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    Summary
    EudraCT Number:2015-004060-11
    Sponsor's Protocol Code Number:0403
    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:2016-02-17
    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 number2015-004060-11
    A.3Full title of the trial
    FORWARD1: A Randomized, Open Label Phase 2 Study to Evaluate the Safety and Efficacy of Mirvetuximab Soravtansine (IMGN853) Versus Investigator?s Choice of Chemotherapy in Adults with Folate Receptor ??positive Advanced Epithelial Ovarian Cancer, Primary Peritoneal Cancer or Primary Fallopian Tube Cancer
    FORWARD1: estudio abierto de fase II aleatorizado para evaluar la seguridad y la eficacia de mirvetuximab soravtansina (IMGN853) frente a la elección del investigador de quimioterapia en adultos con cáncer de las trompas de Falopio, cáncer peritoneal primario o cáncer epitelial de ovario avanzado positivo para el receptor alfa de folato
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    A study to test mirvetuximab soravtansine (IMGN853) aganist doctor's choice of cancer medicines in adults with epithelial ovarian cancer, primary peritoneal cancer or primary fallopian tube cancer
    Un estudio para probar irvetuximab soravtansina (IMGN853) frente a los medicamentos que elija el médico en pacientes con cáncer epitelial de ovario, cáncer peritoneal primario o cáncer de las trompas de Falopio
    A.4.1Sponsor's protocol code number0403
    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 SponsorImmunoGen, 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 supportImmunoGen, Inc.
    B.4.2CountryUnited States
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationImmunoGen, Inc.
    B.5.2Functional name of contact pointMarissa Volpe
    B.5.3 Address:
    B.5.3.1Street Address830 Winter Street
    B.5.3.2Town/ cityWaltham
    B.5.3.3Post codeMA 02451
    B.5.3.4CountryUnited States
    B.5.4Telephone number+34932746085
    B.5.5Fax number1781895 0612
    B.5.6E-mailmarissa.volpe@immunogen.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 Yes
    D.2.5.1Orphan drug designation numberEU/3/15/1458
    D.3 Description of the IMP
    D.3.1Product nameMirvetuximab soravtansina
    D.3.2Product code IMGN853
    D.3.4Pharmaceutical form Concentrate 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 INNMirvetuximab Soravtansina
    D.3.9.1CAS number 1453084-37-1
    D.3.9.2Current sponsor codeIMGN853
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeup to
    D.3.10.3Concentration number5
    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) No
    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.IMP: 2
    D.1.2 and D.1.3IMP RoleComparator
    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 Caelyx 2 mg/ml concentrado para solución para perfusión
    D.2.1.1.2Name of the Marketing Authorisation holderJanssen-Cilag International N.V.
    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 nameDoxorubicina clorhidrato en una formulación liposomal pegilada
    D.3.4Pharmaceutical form Concentrate 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 INNDoxorubicina clorhidrato
    D.3.9.1CAS number 25316-40-9
    D.3.9.3Other descriptive nameDoxorubicina clorhidrato
    D.3.9.4EV Substance CodeSUB01827MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number2
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 3
    D.1.2 and D.1.3IMP RoleComparator
    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 Paclitaxel
    D.2.1.1.2Name of the Marketing Authorisation holderAccord Healthcare S.L.U.
    D.2.1.2Country which granted the Marketing AuthorisationSpain
    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 namePaclitaxel
    D.3.4Pharmaceutical form Concentrate 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 INNPACLITAXEL
    D.3.9.1CAS number 33069-62-4
    D.3.9.3Other descriptive namePaclitaxel
    D.3.9.4EV Substance CodeSUB09583MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number6
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 4
    D.1.2 and D.1.3IMP RoleComparator
    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 Gemcitabine
    D.2.1.1.2Name of the Marketing Authorisation holderAccord Healthcare S.L.U.
    D.2.1.2Country which granted the Marketing AuthorisationSpain
    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 nameGemcitabina
    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 INNGEMCITABINA
    D.3.9.1CAS number 95058-81-4
    D.3.9.4EV Substance CodeSUB07892MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number100
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.IMP: 5
    D.1.2 and D.1.3IMP RoleComparator
    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 Topotecan
    D.2.1.1.2Name of the Marketing Authorisation holderAccord Healthcare S.L.U.
    D.2.1.2Country which granted the Marketing AuthorisationSpain
    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 nameTopotecan
    D.3.4Pharmaceutical form Concentrate 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 INNTOPOTECAN
    D.3.9.1CAS number 123948-87-8
    D.3.9.4EV Substance CodeSUB11191MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number1
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.8 Information on Placebo
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    Advanced Epithelial Ovarian Cancer, Primary Peritoneal Cancer or Primary Fallopian Tube Cancer
    cáncer epitelial de ovario avanzado, cáncer peritoneal primario ó cáncer primario de las trompas de Falopio,
    E.1.1.1Medical condition in easily understood language
    Cancer of ovary and related organs
    cáncer de ovario y órganos relacionados
    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 10061269
    E.1.2Term Malignant peritoneal neoplasm
    E.1.2System Organ Class 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 18.1
    E.1.2Level PT
    E.1.2Classification code 10061328
    E.1.2Term Ovarian epithelial cancer
    E.1.2System Organ Class 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 18.1
    E.1.2Level PT
    E.1.2Classification code 10016180
    E.1.2Term Fallopian tube 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 Yes
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    Stage 1:
    -To determine the safety and anti-tumor activity of IMGN853 administered every 3 weeks and every 4 weeks
    -To select the schedule of IMGN853 to continue in Stage 2

