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    Summary
    EudraCT Number:2015-003338-29
    Sponsor's Protocol Code Number:MK-3475-100
    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:2015-12-17
    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 number2015-003338-29
    A.3Full title of the trial
    A Phase II, Open-label, Single-arm, Multicenter Study to Evaluate Efficacy and Safety of Pembrolizumab Monotherapy in Subjects with Advanced Recurrent Ovarian Cancer
    Estudio de fase II, abierto, de un solo grupo y multicéntrico para evaluar la eficacia y la seguridad de pembrolizumab en monoterapia en mujeres con cáncer de ovario recurrente avanzado
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    Pembrolizumab in Subjects with Advanced Recurrent Ovarian Cancer
    Pembrolizumab en pacientes con cáncer de ovario recurrente avanzado.
    A.3.2Name or abbreviated title of the trial where available
    Phase II Study of Pembrolizumab in Subjects with Advanced Recurrent Ovarian Cancer
    Estudio de fase II de pembrolizumab en mujeres con cáncer de ovario recurrente avanzado
    A.4.1Sponsor's protocol code numberMK-3475-100
    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 SponsorMerck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc.
    B.1.3.4CountryUnited States
    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 supportMerck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc.
    B.4.2CountryUnited States
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationMerck Sharp & Dohme de España S.A.
    B.5.2Functional name of contact pointInvestigación Clínica
    B.5.3 Address:
    B.5.3.1Street AddressC/ Josefa Valcárcel, 38
    B.5.3.2Town/ cityMadrid
    B.5.3.3Post code28027
    B.5.3.4CountrySpain
    B.5.4Telephone number+34913210600
    B.5.5Fax number+34913210590
    B.5.6E-mailensayos_clinicos@merck.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 Keytruda
    D.2.1.1.2Name of the Marketing Authorisation holderMerck Sharp and Dohme, Ltd
    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 namePembrolizumab
    D.3.2Product code 1374853-91-4
    D.3.4Pharmaceutical form Powder 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 INNPembrolizumab
    D.3.9.1CAS number 1374853-91-4
    D.3.9.2Current sponsor codeMK-3475
    D.3.9.3Other descriptive nameAnti-PD-1 monoclonal antibody
    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 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) Yes
    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.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
    A:platinum-resistant or partially platinum-sensitive recurrent ovarian cancer (OC) who received 1 but no more than 3 prior lines of anticancer regimens/local standard following primary or interval debulking surgery with a platinum free interval or treatment-free interval of 3-12 months based on last regimen received
    B:recurrent OC who received 3-5 prior lines of anticancer regimens/local standard with a platinum-free interval or treatment-free interval >or=3months based on last regimen received
    A:Recurrente CO resistente al platino o parcialmente sensible que recibieron 1 y no más de 3 líneas de régimen antineoplásico por procedimiento local después de citorreducción quirúrgica primaria o a intervalos sin platino o intervalo sin tratamiento de 3 a 12 meses según el último régimen
    B: Recurrente CO que recibieron 3 o 5 líneas de régimen antineoplásico por procedimiento local con un intervalo sin platino o intervalos libre de tratamiento>o=3 meses según el último régimen de tratamiento
    E.1.1.1Medical condition in easily understood language
    Ovarian Cancer
    Cáncer de Ovario
    E.1.1.2Therapeutic area Diseases [C] - Cancer [C04]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 18.1
    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
    (1) To evaluate clinical anti-tumor activity of pembrolizumab monotherapy based on overall response rate (ORR) as assessed by CIV per RECIST 1.1 in Cohort A-All Comer group
    (2) To evaluate clinical anti-tumor activity of pembrolizumab monotherapy based on ORR as assessed by CIV per RECIST 1.1 in Cohort A- PD-L1 High (PD-L1H) subgroup using a PD-L1 expression cutpoint established in the training set.
