSN), fosfatasa alcalina (FA), alanina aminotransferasa (ALT) y aspartato transaminasa (AST) ≤ 3,0 veces el LSN. En los pacientes que presenten metástasis hepáticas, se permite que los valores de ALT y AST sean ≤ 5,0 veces el LSN.
    • Renales: Creatinina sérica ≤ 1,2 veces el LSN o aclaramiento calculado de creatinina > 50 ml/min (de acuerdo con la fórmula de Cockcroft-Gault, según se define en el anexo 5) para aquellos pacientes con una concentración de creatinina > 1,2 veces el LSN.
    [11] Varones estériles (incluidos aquellos que se hayan sometido a vasectomía y cuya esterilidad se confirme de acuerdo con los resultados del análisis de semen llevado a cabo tras dicha vasectomía) o que acepten utilizar un método anticonceptivo fiable, y no donar esperma durante el estudio y al menos durante las 12 semanas posteriores a la última dosis de necitumumab y abemaciclib o durante el plazo que se establezca de acuerdo con los requisitos del país, lo que sea mayor, O
    [12] Mujeres que: a) no sean fértiles, bien como consecuencia de la menopausia, bien porque al menos 6 semanas antes hayan sido esterilizadas quirúrgicamente mediante ovariectomía bilateral (con o sin histerectomía) o ligadura de trompas, y siempre que dicha intervención quirúrgica haya sido documentada en su historia clínica; o b) sean fértiles y presenten un resultado negativo en una prueba de embarazo en suero en el transcurso de los 14 días anteriores al reclutamiento en el estudio y estén de acuerdo en utilizar un método anticonceptivo fiable durante el estudio y los 6 meses posteriores a la última dosis de los fármacos del estudio (la administración únicamente de un método anticonceptivo hormonal por vía oral no se considera muy efectiva y deberá utilizarse junto con un método de barrera).
    [13] Ser capaz de ingerir medicamentos por vía oral.
    [14] Tener una esperanza de vida de al menos 12 semanas.
    E.4Principal exclusion criteria
    Patients will be excluded from the study if they meet any of the following criteria:
    [15]The patient is currently enrolled in a clinical trial involving an investigational product or non-approved use of a drug or device (other than the study treatment used in this study), or concurrently enrolled in any other type of medical research judged not to be scientifically or medically compatible with this study. Prior treatment with CDK4/6-targeting agents or necitumumab is not permitted.
    [16]The patient has undergone major surgery or received any investigational therapy in the 30-days prior to study enrollment.
    [17]The patient has undergone chest irradiation within 4 weeks prior to receiving study treatment (except focal palliative irradiation, which is allowed up to 2 weeks prior to receiving study treatment).
    [18]The patient has brain metastases that are symptomatic. (Patients who have completed radiotherapy for brain metastases at least 2 weeks prior to receiving study treatment, who are now non symptomatic or on stable dose of steroids or anticonvulsants during the 2 weeks prior to receiving study treatment, are eligible). Patients with asymptomatic brain metastases without need for treatment with steroids and who have not been treated with radiotherapy are eligible. This exception does not include carcinomatous meningitis which is excluded regardless of clinical stability.
    [19]History of arterial or venous thromboembolism within 3 months prior to study enrollment. Patients with a history of venous thromboembolism beyond 3 months prior to study enrollment can be enrolled if they are appropriately treated with low molecular weight heparin.
    [20]History or evidence of current clinically relevant coronary artery disease ≥ Grade III by the Canadian Cardiovascular Society Angina Grading Scale or uncontrolled congestive heart failure of current > Class III as defined by the New York Heart Association.
    [21]The patient has experienced myocardial infarction within 6 months prior to study enrollment.
    [22]The patient has active infection requiring systemic therapy, including active tuberculosis or known history of infection with the human immunodeficiency virus (HIV 1/2 antibodies), or hepatitis B (e.g., HBsAg reactive) and/or C virus (e.g., HCV RNA qualitative is detected).
    [23]The patient has a history of significant neurological or psychiatric disorders, including dementia, seizures, or bipolar disorder, potentially precluding protocol compliance.
