E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Advanced (unresectable, locally advanced or metastatic) adenocarcinoma of the stomach, or of the gastro-esophageal junction (GEJ) |
adenocarcinoma non resecabile, localmente avanzato o metastatico dello stomaco o della giunzione gastroesofagea |
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E.1.1.1 | Medical condition in easily understood language |
Gastric cancer |
cancro dello stomaco |
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E.1.1.2 | Therapeutic area | Diseases [C] - Cancer [C04] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 21.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10066354 |
E.1.2 | Term | Adenocarcinoma of the gastroesophageal junction |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 21.1 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10063916 |
E.1.2 | Term | Metastatic gastric cancer |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
|
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 21.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10071114 |
E.1.2 | Term | Metastatic gastric adenocarcinoma |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
|
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 21.1 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10017758 |
E.1.2 | Term | Gastric cancer |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
|
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 21.0 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10017761 |
E.1.2 | Term | Gastric cancer recurrent |
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 | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
The primary objectives of this trial are to demonstrate superiority of maintenance therapy with avelumab versus continuation of first-line chemotherapy with regard to Overall Survival (OS) in all randomized subjects or in PD-L1 positive subject who have not progressed on first-line chemotherapy. |
Gli obiettivi principali di questo studio sono dimostrare la superiorità della terapia di mantenimento con avelumab rispetto alla continuazione della chemioterapia di prima linea per quanto riguarda la sopravvivenza globale (OS) in tutti i soggetti randomizzati o in soggetti positivi al PD-L1 che non hanno progredito nella chemioterapia di prima linea . |
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E.2.2 | Secondary objectives of the trial |
- To demonstrate superiority of maintenance therapy with avelumab versus continuation of first-line chemotherapy with regard to Progression-Free Survival (PFS) as per Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST v1.1) according to Investigator assessment. ¿ To demonstrate superiority of maintenance therapy with avelumab versus continuation of first-line chemotherapy with regard to the objective response rate (ORR) as per RECIST v1.1 and per investigator assessment. ¿ To compare the subject-reported outcomes / quality of life (QoL) of subjects when treated with avelumab versus continuation of first-line chemotherapy as assessed by the European Quality of Life, 5-dimensions 5 Level Questionnaire (EQ-5D-5L), and the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 and module QLQSTO22 ¿ To determine the safety and tolerability of avelumab |
- Dimostrare la superiorità della terapia di mantenimento con avelumab vs la continuazione della chemioterapia di prima linea in relazione alla PFS in base ai criteri di valutazione della risposta nei tumori solidi, versione 1.1 (RECIST v1.1), secondo la valutazione dello sperimentatore. ¿Dimostrare la superiorit¿, in termini di tasso di risposta obiettiva (ORR), della terapia di mantenimento con avelumab vs la continuazione della chemioterapia di prima linea in base ai criteri RECIST v1.1 e in base alla valutazione dello sperimentatore; ¿Confrontare gli esiti/qualità della vita riportati dai soggetti trattati con avelumab rispetto alla continuazione della chemioterapia di prima linea valutati sulla base del questionario europeo sulla qualità della vita, a 5 dimensioni e 5 livelli (EQ-5D-5L), del questionario QLQ-C30 e del modulo QLQ-STO22 dell¿Organizzazione europea per la ricerca e il trattamento del cancro (EORTC); ¿Determinare la sicurezza e la tollerabilit¿ di avelumab. |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
Male or female subjects aged = 18 years, with an ECOG PS of 0 to 1 at trial entry, with the availability of a formalin-fixed, paraffin-embedded block containing tumor tissue or a minimum of 7 (preferably 10) unstained tumor slides suitable for PD-L1 expression assessment, at least 1 measurable tumor lesion, and with histologically confirmed unresectable, locally advanced or metastatic, adenocarcinoma of the stomach or the GEJ.
