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    Summary
    EudraCT Number:2015-003594-14
    Sponsor's Protocol Code Number:KCP-330-020
    National Competent Authority:Italy - Italian Medicines Agency
    Clinical Trial Type:EEA CTA
    Trial Status:Ongoing
    Date on which this record was first entered in the EudraCT database:2021-09-06
    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 ConcernedItaly - Italian Medicines Agency
    A.2EudraCT number2015-003594-14
    A.3Full title of the trial
    A Phase 2-3 Multicenter, Randomized, Double-blind Study of Selinexor (KPT-330) versus Placebo in Patients with Advanced Unresectable Dedifferentiated Liposarcoma (DDLS)
    STUDIO DI FASE 2-3, MULTICENTRICO, RANDOMIZZATO, IN DOPPIO CIECO, CONTROLLATO VERSO PLACEBO SU SELINEXOR (KPT-330) IN PAZIENTI CON LIPOSARCOMA DEDIFFERENZIATO (DDLS) AVANZATO NON RESECABILE
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    A Phase 2-3 Multicenter, Randomized, Double-blind Study of Selinexor (KPT-330) versus Placebo in Patients with Advanced Unresectable Dedifferentiated Liposarcoma (DDLS)
    Studio di Fase 2-3 multicentrico, randomizzato, in doppio cieco, di Selinexor (KPT-330) a confronto con il Placebo in Pazienti con Liposarcoma Dedifferenziato non trattabile chirurgicamente
    A.3.2Name or abbreviated title of the trial where available
    SEAL: Selinexor in Advanced Liposarcoma
    SEAL: Selinexor in Liposarcoma Avanzato
    A.4.1Sponsor's protocol code numberKCP-330-020
    A.5.2US NCT (ClinicalTrials.gov registry) numberNCT02606461
    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 SponsorKARYOPHARM THERAPEUTICS, 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 supportKaryopharm Therepeutics Inc.
    B.4.2CountryUnited States
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationKaryopharm Therapeutics, Inc.
    B.5.2Functional name of contact pointClinical Trial Information Desk
    B.5.3 Address:
    B.5.3.1Street Address85, Wells Ave
    B.5.3.2Town/ cityNewton, MA
    B.5.3.3Post code02459
    B.5.3.4CountryUnited States
    B.5.4Telephone number0016176580543
    B.5.5Fax number0016176580543
    B.5.6E-mailclinicaltrials@karyopharm.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 nameSelinexor 20mg coated tablets
    D.3.2Product code KPT-330
    D.3.4Pharmaceutical form Coated tablet
    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 INNSelinexor
    D.3.9.2Current sponsor codeKPT-330
    D.3.9.4EV Substance CodeSUB177942
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number20
    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
    D.8 Placebo: 1
    D.8.1Is a Placebo used in this Trial?Yes
    D.8.3Pharmaceutical form of the placeboFilm-coated tablet
    D.8.4Route of administration of the placeboOral use
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    Dedifferentiated Liposarcoma (DDLS)
    Liposarcoma Dedifferenziato
    E.1.1.1Medical condition in easily understood language
    Advanced Liposarcoma (DDLS)
    Liposarcoma Avanzato
    E.1.1.2Therapeutic area Diseases [C] - Cancer [C04]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 20.0
    E.1.2Level PT
    E.1.2Classification code 10073135
    E.1.2Term Dedifferentiated liposarcoma
    E.1.2System Organ Class 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    E.1.3Condition being studied is a rare disease Yes
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    Phase 2 (now complete):
    Assess and compare PFS of patients with advanced unresectable DDLS treated with selinexor (60 mg) or placebo twice weekly. Progression will be defined by disease progression according to RECIST v. 1.1 (Eisenhauer 2009), or by death due to any cause

    Phase 3:
    Assess and compare PFS of patients with advanced unresectable DDLS treated with selinexor (60 mg) or placebo twice weekly. PFS is defined as time from date of randomization until the first date of progression per RECIST v. 1.1, or death due to any cause. Evaluation of the radiographic data for the PFS primary endpoint will be based on data from a scan review by the independent central reader.