    (3) To evaluate clinical anti-tumor activity of pembrolizumab monotherapy based on ORR as assessed by CIV per RECIST 1.1 in Cohort B-All Comer group
    (4) To evaluate clinical anti-tumor activity of pembrolizumab monotherapy based on ORR as assessed by CIV per RECIST 1.1 in Cohort B PD-L1H subgroup using a PD-L1 expression cutpoint established in the training set from Cohort A
    - Evaluar la actividad clínica antitumoral del pembrolizumab en monoterapia mediante la TRO, según lo determinado por el LCI conforme a los RECIST 1.1, en el grupo de todos los participantes en la cohorte A
    - Evaluar la actividad clínica antitumoral del pembrolizumab en monoterapia mediante la TRO, según lo determinado por el LCI conforme a los RECIST 1.1, en el subgrupo PD-L1H (PD-LIH) de la cohorte A, utilizando el umbral de expresión del PD-L1 establecido en el grupo de preparación
    - Evaluar la actividad clínica antitumoral del pembrolizumab en monoterapia mediante la TRO, según lo determinado por el LCI conforme a los RECIST 1.1, en el grupo de todos los participantes en la cohorte B
    - Evaluar la actividad clínica antitumoral del pembrolizumab en monoterapia mediante la TRO, según lo determinado por el LCI conforme a los RECIST 1.1, en el subgrupo PD-L1H de la cohorte B , utilizando para el umbral de expresión del PD-L1 establecido en el grupo de preparación de la cohorte A
    E.2.2Secondary objectives of the trial
    1 Evaluate duration of response (DOR), disease control rate (DCR) and progression-free survival (PFS) as assessed by CIV per RECIST1.1 in Cohort A-All Comer group, Cohort A-PD-L1H subgroup, Cohort B-All Comer group, Cohort B-PD-L1H subgroup. PFS rate at 6,12,18 months
    2 Evaluate ORR, DOR, DCR, and PFS as assessed by investigator per RECIST1.1 in Cohort A-All Comer group, Cohort A-PD-L1H subgroup, Cohort B-All Comer group, Cohort B-PD-L1H subgroup
    3 Evaluate ORR, DOR, DCR and PFS as assessed by CIV and by investigator per RECIST1.1, in Cohort A-All Comer subgroup with PFI/TFI>or=3?6 months and the subgroup with PFI/TFI>6-12 months
    4 Evaluate OS in Cohort A-All Comer group, Cohort A-PD-L1H subgroup,Cohort A-All Comer subgroup with PFI/TFI>or=3?6 months and the subgroup with PFI/TFI >6-12 months, Cohort B-All Comer group,Cohort B-PD-L1H subgroup
    5 Evaluate and characterize tolerability and safety profile of entire study population, cohorts and subgroups
    6 Assess pharmacokinetics
    - Evaluar duración de respuesta, tasa de control de enfermedad y supervivencia sin progresión, según el LCI conforme los RECIST 1.1, en grupo cohorte A, el subgrupo PD-L1H de cohorte A, el grupo cohorte B y el subgrupo PD-L1H. SSP a los 6, 12 y 18 meses
    - Evaluar TRO, DR, TCE y SSP, según investigador conforme a los RECIST 1.1, en grupo de cohorte A, el subgrupo PD-L1H de cohorte A, el grupo cohorte B y el subgrupo PD-L1H
    - Evaluar TRO, la DR, la TCE y la SSP, según lo determinado por LCI y por investigador conforme a los RECIST 1.1, en el subgrupo cohorte A con un ISP o IST >o= 3 a 6 meses y el subgrupo con un ISP o IST de > 6 a 12 meses
    - Evaluar la SG en el grupo cohorte A, el subgrupo PD-L1H de cohorte A, el subgrupo cohorte A con un ISP o IST de >o=3 a 6 meses y el subgrupo con ISP o IST de > 6 a 12 meses, el grupo cohorte B y subgrupo PD-L1H
    - Evaluar, definir perfil de tolerabilidad, seguridad de la población en total y por cohortes y subgrupos
    - Evaluar farmacocinética
    E.2.3Trial contains a sub-study Yes
    E.2.3.1Full title, date and version of each sub-study and their related objectives
    Merck will conduct Future Biomedical Research on DNA (blood) specimens collected during this clinical trial. Such research is for biomarker testing to address emergent questions not described elsewhere in the protocol (as part of the main trial) and will only be conducted on specimens from appropriately consented subjects. The objective of collecting specimens for Future Biomedical Research is to explore and identify biomarkers that inform the scientific understanding of diseases and/or their therapeutic treatments. The overarching goal is to use such information to develop safer, more effective drugs, and/or to ensure that subjects receive the correct dose of the correct drug at the correct time.
