E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Very early, early and intermediate stage hepatocellular carcinoma |
Pacientes con carcinoma hepatocelular en estadio muy inicial, inicial o intermedio |
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E.1.1.1 | Medical condition in easily understood language |
Liver Cancer |
Cáncer de higado |
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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 | 19.1 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10049010 |
E.1.2 | Term | Carcinoma hepatocellular |
E.1.2 | System Organ Class | 100000004864 |
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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 objective of the present phase I/II study is to investigate whether treatment with IMA970A plus CV8102 following a single pre-vaccination infusion of cyclophosphamide (CY) is safe and tolerable, and able to induce a T-cell response in very early, early and intermediate stage hepatocellular carcinoma (HCC) patients after any standard treatment and without any evidence of active disease that warrant further treatment. |
El presente estudio en fase I/II tiene por objetivo principal investigar si el tratamiento con IMA970A más CV8102 tras una sola infusión prevacunal de ciclofosfamida (CY) es seguro, tolerable y capaz de fomentar una respuesta de los linfocitos T en pacientes con carcinoma hepatocelular (CHC) en estadio muy inicial, inicial e intermedio que ya han recibido algún tipo tratamiento ordinario y que no muestran indicio alguno de enfermedad activa que exija iniciar otro tratamiento. |
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E.2.2 | Secondary objectives of the trial |
Secondary/exploratory objectives are the investigation of additional immunological parameters, infiltrating T-lymphocytes, immune cells and potential other (bio)markers in tumor tissue, influence of standard therapy on natural immune response to IMA970A, time to progression and overall survival. |
Los objetivos secundarios/exploratorios son la investigación de otros parámetros inmunitarios, Linfocitos T infiltrados, células inmunitarias y otros posibles (bio) marcadores presentes en el tejido tumoral (cuando se disponga de tejido), evaluación del impacto potencial del tratamiento ordinario en la respuesta inmunitaria natural a los péptidos contenidos en la vacuna IMA970A, tiempo hasta la progresión y Supervivencia global. |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Aged at least 18 years 2. HLA type: HLA-A*02 and/or HLA-A*24 positive (Screening 1) 3. Very early, early and intermediate stage (Barcelona Clinic Liver Cancer (BCLC) stage 0, A, B disease) hepatocellular carcinoma (HCC) diagnosed by biopsy or resected tissue (pathohistological diagnosis), or imaging findings (non-invasive criteria) following any standard treatment (e.g. hepatic resection, RFA/PEI, TACE, and SIRT) and without any evidence of active disease that warrant further treatment 4. Patients for whom no standard anti-tumor therapy is indicated for the next 3 months (until after visit 7); thereafter any standard anti-tumor therapies applied for the treatment of BCLC stage 0, A and B HCC (e.g. RFA/PEI, TACE, and SIRT) are allowed to be applied in combination with the study treatment. Patients for whom treatment for advanced disease (e.g. sorafenib) is indicated will be withdrawn from study treatment. 5. Eastern Cooperative Oncology Group (ECOG) performance status 0 6. Child-Pugh A5-6 and B7-9 disease |
1. Mayores de 18 años 2. Tipo de HLA:HLA-A*02 o HLA-A*24 positivo (1ª Selección) 3.Carcinoma hepatocelular (CHC) en estadio muy inicial, inicial o intermedio (estadios 0, A y B en el sistema de clasificación del cáncer hepático BCLC, Barcelona Clinic Liver Cancer) diagnosticado mediante biopsia o tejido extirpado (diagnóstico histopatológico) o imágenes (criterios no invasivos) que ha sido objeto de cualquier tipo de tratamiento ordinario (hepatectomía, RFA/PEI, TACE y SIRT, por ejemplo) y sin indicio alguno de enfermedad activa que exija nuevo tratamiento. 4.Pacientes sin ninguna indicación de tratamiento antitumoral ordinario para los próximos 3 meses (hasta después de la 7ª visita del estudio); a partir de entonces estará permitido combinar el tratamiento en estudio con cualquier otro tratamiento ordinario contra el cáncer aplicable para el tratamiento del CHC en los estadios BCLC 0, A y B (p. ej. RFA/PEI, TACE y SIRT). A los pacientes que deban recibir tratamiento contra la enfermedad avanzada (p. ej. sorafenib) se les retirará el tratamiento del estudio. 5. Estado general igual a 0 (PS del ECOG; Eastern Cooperative Oncology Group) 6. Child-Pugh A (5 ó 6 puntos) o B (7, 8 ó 9 puntos) |