    Obiettivo primario della Fase 2 (ora completata):
    Valutare e raffrontare la PFS dei pazienti affetti da DDLS avanzato non resecabile con selinexor (60 milligrammi [mg] o placebo bisettimanale. La PFS sarà definita dalla progressione della malattia secondo i RECIST v. 1.1 (Eisenhauer 2009), o dal decesso dovuto a qualsiasi causa.

    Obiettivo primario della Fase 3
    Valutare e confrontare la PFS dei pazienti con DDLS avanzato non resecabile trattato con selinexor (60 mg) o placebo due volte la settimana. La PFS è definita come il tempo dalla data di randomizzazione alla prima data di progressione secondo i RECIST v. 1.1, o al decesso dovuto a qualsiasi causa. La valutazione dei dati radiografici per l’endpoint primario della PFS sarà basata sui dati delle scansioni esaminati da un revisore centrale indipendente.
    E.2.2Secondary objectives of the trial
    Phase 2 (now complete, refer to protocol for Phase 2 secondary objectives).

    Phase 3:
    • Assess Overall Survival (OS), measured from date of randomization until death due to any cause.
    • Compare TTP on study treatment, per RECIST v. 1.1, with TTP on the patient’s last prior systemic therapy.
    • Assess Quality of Life (QoL) and patient-reported outcomes as measured by the European Organization for Research and Treatment of Cancer (EORTC) Quality of-Life Questionnaire (QLQ-C30) and the EuroQoL Group Health Questionnaire (EQ-5D-5L).
    • Determine the ORR, supported by DOR. Responses will be defined by RECIST v. 1.1.
    • Assess PFS according to the Investigator based on clinical and/or radiologic criteria.
    • Assess safety of each treatment arm
    Obiettivi secondari della Fase 2 (ora completata, prego riferirsi alla sinossi)

    Obiettivi secondari della Fase 3
    Valutare la Sopravvivenza Globale (OS), misurata dalla data di randomizzazione fino al decesso dovuto a qualsiasi causa.
    Confrontare il TTP del trattamento sperimentale, secondo i RECIST v. 1.1, con il TTP dell’ultima previa terapia sistemica del paziente.
    Valutare la Qualità della Vita (QoL) e gli esiti riferiti dai pazienti secondo i criteri applicati per il Questionario sulla Qualità della Vita (QLQ-C30) della European Organization for Research and Treatment of Cancer (EORTC) e il Questionario dell’EuroQoL Group Health (EQ-5D-5L).
    Determinare l’ORR, supportato dalla DOR. Le risposte saranno definite secondo i RECIST v. 1.1.
    Valutare la PFS in conformità con il Ricercatore in base a criteri clinici e/o radiologici.
    Valutare la sicurezza di ciascun braccio del trattamento.
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    Patients eligible for inclusion in this study must meet all of the following criteria:
    1. Written informed consent in accordance with national, local, and institutional guidelines obtained prior to any screening procedures
    2. Must be willing and able to comply with the protocol
    3. Patients = 12 years of age
    4. Patients with a BSA = 1.2 m2 as calculated per Dubois 1916 or Mosteller 1987
    5. Histologic evidence of DDLS at any time prior to randomization AND current evidence of DDLS requiring treatment:
    • This information will be provided based on prior diagnostic testing and is required for randomization.
    • Tissue (fresh or archival) will be provided for confirmatory histology at a central laboratory but confirmatory results are not required prior to randomization.
    • If archival tissue > 12 months old, the quality of the sample for confirmatory histology must be confirmed by the site histopathologist prior to randomization.