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Soggetti di sesso maschile o femminile, di età =18 anni, con stato prestazionale ECOG 0-1 all’ingresso nella sperimentazione e con disponibilità di un blocchetto fissato in formalina e incluso in paraffina contenente tessuto tumorale, o di un minimo di 7 (preferibilmente 10) vetrini del tumore non colorati adatti per la valutazione dell’espressione di PD-L1, con almeno una lesione tumorale misurabile, con adenocarcinoma dello stomaco o del giunto gastroesofageo non resecabile, localmente avanzato o metastatico, confermato istologicamente. |
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E.4 | Principal exclusion criteria |
Prior therapy with any antibody or drug targeting T-cell coregulatory proteins, concurrent anticancer treatment, or immunosuppressive agents. Other exclusion criteria include severe hypersensitivity reactions to monoclonal antibodies (Grade = 3 NCI CTCAE v4.03), any history of anaphylaxis or uncontrolled asthma (that is, 3 or more features of partially controlled asthma), persisting toxicity related to prior therapy of Grade = 2 NCI CTCAE v4.03 and prior chemotherapy for unresectable locally advanced or metastatic adenocarcinoma of the stomach or GEJ. |
Precedente terapia con qualsiasi anticorpo o farmaco diretto contro proteine coregolatorie delle cellule T, trattamento antitumorale concomitante o agenti immunosoppressivi. Altri criteri di esclusione includono gravi reazioni di ipersensibilità ad anticorpi monoclonali (di Grado =3 secondo i criteri NCI-CTCAE v4.03), anamnesi di anafilassi o asma incontrollato (ossia 3 o più caratteristiche di asma parzialmente controllato), tossicità persistente associata a precedente terapia di Grado =2 NCI-CTCAE v4.03 e precedente chemioterapia per adenocarcinoma dello stomaco o del giunto gastroesofageo non resecabile, localmente avanzato o metastatico. |
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E.5 End points |
E.5.1 | Primary end point(s) |
OS, defined as the time (in months) from randomization to the date of death, regardless of the actual cause of the subject’s death. |
OS, definita come l’intervallo di tempo (in mesi) dalla randomizzazione alla data di decesso, indipendentemente dall’effettiva causa del decesso del soggetto |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
The cut-off of the data for primary analysis is expected after II target number of events was reached and the last randomized subject in the study was followed by at least 18 months after randomisation. Primary analysis for Ia PFS is planned at the final analysis time for the OS. If the OS is statistically significant during the interim analysis, only a descriptive analysis of the PFS will be carried out during this time time point of the interim analysis. |
II cut-off del dati per l’analisi primaria è previsto dopo che II numero target di eventi è stato raggiunto e l’ultimo soggetto randomizzato nello studio è stato seguito per almeno 18 mesi dopo Ia randomizzazione. L’analisi primaria per Ia PFS è prevista al momento dell’analisi finale per l’OS. Se l’OS è statisticamente significante durante l’analisi ad interim, verrà effettuata solo un’analisi descrittiva del PFS durante questo time point dell’ analisi ad interim. |
|
E.5.2 | Secondary end point(s) |
- PFS ¿ Best Overall Response (BOR) in Maintenance Phase according to RECIST v1.1 and per Investigator assessment. Other secondary endpoints include subject-reported outcomes / QoL (assessed by the EQ-5D- 5L, EORTC QLQ-C30, and EORTC module QLQ-STO22 questionnaires). |
- PFS - Migliore risposta globale (BOR) nella fase di mantenimento secondo i criteri RECIST v1.1 e la valutazione dello sperimentatore. - Altri endpoint secondari includono gli esiti/QoL riportati dai soggetti (valutati mediante i questionari EQ- 5D-5L ed EORTC QLQ-C30 e il modulo EORTC QLQ-STO22). |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
1.2 From the start of randomization to a minimum of 36 months 3, 4 and 5: From re-baseline to a minimum of 36 months
6: From the first dose of study drug administration up to 28 days after the last dose of study drug administration, assessed up tp 3 years |
1.2: 1 dalla data di randomizzazione fino a un minimo di 36 mesi. 3, 4 e 5: dal basale fino a un minimo di 36 mesi. 6: dalla prima dose somministrata del farmaco in studio fino a 28 giorni dopo l’ultima dose somministrata del farmaco in studio, valutata fino a 3 anni |
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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 | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | Yes |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | Yes |
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 | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
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) | Yes |
E.8.2.2 | Placebo | No |
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
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 14 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 90 |
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 | Information not present in EudraCT |
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 |
Australia |
Brazil |
Canada |
Japan |
Korea, Democratic People's Republic of |
Korea, Republic of |
Russian Federation |
Taiwan |
Thailand |
Turkey |
United States |
France |
Germany |
Hungary |
Italy |
Romania |
Spain |
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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
|
The survival follow-up will continue until 5 years after the last subject receives the last dose of avelumab. Expected date for the primary endpoint is November 2020 and the completion expected date is 31March2024. |
il follow up disopravvivenza continuer¿ fino a 5 anni dopo che l'ultimo soggetto avr¿ ricevuto l'ultima dose di avelumab. Data prevista per l'endpoint primario ¿ Novembre 2020 e la Data di completamento prevista ¿ 31Mar2024. |
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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 | 8 |
E.8.9.1 | In the Member State concerned months | 3 |
E.8.9.1 | In the Member State concerned days | 16 |
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 | 16 |