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    Summary
    EudraCT Number:2015-000324-29
    Sponsor's Protocol Code Number:CA011-001
    National Competent Authority:Spain - AEMPS
    Clinical Trial Type:EEA CTA
    Trial Status:Prematurely Ended
    Date on which this record was first entered in the EudraCT database:2016-07-15
    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 number2015-000324-29
    A.3Full title of the trial
    A Phase I/IIa Trial With BMS-986158, a Small Molecule Inhibitor of the Bromodomain and
    Extra-Terminal (BET) Proteins, in Subjects with Selected Advanced Solid Tumors
    Estudio Fase I/IIa con BMS-986158, una molécula de pequeño tamaño inhibidor del Bromodomain y la proteína extra terminal (BET), en sujetos con tumores sólidos avanzados seleccionados
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    A first-in-human study to explore the BMS-986158 study drug for patients with advanced cancer
    Un primer estudio en humanos para explorar el fármaco BMS-986158 en pacientes con cáncer avanzado.
    A.4.1Sponsor's protocol code numberCA011-001
    A.5.3WHO Universal Trial Reference Number (UTRN)U1111-1166-3919
    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 SponsorBristol-Myers Squibb International Corporation
    B.1.3.4CountryBelgium
    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 supportBristol-Myers Squibb International Corporation
    B.4.2CountryBelgium
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationBristol-Myers Squibb International Corporation
    B.5.2Functional name of contact pointGCT-SU
    B.5.3 Address:
    B.5.3.1Street AddressParc de l'Alliance - Avenue de Finlande, 4
    B.5.3.2Town/ cityBraine-l'Alleud
    B.5.3.3Post code1420
    B.5.3.4CountryBelgium
    B.5.4Telephone number900 150 160
    B.5.6E-mailclinical.trials@bms.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 nameBET-Inhibitor
    D.3.2Product code BMS-986158
    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 INNBET Inhibitor
    D.3.9.1CAS number 1800340-40-2
    D.3.9.2Current sponsor codeCA011-001
    D.3.9.3Other descriptive nameBMS986158
    D.3.9.4EV Substance CodeSUB181499
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number0.25
    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 nameBET-Inhibitor
    D.3.2Product code BMS-986158
    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 INNBET Inhibitor
    D.3.9.1CAS number 1800340-40-2
    D.3.9.2Current sponsor codeCA011-001
    D.3.9.3Other descriptive nameBMS986158
    D.3.9.4EV Substance CodeSUB181499
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number2
    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
    Serious ovarian cancer with wild-type BRCA1/2, triple negative breast cancer and small cell lung cancer
    Cáncer de ovario grave con BRCA1/2, cáncer de mama triple negativo y cáncer microcítico de pulmón
    E.1.1.1Medical condition in easily understood language
    Ovarian cancer, breast cancer and small cell lung cancer
    Cáncer de ovario, cáncer de mama y cáncer microcítico de pulmón
    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 10041067
    E.1.2Term Small cell lung cancer
    E.1.2System Organ Class 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 19.0
    E.1.2Level PT
    E.1.2Classification code 10075566
    E.1.2Term Triple negative breast cancer
    E.1.2System Organ Class 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 19.0
    E.1.2Level PT
    E.1.2Classification code 10033128
    E.1.2Term Ovarian 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
    To assess the safety and tolerability and to define the dose limiting toxicities (DLT) and maximum tolerated dose (MTD) of BMS-986158 as monotherapy and in combination with chemotherapy for subjects with selected advanced solid tumors.
    Evaluar la seguridad y tolerabilidad y definir las toxicidades limitantes de la dosis (DLT) y la dosis máxima tolerada (MTD) de BMS-986158 como monoterapia y en combinación con quimioterapia en sujetos con tumores sólidos avanzados seleccionados.
    E.2.2Secondary objectives of the trial
    -) To assess the preliminary anti-tumor activity of BMS-986158 as measured by objective response rate (ORR), and response duration based on RECIST v1.1.
    -) To characterize pharmacokinetics of BMS-986158 and metabolite in monotherapy and in combination with chemotherapy.