    [24]The patient has a personal history of any of the following conditions: presyncope or syncope of either unexplained or cardiovascular etiology, ventricular arrhythmia (including but not limited to ventricular tachycardia and ventricular fibrillation), or sudden cardiac arrest.
    [25]The patient has any other serious uncontrolled medical disorders or psychological conditions that would, in the opinion of the investigator, limit the patient’s ability to complete the study or sign an informed consent document.
    [26]The patient has a known allergy / history of hypersensitivity reaction to any of the treatment components, including any ingredient used in the formulation of necitumumab or abemaciclib, or any other contraindication to one of the administered treatments.
    [27]The patient is pregnant or breastfeeding.
    [28]The patient has a known history of drug abuse, that in the opinion of the investigator, may have an impact on the safety of the patient and/or limit the patient’s ability to complete the study or adhere to any protocol procedure.
    [29]The patient has a concurrent active malignancy. Previous history of malignancy is permitted, provided that the patient has been free of disease for ≥3 years, with the exception of adequately treated basal or squamous cell carcinoma of the skin, preinvasive carcinoma of the cervix, or any cancers that in the judgment of the investigator and sponsor may not affect the interpretation of results (for example, prostate, bladder).
    [30]The patient is receiving concurrent treatment with other anticancer therapy, including other chemotherapy, immunotherapy, hormonal therapy, chemo-embolization, targeted therapy, or an investigational agent.
    [31]History of interstitial lung disease
    [32]Recent (within 30 days before enrollment) or concurrent yellow fever vaccination
    Se excluirá del estudio a los pacientes en los que se constate alguno de los siguientes criterios:
    [15] Estar participando en la actualidad en un ensayo clínico en el que se administre un fármaco en fase de investigación o se haga un uso no recogido en la ficha técnica de un fármaco o producto sanitario, o estar participando en la actualidad en cualquier otro tipo de investigación médica que se considere incompatible con el estudio, desde un punto de vista científico o médico. No se permite haber recibido tratamiento con fármacos dirigidos a la CDK4 o CDK6 o con necitumumab.
    [16] El paciente se ha sometido a una intervención de cirugía mayor o ha recibido cualquier tratamiento en fase de investigación, en el transcurso de los 30 días anteriores al reclutamiento en el estudio.
    [17] Haber recibido radioterapia torácica en el transcurso de las 4 semanas anteriores a la administración del tratamiento del estudio.
    [18] Presencia de metástasis cerebrales sintomáticas. (Se considerarán idóneos los pacientes que hayan completado un tratamiento radioterápico para metástasis cerebrales al menos 2 semanas antes de recibir el tratamiento del estudio, que en este momento estén asintomáticos o hayan recibido dosis estables de corticosteroides o anticonvulsivos durante las 2 semanas anteriores al tratamiento del estudio). Se considerarán idóneos los pacientes con metástasis cerebrales asintomáticas que no precisen tratamiento con corticosteroides y no hayan recibido radioterapia. Esta excepción no incluye la meningitis carcinomatosa, que constituye un criterio de exclusión, independientemente de que sea estable desde un punto de vista clínico.
    [19] Antecedentes de tromboembolia arterial o venosa en el transcurso de los 3 meses anteriores al reclutamiento en el estudio. Los pacientes que hayan experimentado tromboembolia venosa más de 3 meses antes del reclutamiento en el estudio podrán ser reclutados si reciben un tratamiento adecuado con heparinas de bajo peso molecular.
    [20] Antecedentes o signos de presentar en la actualidad cardiopatías clínicamente relevantes de clase ≥ III, de acuerdo con la escala de valoración de la angina de la Canadian Cardiovascular Society o insuficiencia cardiaca congestiva sin controlar de clase > III, de acuerdo con los criterios de la New York Heart Association.
    [21] Haber experimentado un infarto de miocardio en el transcurso de los 6 meses anteriores al reclutamiento en el estudio.
    [22] Presentar infección activa que requiera tratamiento sistémico, entre otras, tuberculosis activa o antecedentes de infección por el virus de la inmunodeficiencia humana (anticuerpos frente al VIH 1/2), hepatitis B (por ejemplo, reactividad HBsAg) o hepatitis C (por ejemplo, determinación cualitativa de ARN del VHC).