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E.4 | Principal exclusion criteria |
1. Any prior systemic anti-tumor treatment (including drug or treatment regimen, approved or experimental) within 2 weeks before signing of the IC 1 by the patient 2. Liver transplanted patients; patients who are on the liver transplantation waiting list are allowed to be enrolled 3. Patients with a history or evidence of systemic autoimmune disease, e.g. rheumatoid arthritis, multiple sclerosis, systemic lupus erythematodes (SLE), scleroderma, Sjögren's syndrome, Wegener's granulomatosis, Guillain-Barre syndrome 4. Need for concomitant treatment with immunosuppressive drugs or other immune-modifying drugs. The use of inhaled and nasally applied steroids, as well as topical steroids outside the vaccination area are permitted 5. Any medically diagnosed or suspected condition of immunodeficiency or medical history thereof 6. Known HIV infection 7. Acute and active infections requiring oral or intravenous antibiotics, antiviral or antifungal therapy within 30 days prior to signing of the IC 2 by the patient 8. Patients undergoing renal dialysis or with relevant chronic renal failure 9. Abnormal laboratory values as specified 10. Clinically relevant ascites with the only exception of patients that remain free from symptomatic ascites under low-dose diuretics (Spironolactone > 100 mg daily and Furosemide > 40 mg daily). 11. Evidence of current alcohol or drug abuse |
1.Haber recibido algún tratamiento antitumoral de acción general en las dos semanas previas a la firma del primer consentimiento informado por parte del paciente (regímenes farmacológicos o terapéuticos de cualquier tipo, autorizados o experimentales). 2. Pacientes que hayan recibido un trasplante de hígado; podrán participar aquellos que figuren en una lista de espera para ese tipo de trasplante 3. Pacientes con antecedentes o indicios sólidos de enfermedad autoinmunitaria sistémica, como por ejemplo, artritis reumatoide, esclerosis múltiple, lupus eritematoso sistémico (LES), esclerodermia, síndrome de Sjögren, granulomatosis de Wegener o síndrome de Guillain Barré. 4. Necesidad de tratamiento simultáneo con fármacos inmunodepresores u otro tipo de fármacos que alteren el sistema inmunitario. Se permite el uso de corticoesteroides inhalados o instilados por vía nasal, así como por vía tópica, pero solo fuera de la zona de administración de la vacuna. 5. Cualquier trastorno de inmunodeficiencia, diagnosticado o presunto, o antecedentes del mismo 6. Infección por VIH confirmada 7. Infecciones agudas y activas que exijan la administración por vía endovenosa u oral de antibióticos, antimicóticos o antivirales enlos 30 días previos a la firma del segundo consentimientoinformado por el paciente 8. Pacientes sometidos a diálisis renal o con insuficiencia renal crónica relevante 9. Valores analíticos anormales, especificados en el protocolo 10. Ascitis clínicamente relevante, con la única excepción de aquellos pacientes que permanezcan sin ascitis sintomática al recibir diuréticos en dosis bajas (espironolactona > 100 mg diarios y furosemida > 40 mg diarios). 11. Indicios de alcoholemia o toxicomanía |
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E.5 End points |
E.5.1 | Primary end point(s) |
The primary endpoints of the study are safety and tolerability, and immunogenicity (T-cell response in peripheral blood). |
Los criterios principales de valoración del estudio son la seguridad y la tolerabilidad, así como la inmunogenicidad (respuesta de los linfocitos T en la sangre periférica). |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