    -) To assess pharmacodynamic changes in the expression of selected BET regulated genes in peripheral blood.
    -) To assess the dose-response and exposure-response effect on the ECG (QT interval)
    - Evaluar la actividad anti-tumoral preliminar de BMS-986158 medida mediante la tasa de respuesta objetiva (TRO), y la duración de la respuesta de acuerdo con los RECIST v1.1.
    - Caracterizar la farmacocinética de BMS-986158 y su metabolito en monoterapia - Evaluar los cambios farmacodinámicos en la expresión de genes regulados por BET seleccionados en sangre periférica.
    - Evaluar el efecto dosis-respuesta y exposición-respuesta sobre el ECG (intervalo QT)
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1. Signed Written Informed Consent
    2. Target Population
    a) Subjects with a confirmed histologic/cytologic diagnosis of one of the following preferred malignancies for participation in the study and meet the other criteria listed (a specific exception for disease diagnosis criteria is noted in inclusion criteria k)

    i) Ovarian cancer
    (1) Histological or cytological documented epithelial ovarian cancer, primary peritoneal carcinoma, or fallopian tube cancer.
    (2) Received at least one prior Platinum Based Therapy regimen.
    (3) Have platinum-resistant/refractory disease, be intolerant of platinum-containing compounds, and/or have hypersensitivity to platinum-containing compounds.
    (4) For Part 2A Expansion only: All subjects must have serous histology and have germline wild-type BRCA1 and BRCA2
    ii) Triple negative breast cancer
    (1) Women with histological or cytological confirmed triple negative breast carcinoma as defined by ASCO/CAP guidelines.
    (2) Had progression or refractory disease during or after at least 1 chemotherapy regimen
    iii) Small cell lung cancer
    (1) Histologically or cytologically documented SCLC.
    (2) Received at least one prior Platinum Based Therapy regimen.

    b) Subjects with controlled, treated brain metastasis fulfilling all the following criteria may be screened: no radiographic progression for at least 2 weeks following radiation and/or surgical treatment, off steroids for at least 2 weeks, without new or progressing neurological signs or symptoms.
    c) All subjects must have at least one measurable lesion at baseline by CT or MRI as per RECIST v1.1
    d) All subjects must have archival tumor tissue identified and available for correlative biomarker studies unless a fresh biopsy is provided. All subjects not providing a fresh biopsy must consent to provide tumor blocks or slides to the sponsor and the availability of the tissue must be confirmed prior to subjects receiving study medication. If an archived tumor specimen is unavailable or unsuitable for correlative biomarker studies, subjects may consent to a pre-treatment fresh tumor biopsy to be eligible for this study if it can be performed at minimal acceptable clinical risk as judged by the Investigator and if it does not include a target lesion or lesion in an area treated with prior radiation therapy. For the first 25 ovarian subjects enrolled in dose expansion Part 2A, both a pretreatment and on-treatment fresh biopsy must be provided.
    e) Subjects must have a life expectancy of at least 3 months.
    f) Subjects must have an Eastern Cooperative Oncology Group (ECOG) Performance Status of 0 to 1 (Appendix 5)
    g) Subjects must have completed any prior major surgery at least 4 weeks before study drug administration.
    h) Prophylactic anticoagulation for venous access devices with low-dose heparin or similar (e.g. heparin catheter flush) will be permitted.
    i) For antiplatelet agents, prophylactic doses are permitted (e.g. aspirin < 300 mg daily, clopidogrel < 75 mg daily)
    j) This study permits the re-enrollment of a subject that has discontinued the study as a pre treatment failure. If re-enrolled, the subject must re-consent.

    3. Previous Treatment
    a) Prior anti-cancer treatments [therapeutic or diagnostic] are permitted.
    b) If subject had stem cell transplantation, the procedure must have occurred at least 3 months prior to treatment initiation (for autologous SCT) or 4 months (for allogeneic SCT) and without evidence of active graft-versus-host disease (GVHD).
    c) All acute toxicities, from any prior therapy must have resolved to Grade ≤ 1, NCI CTCAE, version 4.03 or to baseline if irreversible.