    6. Must have measurable disease according to:
    • The bidimensional WHO Response Criteria (Miller 1981) (Phase 2 patients only)
    • RECIST v. 1.1 (Eisenhauer 2009)(Phase 3 patients only)
    7. Radiologic evidence of progressive disease (PD) within 6 months prior to randomization. If the patient received other intervening therapy after PD is documented, further PD must be documented after the completion of the intervening therapy.
    8. Must have received at least 2 but no more than 5 prior systemic therapies for the treatment of liposarcoma.
    9. Patients should have recovered from all major surgery, radiation or other interventions = 21 days prior to randomization. Patients must have recovered from any clinically significant therapy-related toxicity to = Grade 1 per CTCAE v. 4.03. Minor procedures, such as biopsies, dental work, or placement of a port or intravenous line for infusion, are permitted.
    10. If patients received any previous systemic therapy, the last dose must have been = 21 days prior to randomization (or = 5 half-lives of that drug [whichever is shorter]), with all clinically significant therapy-related toxicities having resolved to = Grade 1 CTCAE v. 4.03.
    11. ECOG performance status = 1 (Oken 1982)
    12. Adequate laboratory functional values:
    • Adequate hematopoietic function:
    o Absolute neutrophil count (ANC) = 1500/mm3
    o Platelets = 100,000/mm3
    o Hemoglobin (Hb) = 9 g/dL at baseline
    o Transfusions, hematopoietic growth factors, and hematinics are NOT permitted during screening
    • Adequate hepatic function:
    o Bilirubin = 1.5 x upper limit of normal (ULN) (except patients with Gilbert’s syndrome [hereditary indirect hyperbilirubinemia] who must have a total bilirubin of = 3 x ULN)
    o Alkaline phosphatase (ALP), aspartate aminotransferase (AST), and alanine aminotransferase (ALT) < 3.0 x ULN (except patients with liver involvement of their liposarcoma who must have an AST and ALT = 5 x ULN).
    • Adequate renal function: estimated creatinine clearance of = 50 mL/min, calculated using the Cockcroft and Gault formula (140 – Age) • Mass (kg)/ (72 • creatinine mg/dL); multiply by 0.85 if female (Cockcroft 1976).
    13. Female patients of childbearing potential must agree to use two methods of contraception (including one highly effective and one effective method of contraception [as defined in Section 12.2.5.3]) and have a negative serum pregnancy test at Screening. Male patients must use an effective barrier method of contraception if sexually active with a female of childbearing potential. For both male and female patients, effective methods of contraception must be used throughout the study and for 3 months following the last dose of study treatment.
    I soggetti eleggibili per l’inclusione in questo studio devono presentare tutti i seguenti criteri:
    1. Consenso informato scritto in accordo con le linee guida nazionale, locali e istituzionali ottenuto prima di qualsiasi procedura dello screening
    2. Volontà e capacità di attenersi al protocollo
    3. Pazienti di età uguale o superiore ai 12 anni
    4. Pazienti con una BSA (Area della superficie corporea) = 1.2 m2 secondo il calcolo con la Dubois o la Mosteller 1987
    5. Evidenza istologica di DDLS in qualsiasi momento precedente alla randomizzazione e corrente evidenza di DDLL che richieda un trattamento:
    - Questa informazione sarà fornita sulla base di una precedente diagnosi ed è richiesta per la randomizzazione
    - Il tessuto (fresco o di archivio) sarà inviato al laboratorio centralizzato per la istologia confirmatoria ma la conferma non sarà necessaria prima della randomizzazione
    - Se il tessuto di archivio è datato > 12 mesi, la qualità del campione per l’istologia confirmatoria deve essere confermata dall’istopatologo del centro prima della randomizzazione
    6. Devono avere malattia misurabile secondo:
    - I criteri di risposta bidimensionali WHO (Miller 1981) (Per i soli pazienti della fase 2)
    - I Criteri RECIST v. 1.1 (Eisenhauer 2009)( Per i soli pazienti della fase 3)
    7. Evidenza radiologica di malattia progressiva (PD) entro 6 mesi dalla randomizzazione. Se i Pazienti avessero ricevuto altri trattamenti dopo la progessione, si dovrà documentare una progressione successiva al termine di tale trattamento.