    [23] Antecedentes de trastornos neurológicos o psiquiátricos significativos, entre otros, demencia, epilepsia o trastorno bipolar, que posiblemente dificultarían el cumplimiento del protocolo.
    [24] Antecedentes personales de las enfermedades siguientes: presíncope o síncope de etiología inexplicable o cardiovascular; arritmia ventricular (entre otras, taquicardia ventricular y fibrilación ventricular) o paro cardiaco súbito.
    [25] Presencia de cualquier otro trastorno médico o enfermedad psicológica grave sin controlar que, en opinión del investigador, limite la capacidad del paciente para completar el estudio o firmar el documento de consentimiento informado.
    [26] Alergia / antecedentes de reacciones de hipersensibilidad a cualquiera de los componentes del tratamiento, incluido cualquier ingrediente utilizado en la formulación de necitumumab o abemaciclib, o si la administración de alguno de los tratamientos administrados está contraindicada.
    [27] La paciente está embarazada o en período de lactancia.
    [28] Antecedentes de drogadicción que, de acuerdo con el criterio del investigador, puedan afectar la seguridad del paciente o limitar su capacidad para completar el estudio o realizar algún procedimiento del protocolo.
    [29] Presencia simultánea de una neoplasia maligna activa. Se permite que el paciente tenga antecedentes de neoplasias malignas, siempre que no haya presentado enfermedad durante ≥ 3 años, salvo los casos de carcinoma basocelular o escamoso de la piel adecuadamente tratado, carcinoma preinvasor del cuello uterino o cualquier otro cáncer que el investigador y el promotor consideren que no afecte a la interpretación de los resultados (por ejemplo, cáncer de próstata o de vejiga).
    [30] Estar recibiendo un tratamiento antineoplásico concomitante, entre otros, quimioterapia, inmunoterapia, hormonoterapia, quimioembolización, terapia dirigida o con un fármaco en fase de investigación.
    [31] Antecedentes de enfermedad pulmonar intersticial.
    [32] Haber recibido recientemente (en los 30 días anteriores al reclutamiento) o de manera simultánea una vacuna contra la fiebre amarilla.
    E.5 End points
    E.5.1Primary end point(s)
    PART A: dose-limiting toxicity (DLT) of abemaciclib when combined with necitumumab 800 mg, as measured by the number of patients with a DLT in Cycle 1

    PART B: The primary endpoint is Progression Free Survival Rate at 3 months as defined by RECIST 1.1 (Eisenhauer et al. 2009).
    PARTE A: Toxicidades limitantes de la dosis (TLD) de abemaciclib cuando se administra con 800 mg de necitumumab, según el número de pacientes que presenten una TLD en el ciclo 1.
    PARTE B: El criterio principal de valoración es la tasa de supervivencia sin progresión al cabo de 3 meses, de acuerdo con los criterios RECIST 1.1(Eisenhauer et al. 2009).
    E.5.1.1Timepoint(s) of evaluation of this end point
    PART A: cycle 1 of each cohort

    PART B: approximately 5 month after enrollment completion
    PARTE A: ciclo 1 de cada cohorte.
    PARTE B: aproximadamente 5 meses después de que se complete el reclutamiento.
    E.5.2Secondary end point(s)
    PART A and Part B
    Objective Response Rate (ORR): The objective response rate is the percentage of patients with a best response of CR or PR.
    Immunogenicity: Incidence of anti-necitumumab antibodies will be tabulated.
    Pharmacokinetics: Pharmacokinetic parameters of abemaciclib and necitumumab in Part A will be calculated using noncompartmental analysis (NCA) methodology. Summary level data for Part B will be presented as graphics and table listings.
    Safety: Safety analyses will be performed for all patients enrolled in the study who receive any amount of study drug (necitumumab or abemaciclib).

    PART B only
    Progression Free Survival Rate (PFS): The time from the date of enrollment to the date of objective progression or the date of death due to any cause, whichever is earlier as defined by RECIST 1.1 (Eisenhauer et al. 2009)
    Overall Survival (OS): OS duration is measured from the date of enrollment to the date of death from any cause.
    Disease Control Rate (DCR): The proportion of patients in the analysis population who exhibit a SD or confirmed CR or PR relative to baseline during the study. Response is defined by RECIST 1.1 (Eisenhauer et al. 2009).