    Merck realizará investigaciones biomédicas futuras con las muestras obtenidas para tal finalidad durante este ensayo clínico. Estas investigaciones tendrán por objeto el análisis de biomarcadores con el fin de abordar aspectos nuevos que no se describen en otras partes del protocolo (como parte del ensayo principal) y solo se llevarán a cabo en muestras de los pacientes que hayan otorgado el consentimiento correspondiente. El objetivo de la obtención de muestras para investigaciones biomédicas futuras es estudiar e identificar biomarcadores que proporcionen información a los científicos sobre las enfermedades y sus tratamientos. El objetivo último es utilizar tal información para desarrollar fármacos más seguros y eficaces o para garantizar que los sujetos reciban la dosis correcta del fármaco en el momento preciso.
    E.3Principal inclusion criteria
    1. Be willing and able to provide written informed consent for the trial. The subject may also provide consent for Future Biomedical Research. However, the subject may participate in the main trial without participating in Future Biomedical Research.
    2. Be > or = 18 years of age on day of signing informed consent.
    3. Have histologically confirmed epithelial ovarian cancer, fallopian tube cancer or primary peritoneal cancer
    4. Have received a front line platinum-based regimen (administered via either IV or IP route) per local SOC or treatment guideline following the primary or interval debulking surgery with documented disease recurrence.
    Note: Maintenance treatment following the front line treatment is permitted and counted together as part of the front line treatment.
    5. Have fulfilled the following additional requirements regarding prior treatments for recurrent ovarian cancer (ROC) depending on the cohort subject is to be enrolled. Each subject must have documented evidence of clinical response or disease stabilization to the last regimen received.
    Cohort A: Have received 0 to 2 additional prior lines for treating ROC (or 1-3 total prior lines counting the front line) and must have a platinum-free interval (PFI) of > or = 3 to 12 months if the last regimen received is a platinum-based, or a treatment-free interval (TFI) of > or = 3 to 12 months if the last regimen received is a non-platinum-based.
    Cohort B: Have received 3 to 5 additional prior lines for treating ROC (or 4-6 total prior lines counting the front line) and must have a PFI of > or =3 months if the last regimen received is a platinum-based, or a TFI of > or = 3 months if the last regimen received is a non-platinum-based.
    Note: PFI is defined as the time elapsed between the last dose of platinum and the documented evidence of disease progression per RECIST 1.1. TFI is defined as the time elapsed between the last dose of the regimen received and the documented evidence of disease progression per RECIST 1.1.
    6. Have measurable disease at baseline based on RECIST 1.1 as determined by the central imaging vendor.
    Note: Tumor lesions situated in a previously irradiated area are considered measurable if progression has been demonstrated in such lesions.
    7. Have an ECOG performance status of 0 or 1
    8. Have a life expectancy of > or =16 weeks.
    9. Have provided a tumor tissue sample either collected from prior cytoreductive surgery or fresh newly obtained tumor tissue at screening. Formalin-fixed paraffin-embedded (FFPE) block specimens are preferred to slides. Additional samples may be requested if tumor tissue provided is not adequate for quality and/or quantity as assessed by the central laboratory.
    Note 1: Tumor tissue samples from recent biopsy are much preferred as it represents the current disease status and is much more informative for understanding the correlation between clinical activity and tumor microenvironment.
    If available, paired tumor tissue samples from prior cytoreductive surgery and recent biopsy are strongly encouraged in order to understand the changes in tumor microenvironment during the course of the treatments.
    Note 2: For archival tumor tissue samples, block specimens are much preferred than slides. If submitting unstained cut slides, freshly cut slides should be submitted to the testing laboratory within 14 days from when the slides are cut. See Section 4.2.3.3 in protocol for an explanation.
    10. Have demonstrated adequate organ function as defined in Table 1 of the protocol. All screening labs should be performed within 10 days of treatment initiation.