    4. Age and Reproductive Status
    a) Males and Females, ages 18 years of age or greater
    b) Women of childbearing potential (WOCBP) must have a negative serum or urine pregnancy test during screening and within 24 hours prior to the start of study drug.
    c) Women must not be breastfeeding
    d) WOCBP must agree to follow instructions for method(s) of contraception for the duration of treatment with study drug (s) BMS-986158 plus 30 days (duration of ovulatory cycle) for a total of 30 days post-treatment completion.
    e) Males who are sexually active with WOCBP must agree to follow instructions for method(s) of contraception for the duration of treatment with study drug (s) BMS-986158 plus 90 days (duration of sperm turnover) for a total of 90 days posttreatment completion.
    f) Azoospermic males are exempt from contraceptive requirements.
    1.Consentimiento informado firmado2.Población objetivoa) Sujetos con diagnóstico histológico/citológico confirmado de uno de los siguientes tipos de tumores malignos para la participación en el estudio y cumplir con los otros criterios descritos(en el criterio de inclusión K se describe una excepción específica para el criterio de diagnóstico de la enfermedad)i)Cáncer ovario(1)Cáncer ovario epitelial documentado histológica o citológicamente, carcinoma peritoneal primario o cáncer de trompas de falopio(2) Administración de al menos un régimen de tratamiento anterior basado en platino(3)Presencia de enfermedad resistente/refractaria a platino, intolerancia a componentes conteniendo platino, y/o presencia de hipersensibilidad a componentes conteniendo platino4)Sólo para la Parte 2A de expansión:Todos los sujetos deben tener histología serosa BRCA1 y BRCA2ii)Cáncer mama triple negativo(1)Mujeres con carcinoma mama triple negativo histológico o citológicamente confirmado como se define en las guías de ASCO/CAP(2)Presencia de progresión o enfermedad refractaria durante o después de al menos un tratamiento de quimioterapiaiii)Cáncer microcítico de pulmón(1)Cáncer microcítico de pulmón histológica o citológicamente documentado(2)Tratamiento previo con al menos un régimen basado en platinob)Los sujetos con metástasis cerebral tratada y controlada que cumplan los siguientes criterios pueden ser seleccionados:sin progresión radiográfica durante al menos 2 semanas tras radiación y/o tratamiento quirúrgico, ausencia de tratamiento con esteroides durante al menos 2 semanas, sin signos o síntomas nuevos y de progresión neurológicac)Todos los sujetos deben tener al menos una lesión medible al inicio por CT o MRI según RECIST V1.1.d) Todos los sujetos deben tener tejido tumoral de archivo identificado y disponible para los estudios correlativos de biomarcadores a menos que se proporcione biopsia fresca. Todos los sujetos que no proporcionen biopsia fresca deben consentir proporcionar los bloques o partes del tumor al promotor y la disponibilidad del tejido debe confirmarse antes de que los sujetos reciban la medicación del estudio.Si una muestra del tumor archivado no está disponible o no es adecuada para los estudios correlativos de biomarcadores, los sujetos pueden consentir biopsia de tumor fresco antes del tratamiento para ser elegibles para este estudio, si se puede realizar con un riesgo clínico mínimo aceptable a juicio del investigador y si no incluye una lesión objetiva o una lesión en el área tratada con tratamiento anterior de radiación.Para los primeros 25 sujetos de cáncer de ovario incluidos en la Parte 2A de expansión de dosis, se debe proporcionar biopsia fresca tanto antes del tratamiento como durante el tratamientoe) Los sujetos deben tener una esperanza de vida de al menos 3 mesesf)Los sujetos deben tener un resultado de 0 a 1 en la escala del Eastern Cooperative Oncology Group(Apéndice 5)g)Los sujetos deben haber completado cualquier cirugía previa importante al menos 4 semanas antes de la administración del fármaco del estudioh)Se permitirá anticoagulación profiláctica con productos de acceso