    8. Devono aver ricevuto almeno 2 ma non più di 5 trattamenti sistemici precedenti per il trattamento del liposarcoma
    9. I pazienti devono essersi ristabiliti da tutte le chirurgie importanti, radiazioni o altri trattamenti almeno = 21 giorni prima della randomizzazione. I Soggetti dovranno aver risolto tutte le tossicità significative dovute alla terapia a = Grado 1 secondo i CTCAE v. 4.03. procedure minori, come biopsie, cure dentali, o il posizionamento di un port per la linea di infusione, sono permessi.
    10. Se i pazienti hanno ricevuto qualsiasi terapia sistemica precedente, l’ultima dose deve essere stata somministrata = 21 giorni prima della randomizzazione (o = 5 emivite di quel farmaco – qualunque sia il più breve), con risoluzione di tutte le tossicità clinicamente significative dovute alla terapia a = Grado 1 secondo i CTCAE v. 4.03.
    11. ECOG performance status = 1 (Oken 1982)
    12. Valori funzionali di laboratorio adeguati:
    - Adeguata funzione ematopoietica: Conta Assoluta dei Neutrofili (ANC) = 1500/mm3; Piastrine = 100,000/mm3; Emoglobina (Hb) = 9 g/dL al basale; Transfusioni, fattori di crescita ematopoietici , e ematinici non sono permessi durante lo screening
    - Funzionalità epatica adeguata:
    Bilirubina = 1.5 x il limite superirore di normalità (ULN) (eccetto soggetti con la sindrome di Gilbert [iperbilirubinemia indiretta ereditaria] che devono avere una bilirubina totale = 3 x ULN); Fosfatasi Alcalina (ALP), Aspartato Aminotransferasi (AST), ed Alanina Aminotransferasi (ALT) < 3.0 x ULN (eccetto pazienti con un coinvolgimento epatico del loro liposarcoma che devono avere AST e ALT = 5 x ULN).
    - Adeguata funzionalità renale: clearance della creatinina stimata = 50 mL/min, calcolata usando la formula Cockcroft e Gault (140 – Età) x Massa (kg)/ (72 x creatinina mg/dL); multiplicare per 0.85 se femmina (Cockcroft 1976).
    13. Soggetti di sesso femminile in età potenzialmente fertile devono acconsentire ad utilizzare 2 metodi di contraccezione (comprendendo un metodo di contraccezione altamente efficace e uno efficace, come definito nella sezione 12.2.5.3. del protocollo) e avere un test fi gravidanza negativo sul siero allo screening. Soggetti di sesso maschile devono utilizzare un metodo a barriera efficace se attivi sessualmente con una partner femmina potenzialmente fertile. Sia per le femmine che per i maschi, i metodi efficaci di contraccezione devono essere utilizzati nel corso dello studio e per i 3 mesi successivi all’ultima dose di farmaco in studio.
    E.4Principal exclusion criteria
    Patients meeting any of the following exclusion criteria are not eligible to enroll in this study:
    1. Patients with liposarcoma of pure WDLS, myxoid/round cell or pleomorphic tumor histologic subtypes.
    2. Significant cardiovascular impairment, defined as:
    a. Cardiac failure, New York Heart Association (NYHA) Class = 3 according to the NYHA Functional Classification
    b. Unstable angina or myocardial infarction within 3 months of enrollment
    c. Serious and potentially life-threatening arrhythmia.
    3. Patients with known central nervous system metastases.
    4. Female patients who are pregnant or nursing.
    5. Prior malignancy that required treatment, or has shown evidence of recurrence (except for non melanoma skin cancer or adequately treated cervical carcinoma in situ) during the 5 years prior to randomization. Cancer treated with curative intent > 5 years prior to randomization and without evidence of recurrence is allowed.