    11. Female subjects of childbearing potential (see Section 5.7.2) must be willing to use an adequate method of contraception as outlined in Section 5.7.2 ? Contraception, for the course of the study through 120 days after the last dose of study medication. Note: Abstinence is acceptable if this is the usual lifestyle and preferred contraception for the subject.
    12. Female subjects of childbearing potential must have a negative urine or serum pregnancy test within 72 hours prior to receiving the first dose of study medication. If the urine test is positive or cannot be confirmed as negative, a serum pregnancy test will be required.
    1.Estar dispuestos a otorgar su consentimiento informado por escrito para el ensayo y ser capaz de hacerlo. Podrán otorgar también su consentimiento para investigaciones biomédicas futuras. No obstante, podrán participar en el ensayo principal sin necesidad de hacerlo en las investigaciones biomédicas futuras
    2.Tener una edad mínima de 18 años el día de la firma del consentimiento informado
    3.Tener un cáncer epitelial de ovario, cáncer de trompas de Falopio o cáncer peritoneal primario con confirmación histológica
    4.Haber recibido un régimen de primera línea basado en platino (por vía IV o IP) conforme al tratamiento de referencia o las normas de tratamiento locales después de la citorreducción quirúrgica primaria o a intervalos con recidiva confirmada de la enfermedad
    Nota: Se permite el tratamiento de mantenimiento después del régimen de primera línea y se cuenta como parte de este último
    5.Cumplir los siguientes requisitos adicionales relativos al tratamiento previo del cáncer de ovario recurrente,dependiendo de la cohorte en la que se vaya a incluir al sujeto. Todos los sujetos deben pruebas documentadas de respuesta clínica o enfermedad estable con el último régimen recibido
    Cohorte A: haber recibido con anterioridad entre 0 y 2 líneas adicionales de tratamiento para el COR (o entre 1 y 3 líneas en total si se tiene en cuenta el tratamiento de primera línea) y tener un intervalo sin platino de > o = 3 a 12 meses, en el caso de que el último régimen recibido estuviera basado en platino, o un intervalo sin tratamiento de > o = 3 a 12 meses si el último régimen recibido no estaba basado en platino
    Cohorte B: haber recibido con anterioridad entre 3 y 5 líneas adicionales de tratamiento para el COR (o entre 4 y 6 líneas en total si se tiene en cuenta el tratamiento de primera línea) y tener un ISP > o = 3 meses, en el caso de que el último régimen recibido estuviera basado en platino, o un IST > o = 3 meses si el último régimen recibido no estaba basado en platino
    Nota: El ISP se define como el tiempo transcurrido entre la última dosis de platino y la progresión documentada de la enfermedad conforme a los RECIST 1.1. El IST se define como el tiempo transcurrido entre la última dosis del régimen recibido y la progresión documentada de la enfermedad conforme a los RECIST 1.1
    6.Presentar en el momento basal enfermedad mensurable conforme a los criterios RECIST 1.1 según lo determinado por el laboratorio central de imagen
    Nota: Las lesiones tumorales ubicadas en una zona previamente irradiada se considerarán mensurables siempre que se haya demostrado progresión en dichas lesiones
    7.Tener un estado funcional de 0 o 1 en la escala del ECOG
    8.Tener una esperanza de vida >o= 16 semanas
    9.Haber proporcionado una muestra de tejido tumoral recogida durante la citorreducción quirúrgica previa o bien una muestra reciente obtenida en el período de selección. Se prefieren las muestras en bloque fijado en formol e incluido en parafina (FFIP) a los cortes para microscopio. Podrían necesitarse nuevas muestras en caso de que no se dispusiera de tejido suficiente en cantidad o calidad según lo determinado por el laboratorio central
    Nota 1: Se prefieren muestras de tejido tumoral de una biopsia reciente porque representan el estado actual de la enfermedad y facilitan mucha más información para investigar la correlación entre la actividad clínica y el microambiente tumoral
    Si se dispone de ellas, se recomienda entregar muestras emparejadas de tejido tumoral obtenidas durante la citorreducción quirúrgica previa y mediante una biopsia reciente, a fin de investigar los cambios que se producen en el microambiente tumoral durante el tratamiento
    Nota 2: Con respecto a las muestras de tejido tumoral de archivo, se prefieren los bloques a los cortes para el microscopio. Si se van a proporcionar cortes sin teñir, se deberán enviar preparaciones recién cortadas al laboratorio de análisis en un plazo de 14 días desde la fecha del corte. En la sección 4.2.3.4 del protocolo se facilita más información