venoso con dosis bajas de heparina o similar(ej.infusión de heparina por catéter)i)Para los agentes antiplaquetarios, se permiten dosis profilácticas(ej< 300 mg diarios, clopidogrel< 75mg diarios)j)Este estudio permite la re-inclusión de un sujeto que haya discontinuado el estudio como un fracaso pre-tratamiento.Si se vuelve a incluir, el sujeto debe volver a consentir3.Tratamiento previoa)Se permiten tratamientos anticancerosos previos[terapéuticos o diagnósticos]b)Si los sujetos han tenido trasplante de células madre, el procedimiento debe haber ocurrido al menos 3 meses antes del inicio del tratamiento(para trasplante autólogo) o 4 meses(para trasplante alogénico) y sin evidencia de enfermedad injerto-contra-huésped activa(c)Todas las toxicidades agudas, de cualquier tratamiento anterior, se deben de haber resuelto a Grado≤ 1, NCI CTCAE, versión 4.03 o al nivel basal si son irreversibles4.Edad y estado reproductivoa)Hombres y mujeres de 18 años o mayoresb)Las mujeres fértiles deben tener un test de embarazo negativo en suero u orina durante la selección y en las 24 horas antes del inicio del fármacoc)Las mujeres no deben estar en periodo de lactanciad)Las mujeres fértiles deben estar de acuerdo en seguir las instrucciones para los métodos de anticoncepción durante la duración del tratamiento con el fármaco BMS-986158 más 30 días(duración del ciclo ovulatorio) hasta un total de 30 días tras la finalización del post-tratamientoe)Los hombres sexualmente activos con mujeres fértiles deben estar de acuerdo en seguir las instrucciones para los métodos de anticoncepción durante la duración del tratamiento con el fármaco BMS-986158 más 90 días(duración del reemplazo del esperma) hasta un total de 90 días tras la finalización del post-tratamientof)Los hombres azoospérmicos están exentos de requerimiento anticonceptivos.
    E.4Principal exclusion criteria
    1. Medical History and Concurrent Diseases

    a) Evidence of uncontrolled, active infection, requiring parenteral anti-bacterial, anti-viral or anti-fungal therapy < 7 days prior to administration of study medication
    b) Current or recent (within 3 months of study drug administration) gastrointestinal disease such as chronic or intermittent diarrhea, or disorders that increase the risk of diarrhea. Non-chronic conditions (e.g. infectious diarrhea) that are completely resolved for at least 2 weeks prior to starting study treatment are not exclusionary
    c) Subjects with concomitant second malignancies (except adequately treated nonmelanomatous
    skin cancers or in situ bladder, breast or cervical cancers) are excluded unless a complete remission was achieved at least 3 years prior to study entry and no additional therapy is required or anticipated to be required during the study period
    d) Conditions requiring chronic systemic glucocorticoid use, such as autoimmune disease or severe asthma
    e) History of medically significant thromboembolic events or bleeding diathesis within the past 6 months
    f) Uncontrolled or significant cardiovascular disease including:
    i) Congestive heart failure NYHA (New York Heart Association) Class 3 or greater within 3 months.
    ii) History of congenital long QT syndrome or clinically significant ventricular arrhythmias (such as ventricular tachycardia, ventricular fibrillation or Torsade de Pointes). Controlled atrial fibrillation is not an exclusion criterion.
    iii) Active coronary artery disease, unstable or newly diagnosed angina or myocardial infarction in the past 6 months.
    g) Inability to tolerate oral medication.
    h) HIV-related disease or known positivity for human immunodeficiency virus (HIV).
    i) Past or active hepatitis B or C infection.
    j) Any other sound medical, psychiatric and/or social reason as determined by the investigator.
    k) Use of strong inhibitors of CYP3A4 or P-gp within 1 week or 5 half-lives (whichever is longer) or strong inducers of CYP3A4 or P-gp within 2 weeks or 5 half-lives (whichever is longer).