    6. Known active Hepatitis B (HepB), Hepatitis C (HepC) or human immunodeficiency virus (HIV) infection. Note: (HepB, HepC, or HIV testing is not required as part of this study).
    7. Any medical condition, such as an uncontrolled infection or uncontrolled diabetes mellitus (Type 2), which in the opinion of the Investigator would make study involvement unreasonably hazardous
    8. Psychiatric illness that would prevent the patient from giving informed consent or being compliant with the study procedures
    9. Patients unable to swallow tablets, patients with malabsorption syndrome, or any other GI disease or GI dysfunction that could interfere with absorption of study treatment
    10. Inability or unwillingness to take supportive medications such as anti-nausea and anti-anorexia agents as recommended by the NCCN CPGO for antiemesis and anorexia/cachexia (palliative care).
    11. Patients who had involuntary weight loss of = 10% in the 3 months prior to randomization.
    12. Participation in an investigational anticancer study = 21 days prior to randomization.
    I soggetti che presentano qualsiasi dei seguenti criteri di esclusione non sono eleggibili per questo studio:
    1. Pazienti con Liposarcoma puro WDLS, o i sottotipi istologici MLS, RCL o a pleomorfo.
    2. Compromissione cardiovascolare significativa, definita come:
    - Scompenso cardiaco di classe = 3 secondo la classificazione (NHYA) New York Heart Association;
    - Angina instabile o infarto del miocardio entro 3 mesi dall’arruolamento;
    - Aritmie serie e potenzialmente a rischio di vita.
    3. Pazienti con metastasi note al sistema nervoso centrale.
    4. Pazienti di sesso femminile che siano in gravidanza o stiano allattando.
    5. Precedenti tumori che richiedano trattamenti, o che abbiano mostrato segni di ricaduta entro i 5 anni dalla randomizzazione (eccetto per il cancro alla pelle non melanoma o carcinoma della cervice in situ adeguatamente trattato. Il tumore trattato con intento curativo > 5 anni prima della randomizzazione e senza segni di ricaduta sono ammessi.
    6. Infezione attiva nota per Epatite B, Epatite C, o da virus dell’immunodeficienza (HIV). Nota: test per HepB, HepC, o HIV non sono richiesti come parte di questo studio.
    7. Qualsiasi condizione medica, quale infezioni non controllate o diabete mellito di tipo 2 non controllato, che in base all’opinione dello Sperimentatore potrebbe rendere la partecipazione nello studio irragionevolmente rischioso.
    8. Malattie psichiatriche che impedirebbero al paziente di dare un consenso informato o di seguire le procedure dello studio.
    9. Pazienti incapaci di deglutire capsule, pazienti con sindrome di malassorbimento, o qualsiasi altra malattia o disfunzione gastrointestinale che potrebbero interferire con l’assorbimento del farmaco in studio.
    10. Incapacità o non volontà di assumere farmaci di supporto come anti-emetici o anti-anoressici come da raccomandazione dal NCCN CPGO per antiemesi e anoressia/cachessia (cure palliative).
    11. Pazienti che abbiano una calo ponderale involontario = 10% nei 3 mesi precedenti la randomizzazione.
    12. La partecipazione in uno studio con un farmaco sperimentale antitumorale = 21 giorni prima della randomizzazione.
    E.5 End points
    E.5.1Primary end point(s)
    - Progression-free survival (PFS), measured from date of randomization until the first date of PD, per RECIST v. 1.1, or death due to any cause.
    • Patients who have clinical progression: documented by radiographic imaging;
    • Phase 2 PFS data informed the final Phase 3 design and sample size.
    - Sopravvivenza libera da malattia (PFS), misurata dalla data della randomizzazione alla data della prima progressione (RECIST v 1.1), o morte per qualsiasi causa.
    - Progressione clinica: documentata da immagini radiografiche;
    - I dati della PFS della Fase I, contribuiranno a determinare il disegno della Fase 3 e la dimensione del campione.