    10.Presentar una función orgánica adecuada, como se define en la tabla 1 del protocolo. Todas las pruebas analíticas de selección deberán efectuarse en los 10 días previos al comienzo del tratamiento
    11.Las pacientes en edad fértil (sección 5.7.2) deben estar dispuestas a utilizar un método anticonceptivo adecuado como se indica en la sección 5.7.2, Anticoncepción, durante el estudio y hasta 120 días después de la última dosis de la medicación del estudio. Nota: La abstinencia es aceptable si se adapta al modo de vida y es el método anticonceptivo preferido de la paciente
    12.Las mujeres en edad fértil deberán tener un resultado negativo en la prueba de embarazo en orina o en suero realizada en las 72 horas anteriores a la administración de la primera dosis de la medicación del estudio. Cuando el resultado de la prueba en orina sea positivo o no pueda confirmarse que es negativo, será necesario una prueba de embarazo en suero
    E.4Principal exclusion criteria
    1. Is currently participating in or has participated in a clinical study and received an investigational agent or used an investigational device within 4 weeks prior to the first dose of study treatment.
    Note: Subjects who have entered the follow-up phase of an investigational study may participate as long as it has been 4 weeks since the last dose of the previous investigational agent or device.
    2. Has an active autoimmune disease that has required systemic treatment in the past 2 years (i.e. use of disease modifying agents, corticosteroids or immunosuppressive drugs). Replacement therapy (e.g., thyroxine, insulin, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency, etc.) is not considered a form of systemic treatment.
    3. Has a diagnosis of immunodeficiency or is receiving systemic steroid therapy or any other form of immunosuppressive therapy within 7 days prior to the planned first dose of the study. The use of physiologic doses of corticosteroids may be approved after consultation with the Sponsor.
    4. Has had prior anti-cancer monoclonal antibody (mAb), chemotherapy, targeted small molecule therapy, or radiation therapy within 4 weeks prior to the planned first dose of the study
    5. Has not recovered from adverse events to < or = Grade 1 or prior treatment level due to a previously administered agent
    Note: Subjects with < or = Grade 2 neuropathy or alopecia of any grade are an exception to this criterion and may qualify for the study.
    Note: If subject received major surgery, they must have recovered adequately from the toxicity and/or complications from the intervention prior to starting therapy.
    6. Has EOC with mucinous histology subtype. Or has a known additional malignancy that progressed or required active treatment within the last 5 years. Exceptions include basal cell carcinoma of the skin, squamous cell carcinoma of the skin that has undergone potentially curative therapy or in situ cervical cancer.
    7. Has known active central nervous system (CNS) metastases and/or carcinomatous meningitis. Subjects with previously treated brain metastases may participate provided they have stable brain metastases.
    8. Has known history of, or any evidence of active, non-infectious pneumonitis.
    9. Has an active infection requiring systemic therapy.
    10. Has symptoms of bowel obstruction in the past three months
    11. Has a history or current evidence of any condition, therapy, or laboratory abnormality that might confound the results of the trial, interfere with the subject?s participation for the full duration of the trial, or is not in the best interest of the subject to participate, in the opinion of the treating investigator.
    12. Has known psychiatric or substance abuse disorders that would interfere with cooperation with the requirements of the trial.
    13. Is pregnant or breastfeeding, or expecting to conceive children within the projected duration of the trial, starting with the screening visit through 120 days after the last dose of trial treatment.
    14. Has received prior therapy with an anti-PD-1, anti-PD-L1, anti-PD-L2 agent or with an agent directed to another co-inhibitory T-cell receptor (e.g. CTLA-4, OX-40, CD137) or has participated in prior pembrolizumab trials.
    15. Has a known history of Human Immunodeficiency Virus (HIV) (HIV 1/2 antibodies).
    16. Has known active Hepatitis B (e.g., HBsAg reactive) or Hepatitis C (e.g., HCV RNA [qualitative] is detected).
    17. Has received a live vaccine within 30 days of the planned first dose of the study.
    Note: Seasonal influenza vaccines for injection are generally inactivated flu vaccines and are allowed; however intranasal influenza vaccines (e.g., Flu-Mist®) are live attenuated vaccines, and are not allowed.