    2. Physical and Laboratory Test Findings
    a) Inadequate bone marrow function defined as:
    i) Absolute neutrophil count (ANC) < 1,500 cells/mm3;
    ii) Platelet count < 100,000 cells/mm3;
    iii) Hemoglobin < 8 g/dL
    b) Abnormal blood coagulation parameters:
    i) PT such that international normalized ratio (INR) is > 1.5x ULN (or > 2.5 x baseline, if a subject is on a stable dose of therapeutic warfarin) and a PTT > 1.2x upper limit of normal (ULN).
    c) Inadequate hepatic function defined as:
    i) Aspartate aminotransferase (AST) > 3x ULN
    ii) Alanine aminotransferase (ALT) > 3x ULN
    iii) Total bilirubin > 1.5 x ULN (except known Gilbert’s syndrome, direct bilirubin >
    1.5x ULN);
    d) Inadequate renal function defined as:
    i) Creatinine clearance (CrCl) ≤ 50 mL/minute (either measured or calculated using a standard formula such as Cockcroft and Gault) within 14 days prior to randomization
    e) Any of the following on 12-lead electrocardiogram (ECG) prior to study drugadministration, confirmed by repeat.
    i) QRS ≥ 120 msec, except right bundle branch block
    ii) QTcF > 450 msec

    3. Allergies and Adverse Drug Reaction
    History of significant allergy or severe drug toxicity to one of the mandatory chemotherapeutic agents or their diluents (e.g. Cremaphor) excludes a subject from that particular arm, except a Grade ≤ 2 infusion reaction to paclitaxel, with successful subsequent retreatment with premedication.

    4. Other Exclusion Criteria
    a) Prisoners or subjects who are involuntarily incarcerated
    b) Subjects who are compulsorily detained for treatment of either a psychiatric or physical (eg, infectious disease) illness
    c) Inability to comply with restrictions and prohibited activities/treatments as listed in protocol.

    Eligibility criteria for this study have been carefully considered to ensure the safety of the study
    subjects and that the results of the study can be used. It is imperative that subjects fully meet all
    eligibility criteria.
    1. Historial médico y enfermedades concomitantes
    a) Evidencia de infección activa no controlada, que requiera tratamiento bacteriano, anti-viral o anti-fúngico parenteral < 7 días antes de la administración de la medicación del estudio.
    b) Enfermedad gastrointestinal actual o reciente (a menos de 3 meses de la administración del fármaco del estudio), como diarrea crónica o intermitente o alteraciones que aumenten el riesgo de diarrea. Las condiciones no crónicas (ejemplo, diarrea infecciosa) que se resuelvan completamente durante al menos 2 semanas antes del inicio del tratamiento del estudio, no son exclusivas.
    c) Se excluye a los sujetos con malignidades secundarias concomitantes (excepto cáncer de piel no melanomatoso adecuadamente tratado o cáncer de vejiga, mama o cervical in situ) a menos que se haya alcanzado una remisión completa al menos 3 años antes de la entrada en el estudio y no se necesite tratamiento adicional o se anticipe que se requiera durante el periodo del estudio.
    d) Condiciones que requieren uso crónico de glucocorticoides sistémicos, tales como enfermedad autoinmune o asma grave.
    e) Historial de eventos tromboembólicos clínicamente significativos o diátesis hemorrágica dentro de los últimos 6 meses
    f) Enfermedad cardiovascular no controlada o significativa incluyendo:
    i) Enfermedad cardiaca congestiva NYHA (New York Heart Association) Clase 3 o superior en 3 meses.
    ii) Historial de síndrome congénito de alargamiento QT o arritmias ventriculares clínicamente significativas (como taquicardia ventricular, fibrilación ventricular o Torsade de Pointes). La fibrilación auricular controlada no es un criterio de exclusión.
    iii) Enfermedad arterial coronaria activa, angina inestable o de nuevo diagnóstico o infarto de miocardio en los últimos 6 meses.
    g) Incapacidad para tolerar medicación oral.
    h) Enfermedad relacionada con el VIH o positividad conocida al virus de la inmunodeficiencia humana (VIH).
    i) Infección por hepatitis B o C previa o activa.