Safety and Tolerability: continuous full safety surveillance between S2 and EOV visit. Limited safety surveillance between S1 and S2 and during the non-interventional follow-up starting after EOV Visit. Immunogenicity: PBMCs for immunogenicity assessment will be drawn at visits S1, S2, C, 4, 5, 6, 7, 9, EOV. |
Seguridad y Tolerabilidad: Vigilancia completa continua de la seguridad entre la visita S2 y EOV. Supervisión limitada de la seguridad entre S1 y S2 y durante el seguimiento no intervencional que comienza después de la visita de la EOV. Inmunogenicidad: Las evaluaciones de PBMC para la inmunogenicidad se sacarán en las visitas S1, S2, C, 4, 5, 6, 7, 9, EOV. |
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E.5.2 | Secondary end point(s) |
• Additional immunological parameters in blood (e.g. regulatory T-cells, myeloid-derived suppressor cells) • Infiltrating T-lymphocytes, immune cells and potential other (bio)markers in tumor tissue (depending on availability of tissue) • Assessment of the potential impact of the standard therapy on the natural immune response to peptides contained in IMA970A • Time to progression (TTP) • Overall survival (OS) |
Otros parámetros inmunitarios analizados a través de la sangre (p. ej. linfocitos T reguladores y células mieloides supresoras) • Linfocitos T infiltrados, células inmunitarias y otros posibles (bio)marcadores presentes en el tejido tumoral (cuando se disponga de tejido) • Evaluación del impacto potencial del tratamiento ordinario en la respuesta inmunitaria natural a los péptidos contenidos en la vacuna IMA970A • Tiempo hasta la progresión (TTP) • Supervivencia global (SG) |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
Additional immunological parameters in blood: PBMCs for immunogenicity assessment will be drawn at visits S1, S2, C, 4, 5, 6, 7, 9, EOV. Infiltrating T-lymphocytes: depending on availability of tumor tissue Assessment of potential impact of standard therapy: S1 and S2 TTP: S1, S2, V7, EOV visit OS: continues capture until end-of-trial. |
Otros parámetros inmunitarios analizados a través de la sangre: las evaluaciones PBMC de la inmunogenicidad se sacarán en las visitas S1, S2, C, 4, 5, 6, 7, 9, EOV. Linfocitos T infiltrados: dependiendo de la disponibilidad de tejido tumoral. Evaluación del impacto potencial del tratamiento ordinario: visitas S1 y S2 TTP: visitas S1, S2, V7, EOV SG: seguimiento hasta el final del ensayo. |
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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 | No |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | Yes |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | Yes |
E.7.1.3.1 | Other trial type description |
First administration to Humans for PR1 |
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E.7.2 | Therapeutic exploratory (Phase II) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | No |
E.8.1.1 | Randomised | Information not present in EudraCT |
E.8.1.2 | Open | Information not present in EudraCT |
E.8.1.3 | Single blind | Information not present in EudraCT |
E.8.1.4 | Double blind | Information not present in EudraCT |
E.8.1.5 | Parallel group | Information not present in EudraCT |
E.8.1.6 | Cross over | Information not present in EudraCT |
E.8.1.7 | Other | Information not present in EudraCT |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | Information not present in EudraCT |
E.8.2.2 | Placebo | Information not present in EudraCT |
E.8.2.3 | Other | Information not present in EudraCT |
E.8.3 |
The trial involves single site in the Member State concerned
| Yes |
E.8.4 | The trial involves multiple sites in the Member State concerned | No |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 6 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | No |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.7 | Trial has a data monitoring committee | Yes |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 1 |
E.8.9.1 | In the Member State concerned months | 6 |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial years | 1 |
E.8.9.2 | In all countries concerned by the trial months | 6 |