    1.Está participando o ha participado en un estudio clínico y ha recibido un fármaco en investigación o ha utilizado un dispositivo en investigación en las 4 semanas anteriores a la administración de la primera dosis del tratamiento
    Nota: Los sujetos que se hayan incorporado a la fase de seguimiento de un estudio de investigación podrán participar siempre que hayan transcurrido 4 semanas desde la última dosis o uso del anterior fármaco o dispositivo en investigación.
    2.Presentar una enfermedad autoinmunitaria activa que haya necesitado tratamiento sistémico en los dos años anteriores (es decir, fármacos modificadores de la enfermedad, corticosteroides o inmunodepresores). El tratamiento de sustitución (p. ej., tiroxina, insulina o corticosteroides en dosis fisiológicas para una insuficiencia suprarrenal o hipofisaria, etc.) no se considera una forma de tratamiento sistémico.
    3.Tiene un diagnóstico de inmunodeficiencia o está recibiendo corticoterapia sistémica o algún tipo de tratamiento inmunodepresor en los 7 días anteriores a la administración de la primera dosis prevista del tratamiento del estudio. El uso de dosis fisiológicas de corticosteroides podrá autorizarse previa consulta con el promotor
    4.Haber recibido tratamiento antineoplásico con un anticuerpo monoclonal (AcM), quimioterapia, tratamiento dirigido con moléculas pequeñas o radioterapia en las 4 semanas anteriores a la primera dosis prevista del tratamiento del estudio
    5.No haberse recuperado de acontecimientos adversos (es decir, mejoría hasta un grado < o = 1 o la situación basal) provocados por un tratamiento previamente administrado
    Nota: Los sujetos con neuropatía de grado < o = 2 o alopecia de cualquier grado constituyen una excepción en relación con este criterio y podrán participar en el ensayo
    Nota: Si el sujeto se ha sometido a una intervención de cirugía mayor, deberá haberse recuperado suficientemente de la toxicidad y/o las complicaciones de la intervención antes de empezar el tratamiento
    6.Presentar un CEO del subtipo histológico mucinoso o presentar otra neoplasia maligna conocida que progresó o necesitó tratamiento activo en los últimos 5 años. Son excepciones el carcinoma basocelular de la piel, el carcinoma espinocelular de la piel que haya recibido un tratamiento potencialmente curativo o el cáncer de cuello uterino in situ
    7.Presentar metástasis activas en el sistema nervioso central (SNC) y/o meningitis carcinomatosa. Los sujetos con metástasis cerebrales tratadas con anterioridad podrán participar siempre que dichas metástasis se mantengan estables
    8.Tener antecedentes o algún signo de neumonitis no infecciosa activa
    9.Presentar una infección activa con necesidad de tratamiento sistémico
    10.Presentar síntomas de obstrucción intestinal en los últimos tres meses
    11.Tener antecedentes o signos actuales de cualquier trastorno, tratamiento o anomalía analítica que, en opinión del investigador, pueda confundir los resultados del ensayo, afectar a la participación del sujeto durante todo el ensayo o hacer que la participación no sea lo más conveniente para ese sujeto
    12.Padecer un trastorno psiquiátrico o por abuso de sustancias que pudiera dificultar el cumplimiento de los requisitos del ensayo.
    13.Estar embarazada o en período de lactancia o tener intención de concebir un hijo durante el período previsto del ensayo, desde la visita de selección hasta 120 días después de la última dosis del tratamiento del estudio
    14.Han recibido tratamiento previo con un fármaco anti-PD-1, anti-PD-L1, anti-PD-L2 o dirigido contra otro receptor de los linfocitos T coinhibidores (por ejemplo, CTLA-4, OX-40 o CD137) o han participado anteriormente en ensayos con pembrolizumab
    15.Tener antecedentes de infección por el virus de la inmunodeficiencia humana (VIH) (anticuerpos contra el VIH 1/2).