    j) Cualquier otra razón sólida médica, psiquiátrica y/o social determinada por el investigador
    k) Utilización de inhibidores potentes del CYP3A4 o de la gp-P en 1 semana o 5 semividas (lo que sea más largo) o inductores potentes del CYP3A4 o de la gp-P en 2 semanas o 5 semividas (lo que sea más largo)

    2. Hallazgos físicos y de las pruebas de laboratorio
    a) Función de la médula ósea inadecuada definida como:
    i) Recuento absoluto de neutrófilos < 1.500 células/mm3;
    ii) Recuento de plaquetas < 100.000 células/mm3;
    iii) Hemoglobina < 8 g/dL
    b) Parámetros de coagulación sanguínea anormales:
    i) PT como el índice internacional normalizado (INR) es > 1,5x LSN (o > 2,5 x basal, si un sujeto está con una dosis estable de warfarina terapéutica) y un PTT > 1,2x LSN.
    c) Función hepática inadecuada definida como:
    i) Aspartato aminotransferasa (AST) > 3x LSN
    ii) Alanina aminotransferasa (ALT) > 3x LSN
    iii) Bilirrubina total > 1,5 x LSN (excepto síndrome de Gilbert conocido, bilirrubina directa > 1,5x LSN);
    d) Función renal inadecuada definida como:
    i) Aclaramiento de creatinina (CrCl) ≤ 50 ml/minuto (o medido o calculado utilizando una fórmula estándar como Cockcroft y Gault) dentro de los 14 días antes de la aleatorización
    e) Cualquiera de lo siguiente en el electrocardiograma de 12 derivaciones (ECG) antes de la administración del fármaco del estudio, confirmado por repetición.
    i) QRS ≥ 120 mseg, excepto bloqueo de rama derecha
    ii) QTcF > 450 mseg

    3. Alergias o reacciones adversas al fármaco
    Historial de alergia significativa o toxicidad grave a alguno de los agentes quimioterápicos obligatorios o sus diluyentes (ejemplo, Cremaphor) excluyen al sujeto de ese brazo particular, excepto una reacción por la infusión de paclitaxel de Grado ≤ 2, con retratamiento posterior exitoso con premedicación.
    4. Otros criterios de exclusión
    a) Prisioneros o sujetos encarcelados involuntariamente
    b) Sujetos que son detenidos obligatoriamente para tratamiento de enfermedades psiquiátricas o físicas (ejemplo, enfermedad infecciosa)
    c) Incapacidad para cumplir con restricciones y actividades/tratamientos prohibidos como se indica en el protocolo.

    Los criterios de elegibilidad para este estudio se han considerado cuidadosamente para asegurar la seguridad de los sujetos del estudio y para que los resultados del estudio se pueden utilizar. Es fundamental que los sujetos cumplan completamente todos los criterios de elegibilidad.
    E.5 End points
    E.5.1Primary end point(s)
    The primary objective which is to assess the safety and tolerability and to define the dose limiting
    toxicity and MTD of BMS-986158) will be measured by the primary endpoint(s) of: Incidence of
    adverse events (AEs) at its worst grade, serious adverse events (SAEs) at its worst grade, adverse
    events leading to discontinuations, deaths, frequency of laboratory test toxicity grade shifting
    from baseline.
    El objetivo primario que es evaluar la seguridad y tolerabilidad y definir la toxicidad limitante de la dosis y la dosis máxima tolerada (MTD) de BMS-986158 se medirá por el criterio de valoración primario: incidencia de acontecimientos adversos en su peor grado, acontecimientos adversos graves en su peor grado, acontecimientos adversos que conllevan discontinuaciones, muertes, frecuencia de grados de toxicidad en pruebas de laboratoriocon cambio respecto al grado basal .
    E.5.1.1Timepoint(s) of evaluation of this end point
    Safety will be evaluated from the time that the subject signs the informed consent, and for up to 30 days after the last dose of study drug or until resolution of any adverse event for which alternative causes could not be identified resolve to ≤ Grade 1 or baseline or until the event has stabilized, whichever is longer.
    La seguridad se evaluará desde el momento en que el sujeto firme el consentimiento informado, y hasta 30 días después de la última dosis del fármaco del estudio o hasta la resolución de cualquier acontecimiento adverso para el que no se puedan identificar causas alternativas resuelto a ≤ Grado 1 o basal o hasta que el acontecimiento se haya estabilizado, lo que sea más largo.