    E.5.1.1Timepoint(s) of evaluation of this end point
    Phase 2: The primary endpoint analysis has been completed.
    Phase 3: The primary endpoint analysis will be performed approximately 12 months after enrollment of the last patient, once 209 PFS events have occurred, at which time all Phase 3 patients will be evaluable for assessment of the primary endpoint.
    Fase 2: L'analisi dellìendpoint primario è stato completata.
    Fase 3: L'analisi dell'endpoint primario verrà condotta approssimativamente 12 mesi dopo l'arruolamento dell'ultimo paziente, una volta raggiunti dati di 209 PFS, a quel punto, tutti i soggetti di Fase 3 verranno valutati per la determinzaione dell' endpoint primario.
    E.5.2Secondary end point(s)
    - OS for non-inferiority, measured from date of randomization until death due to any cause, for all randomized patients. Patients who are alive at the time of the analysis will be censored for survival at the date of the last contact.
    • OS for superiority, measured from date of randomization until death due to any cause, for all randomized patients. Patients who are alive at the time of the analysis will be censored for survival at the date of the last contact.
    • TTP, defined as duration of time from date of first dose of study treatment to date of PD or death due to disease progression, per RECIST v. 1.1. Patients who remain progression free (whether they withdrew from the study or reached their maximum follow-up) will be censored at the date of their last disease assessment.
    • ORR, defined as the proportion of patients who achieve complete response (CR) or partial response (PR), per RECIST v. 1.1.
    • DOR, defined as the duration of time from first occurrence of CR or PR until the first date of recurrence of disease per RECIST v. 1.1. Patients will be censored for DOR at the date of last assessment if they have reached maximum follow up without PD (or are lost to follow-up without PD).
    • Tumor glucose metabolism, density, and size using FDG-PET (Phase 2 only) and CT (diagnostic) after 6 weeks of treatment.
    • PFS according to the Investigator, measured from the date of randomization until the first date of PD as defined by the Investigator based on clinical and/or radiologic criteria.
    • QoL as measured by the EORTC QLQ-C30 total score and EuroQoL EQ 5D 5L category scores and total score.
    • Safety and tolerability will be evaluated by AE reports, physical examination, Eastern Cooperative Oncology Group (ECOG) Performance Status, and laboratory evaluations. The CTCAE, v. 4.03, will be used for grading of AEs. Investigators will provide assessment of causality for all AEs as either related or not related to study treatment. An independent DSMB will review study safety, including any SAEs that occur.
    • OS for non-inferiority, measured from date of randomization until death due to any cause, for all randomized patients. Patients who are alive at the time of the analysis will be censored for survival at the date of the last contact.
    • OS for superiority, measured from date of randomization until death due to any cause, for all randomized patients. Patients who are alive at the time of the analysis will be censored for survival at the date of the last contact.
    • TTP, defined as duration of time from date of first dose of study treatment to date of PD or death due to disease progression, per RECIST v. 1.1. Patients who remain progression free (whether they withdrew from the study or reached their maximum follow-up) will be censored at the date of their last disease assessment.
    ; - Sopravvivenza Globale per non inferiorità (OS), misurata dalla data della randomizzazione alla data della morte per qualsiasi causa per tutti i pazienti randomizzati. I Pazienti che saranno vivi al termine dell’analisi, verranno censiti per la sopravvivenza alla data dell’ultimo contatto.
    - Sopravvivenza Globale per superiorità (OS), misurata dalla data della randomizzazione alla data della morte per qualsiasi causa per tutti i pazienti randomizzati. I Pazienti che saranno vivi al termine dell’analisi, verranno censiti per la sopravvivenza alla data dell’ultimo contatto.
    - Tempo alla progressione (TTP) definito come il tempo dalla data della prima dose di farmaco in studio alla data della prima progressione (RECIST v 1.1). Pazienti che rimangono liberi da progressione (se interrompono il trattamento o raggiungono il loro massimo follow up) saranno censiti alla data della loro ultima valutazione di malattia.