    16.Presentar hepatitis B activa demostrada (p. ej., reactividad del HBsAg) o hepatitis C demostrada (p. ej., detección [cualitativa] de ARN del VHC)
    17.Haber recibido una vacuna de microorganismos vivos en los 30 días previos a la primera dosis prevista del tratamiento del estudio.
    Nota: Las vacunas contra la gripe estacional inyectables contienen, por lo general, virus inactivados y se permite su uso; en cambio, las vacunas antigripales intranasales (por ejemplo, Flu-Mist®) son vacunas de virus vivos atenuados y no se permite su uso
    E.5 End points
    E.5.1Primary end point(s)
    Overall response rate (ORR) based on the disease assessment by the central imaging vendor (CIV) per RECIST 1.1
    Tasa de respuesta total (TRO) basado en la evaluación de la enfermedad efectuada en el laboratorio central de imagen conforme a los RECIST 1.1
    E.5.1.1Timepoint(s) of evaluation of this end point
    At least 8 months after the last subject for each cohort is enrolled.
    Al menos 8 meses después de la inclusión del último sujeto para cada cohorte.
    E.5.2Secondary end point(s)
    1) Duration of Response (DOR), Disease Control Rate (DCR) , Progression-Free Survival (PFS) , per RECIST 1.1 as assessed by CIV; 2) ORR, DOR, DCR, PFS per RECIST 1.1 as assessed by investigator; 3) Overall survival; 4) Proportions of PFS at 6, 12 and 18 months and proportions of survival at 6, 12, 18, and 24 months
    1) Duración de la respuesta (DR), la tasa de control de la enfermedad (TCE), la supervivencia sin progresión (SSP), según lo determinado por el LCI conforme a los RECIST 1.1; 2) TRO, la DR, la TCE, SSP, según lo determinado por el investigador conforme a los RECIST 1.1; 3) Supervivencia total; 4) Porcentaje de SSP a los 6, 12 y 18 meses y porcentaje de supervivencia a los 6, 12, 18 y 24 meses
    E.5.2.1Timepoint(s) of evaluation of this end point
    The final clinical cutoff for the study (i.e., study completion) will be 3 years after the last subject is enrolled for final OS analysis
    El punto de corte clínico del estudio (es decir, la conclusión del estudio) para el análisis final de la supervivencia global (SG) será 3 años después de la inclusión del último sujeto
    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 No
    E.6.8Bioequivalence No
    E.6.9Dose response No
    E.6.10Pharmacogenetic No
    E.6.11Pharmacogenomic No
    E.6.12Pharmacoeconomic No
    E.6.13Others No
    E.7Trial type and phase
    E.7.1Human pharmacology (Phase I) No
    E.7.1.1First administration to humans No
    E.7.1.2Bioequivalence study No
    E.7.1.3Other No
    E.7.1.3.1Other trial type description
    E.7.2Therapeutic exploratory (Phase II) 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 No
    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 concerned5
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA30
    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
    Canada
    Israel
    Japan
    Russian Federation
    South Africa
    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
    LVLS
    LVLS
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years4
    E.8.9.1In the Member State concerned months0
    E.8.9.1In the Member State concerned days0
    E.8.9.2In all countries concerned by the trial years4
    E.8.9.2In all countries concerned by the trial months0
    E.8.9.2In all countries concerned by the trial days0
    F. Population of Trial Subjects
    F.1 Age Range
    F.1.1Trial has subjects under 18 No
    F.1.1.1In Utero No
    F.1.1.2Preterm newborn infants (up to gestational age < 37 weeks) No
    F.1.1.3Newborns (0-27 days) No
    F.1.1.4Infants and toddlers (28 days-23 months) No
    F.1.1.5Children (2-11years) No
    F.1.1.6Adolescents (12-17 years) No
    F.1.2Adults (18-64 years) Yes
    F.1.2.1Number of subjects for this age range: 195
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 130
    F.2 Gender
    F.2.1Female Yes
    F.2.2Male No
    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 state17
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 156
    F.4.2.2In the whole clinical trial 325
    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)
    Not Applicable
    No aplica
    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 Decision2016-02-10
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2016-02-04
    P. End of Trial
    P.End of Trial StatusCompleted
    P.Date of the global end of the trial2021-03-18
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