    PARTES A y B: Tasa de respuestas objetivas (TRO): La tasa de respuestas objetivas es el porcentaje de pacientes que presenten una mejor respuesta de RC o RP.
    Inmunogenicidad: Se tabulará la incidencia de anticuerpos frente a necitumumab. Farmacocinética: Los parámetros farmacocinéticos de abemaciclib y necitumumab en la parte A se calcularán mediante una metodología basada en análisis no compartimentales (ANC). Los datos resumidos de la parte B se presentarán mediante gráficos y listados tabulados.
    Seguridad: Se realizarán análisis de seguridad en los que se incluirán los datos de todos los pacientes reclutados en el estudio que reciban cualquier cantidad de los fármacos del estudio (necitumumab o abemaciclib).
    PARTE B, solo tasa de supervivencia sin progresión (SSP): Período comprendido entre la fecha de reclutamiento y la fecha en la que se determine la progresión objetiva de la enfermedad (de acuerdo con los criterios RECIST 1.1 [Eisenhauer et al. 2009]), o la fecha de fallecimiento por cualquier causa (lo que acontezca en primer lugar).
    Supervivencia global (SG): La duración de la SG se define como el tiempo transcurrido desde la fecha del reclutamiento hasta la fecha de la muerte por cualquier causa.
    Tasa de control de la enfermedad (TCE): Proporción de pacientes de la población de análisis que durante el estudio muestren EE o una RC o RP confirmadas, en relación con la evaluación basal. La respuesta se determina de acuerdo con los criterios RECIST 1.1 (Eisenhauer et al. 2009).
    E.5.2.1Timepoint(s) of evaluation of this end point
    Safety:An interim safety analysis will be performed after the first 15 evaluable patients in the Part B portion of the trial have completed 2 cycles of study treatment (or otherwise discontinued study treatment). Patients with squamous and nonsquamous NSCLC who received the recommended abemaciclib dose for Part B in Part A will be taken into account for the safety interim analysis. The interim analysis will be conducted to permit evaluation of safety data by the sponsor.

    All endpoints:approximately 5 month after enrollment completion
    Seguridad: Se realizará un análisis provisional de los datos de seguridad después de que los 15 primeros pacientes evaluables en la parte B hayan completado 2 ciclos del tratamiento del estudio (o hayan dejado de recibir definitivamente el tratamiento del estudio).
    Los pacientes con CPNM escamoso y no escamoso que en la parte A hayan recibido la dosis de abemaciclib recomendada para la parte B se incluirán en los análisis provisionales de los datos de seguridad. El análisis provisional se realizará para que el promotor pueda evaluar los datos de seguridad. Todos los criterios de valoración: aproximadamente 5 meses después de que se complete el reclutamiento.
    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 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) Yes
    E.7.1.1First administration to humans No
    E.7.1.2Bioequivalence study No
    E.7.1.3Other Yes
    E.7.1.3.1Other trial type description
    Novel novel combination
    E.7.2Therapeutic exploratory (Phase II) Yes
    E.7.3Therapeutic confirmatory (Phase III) No
    E.7.4Therapeutic use (Phase IV) No
    E.8 Design of the trial
    E.8.1Controlled No
    E.8.1.1Randomised No
    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 No
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) No
    E.8.2.2Placebo No
    E.8.2.3Other 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.8.4.1Number of sites anticipated in Member State concerned4
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA18
    E.8.6 Trial involving sites outside the EEA
    E.8.6.1Trial being conducted both within and outside the EEA No
    E.8.6.2Trial being conducted completely outside of the EEA No
    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
    LVLS
    Ultima visita ultimo paciente
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years1
    E.8.9.1In the Member State concerned months9
    E.8.9.1In the Member State concerned days11
    E.8.9.2In all countries concerned by the trial years1
    E.8.9.2In all countries concerned by the trial months9
    E.8.9.2In all countries concerned by the trial days11
    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: 40
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 28
    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 state68
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 68
    F.4.2.2In the whole clinical trial 68
    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 subject has ended the participation in the trial Investigators may perform standard procedures and tests needed to treat and evaluate patients
    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 Decision2016-07-29
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2016-07-27
    P. End of Trial
    P.End of Trial StatusCompleted
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