    - Tasso di risposta globale (ORR) definita come la proporzione di pazienti con risposta completa (CR) o risposta parziale (PR) per RECIST v1.1.
    - Durata di risposta globale (DOR) definita come il tempo dalla prima risposta completa (CR) o risposta parziale (PR) alla data della prima ricaduta di malattia per RECIST v1.1. I pazienti che non abbiamo progressione, verranno censiti per DOR alla data dell’ultima valutazione se hanno raggiunto il massimo follow up senza PD o se sono persi al Fup senza aver PD.
    - Metabolismo del glucosio nelle cellule tumorali, densità e misura utilizzando la FDG-PET (solo sui pazienti di fase 2) e TAC dopo 6 settimane di trattamento.
    - Sopravvivenza libera da malattia (PFS), su valutazione dello Sperimentatore, misurata dalla data della randomizzazione alla data della prima progressione come da definizione dello Sperimentatore in base a criteri clinici o radiologici.
    - Punteggio totale ai questionari di qualità della vita misurati tramite EORTC QLQ-C30 e il punteggio totale di categoria secondo l’ EuroQoL EQ 5D 5L.
    - Sicurezza e tollerabilità tramite registrazione degli eventi avversi, esame fisico, punteggio ECOG, valutazioni di laboratorio. Gli eventi verranno graduati secondo CTCAE, v. 4.03. Gli Sperimentatori dovranno fornire la causa di tutti gli Eventi avversi, sia correlati che non correlati al farmaco in studio. I dati verranno rivisti dal Data Safety Monitoring Board, compresi qualsiasi Evento Avverso Serio.
    E.5.2.1Timepoint(s) of evaluation of this end point
    End of study
    End of study; Fine dello studio
    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 No
    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 No
    E.6.11Pharmacogenomic Yes
    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) Yes
    E.7.4Therapeutic use (Phase IV) No
    E.8 Design of the trial
    E.8.1Controlled Yes
    E.8.1.1Randomised Yes
    E.8.1.2Open No
    E.8.1.3Single blind No
    E.8.1.4Double blind Yes
    E.8.1.5Parallel group No
    E.8.1.6Cross over No
    E.8.1.7Other Yes
    E.8.1.7.1Other trial design description
    Prego riferirsi al protocollo riguardo le differenti fasi del protocollo (La Fase 2 è ora completata
    Refer to protocol regarding different phases (Phase 2 is now complete).
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) No
    E.8.2.2Placebo Yes
    E.8.2.3Other No
    E.8.2.4Number of treatment arms in the trial2
    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 concerned3
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA24
    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 Information not present in EudraCT
    E.8.6.3If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned
    Canada
    Israel
    United States
    Belgium
    France
    Germany
    Poland
    Spain
    United Kingdom
    E.8.7Trial 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
    LVLS
    LVLS
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years1
    E.8.9.1In the Member State concerned months9
    E.8.9.1In the Member State concerned days0
    E.8.9.2In all countries concerned by the trial years2
    E.8.9.2In all countries concerned by the trial months8
    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 Yes
    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) Yes
    F.1.1.6.1Number of subjects for this age range: 10
    F.1.2Adults (18-64 years) Yes
    F.1.2.1Number of subjects for this age range: 135
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 134
    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 state22
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 110
    F.4.2.2In the whole clinical trial 279
    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)
    Patients will remain on treatment until disease progression, another withdrawal criteria is met or until death. After stopping study treatment patients will be followed up for survival and their own doctor will manage any further treatment.
    I soggetti rimarranno in trattamento fino a progressione della malattia, o fino a che sopraggiunga un altro criterio di interruzione o fino al decesso. Al termine del trattamento i soggetti verranno seguiti per la sopravvivenza e il loro medico gestirà eventuali trattamenti futuri.
    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 Decision2018-06-05
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2018-04-23
    P. End of Trial
    P.End of Trial StatusOngoing
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