    E.5.2Secondary end point(s)
    The endpoint(s) used to measure efficacy, PK, biomarker (pharmacodynamic) and ECG objectives are described below:
    1) Efficacy will be based on RECIST v1.1 for solid tumors using the following secondary endpoints:
    Best overall response (BOR),
    Objective Response Rate (ORR),
    Duration of Response,
    Progression Free Survival (PFS)
    Progression Free Survival Rate (PFSR) at week ‘t’: defined as the proportion of subjects who
    remain progression free and surviving at ‘t’ weeks (t=12, 24).
    2) Pharmacokinetics
    Pharmacokinetics of BMS-986158 (parent and metabolite, as data permits) will be derived from
    plasma concentration versus time
    3) Pharmacodynamic Biomarkers
    Summary changes from baseline in the expression of BET regulated genes
    4) ECG/QTc
    Changes in QTcF, (ΔQTcF) from baseline, at selected times.
    Los criterios de valoración utilizados para medir la eficacia, farmacocinética, biomarcadores (farmacodinámica) y objetivos ECG son:
    1) La eficacia se basará en RECIST v1.1 para tumores sólidos utilizando los siguientes criterios de valoración secundarios:
    Mejor respuesta global (MRG),
    Tasa de respuesta objetiva (TRR),
    Duración de la respuesta,
    Supervivencia libre de progresión (SLP)
    Índice de supervivencia libre de progresión (ISLP) a la semana 't': definida como la proporción de sujetos que permanecen libres de progresión y sobreviven a 't' semanas (t=12, 24).
    2) Farmacocinética
    La farmacocinética de BMS-986158 (padre y metabolito, como los datos lo permitan) será derivada de la concentración plasmática versus el tiempo
    3) Biomarcadores farmacodinámicos
    Resumen de los cambios desde el basal en la expresión de los genes regulados por BET.
    4) ECG/QTc
    Cambios en QTcF, (ΔQTcF) desde el basal, en los tiempos seleccionados.
    E.5.2.1Timepoint(s) of evaluation of this end point
    PK and QTc: Tables 5.5.1-4, 5.5.1-5 and 5.5.1-6 (pages 108-110 of protocol) detail time points
    PD: Tables 5.6.4, 5.6.5 and 5.6.6 (pages 115-118 of protocol) detail time points
    Farmacocinética y QTc: Las tablas 5.5.1-4, 5.5.1-5 y 5.5.1-6 (páginas 108-110 del protocolo) detallan los intervalos de tiempo.
    Farmacodinamia: Las tablas 5.6.4, 5.6.5 y 5.6.6 (páginas 115-118 del protocolo) detallan los intervalos de tiempo.
    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 Yes
    E.6.10Pharmacogenetic Yes
    E.6.11Pharmacogenomic Yes
    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 Yes
    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) 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.8.2.4Number of treatment arms in the trial3
    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 concerned2
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA10
    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
    Belgium
    Canada
    Netherlands
    Spain
    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 end of the study will occur after the last treated subject completes their Clinical Follow-up, unless if a subject discontinues prematurely.
    The Clinical Follow-Up visits will occur approximately 30 days after the subject discontinues study treatment.
    El final del estudio ocurrirá después de que el último sujeto tratado complete su seguimiento clínico, a menos que un sujeto discontinúe prematuramente.
    Las visitas de seguimiento clínico ocurrirán aproximadamente 30 días después de que el sujeto discontinúe el tratamiento.
    Al final del estudio, BMS no continuará proporcionando el fármaco del estudio a los sujetos/investigadores a menos que BMS decida extender el estudio.
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years3
    E.8.9.1In the Member State concerned months2
    E.8.9.1In the Member State concerned days12
    E.8.9.2In all countries concerned by the trial years5
    E.8.9.2In all countries concerned by the trial days36
    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: 133
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 17
    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 state20
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 58
    F.4.2.2In the whole clinical trial 150
    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)
    At the end of the study, BMS will not continue to provide BMS supplied study drug to subjects/investigators unless BMS chooses to extend the study.
    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 Decision2016-09-27
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2016-09-21
    P. End of Trial
    P.End of Trial StatusPrematurely Ended
    P.Date of the global end of the trial2020-12-14
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