    Stage 2:
    -To compare the objective response rate (ORR) of patients with EOC, primary peritoneal cancer or fallopian tube cancer randomized to IMGN853 or selected standard of care chemotherapy
    Etapa 1:
    - Determinar la seguridad y la actividad antitumoral de IMGN853 administrado cada tres semanas y cada cuatro semanas
    - Seleccionar la pauta de IMGN853 para continuar en la Etapa 2
    Etapa 2:
    - Comparar la tasa de respuesta objetiva (TRO) de los pacientes con CEO, cáncer peritoneal primario o cáncer de las trompas de Falopio primario aleatorizadas a IMGN853 o quimioterapia de referencia seleccionada
    E.2.2Secondary objectives of the trial
    Stage 1:
    ?To evaluate the pharmacokinetics of IMGN853
    ?Assess the immunogenicity of IMGN853 (Anti-drug antibodies, ADA)
    ?Assess the quality of life using the Fact-O Questionnaire

    Stage 2:
    ?To compare the safety and tolerability of IMGN853 with that of selected standard of care chemotherapy
    ?To compare the progression free survival (PFS), overall survival (OS), duration of response (DOR) of patients randomized to IMGN853 or selected standard of care chemotherapy
    ?To evaluate the pharmacokinetics of IMGN853
    ?Assess the immunogenicity of IMGN853(Anti-drug antibodies, ADA)
    ?Assess the quality of life using the Fact-O Questionnaire
    Etapa 1:
    -Evaluar la farmacocinética de IMGN853
    -Evaluar la inmunogenia de IMGN853 (anticuerpos antifármaco, AAF)
    -Evaluar la calidad de vida mediante el cuestionario de evaluación funcional del tratamiento del cáncer de ovario

    Etapa 2:
    -Comparar la seguridad y la tolerabilidad de IMGN853 con las de la quimioterapia de referencia seleccionada
    -Comparar la supervivencia sin progresión (SSP), la supervivencia global (SG) y la duración de la respuesta (DDR) de los pacientes aleatorizados a IMGN853 o quimioterapia de referencia
    seleccionada
    -Evaluar la farmacocinética de IMGN853
    -Evaluar la inmunogenia de IMGN853 (anticuerpos antifármaco, AAF)
    -Evaluar la calidad de vida mediante el cuestionario de evaluación funcional del tratamiento del cáncer de ovario
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1. Patients must have one of the following pathologically documented, definitively diagnosed tumor types:
    a. Advanced EOC
    b. Primary peritoneal cancer
    c. Fallopian tube cancer
    2. Patients must have at least one lesion that meets the definition of measurable according to RECIST v1.1.
    3. Patients must have received at least three but not more than four prior systemic treatment regimens
    a. Adjuvant +/- Neoadjuvant will be considered as one regimen
    b. Maintenance therapy will be considered to be part of the preceding regimen
    4. Patients must be willing to provide an archival tumor tissue block or slides, or fresh biopsy. Eligibility is determined based on the IHC performed on the archival tumor tissue. If archival tisuue is not available, then a fresh tumor biopsy, collected using a non significant risk procedure, may be used in place of archival tumor tissue. Patients who do not have archival tisuue and for whom the only sites of disease would require biopsy procedure considered to be of significant risk, must not be enrolled in the study.
    5. Patients must have confirmation of FR? positivity by IHC (> 50% of tumor staining at >2+ intensity).
    6. > or = 18 years of age
    7. Eastern Cooperative Oncology Group (ECOG) performance status (PS) 0 or 1
    8. Time from prior therapy:
    a. Systemic anti-neoplastic therapy: five half-lives or four weeks, whichever is shorter
    b. Radiotherapy: wide-field radiotherapy (e.g. > 30% of marrow-bearing bones) completed at least four weeks, or focal radiation completed at least two weeks, prior to starting study drug
    9. Patients must have stabilized or recovered (Grade 1 or baseline) from all therapy-related toxicities.
    10. Major surgery (not including placement of vascular access device or tumor punch/scrape biopsies) must be completed four weeks prior to Day 1. Patients must have recovered or stabilized from the side effects prior to study treatment
    11. Patients must have adequate hematologic, liver and kidney function as defined by the following parameters:
    a. Absolute neutrophil count (ANC) > or = 1.5 x 10^9/L (1,500/?L)
    b. Platelet count > or = 100 x 10^9/L (100,000/microL); no transfusion within previous 10 days
    c. Hemoglobin > or = 9.0 g/dL
    d. Serum creatinine ? 1.5 x upper limit of normal (ULN) or 24-hour creatinine clearance of > or = 60 mL/minute
    e. AST < or = 2.5 x ULN; ALT < or = 2.5 x ULN
    f. Serum bilirubin < o = 1.5 x ULN (Patients with documented diagnosis of Gilbert syndrome are eligible if total bilirubin < 3.0 x ULN).
    12. Patients must be willing and able to sign the informed consent form, and to adhere to the study visit schedule and other protocol requirements.
    13. Women of child bearing potential (WCBP), defined as a sexually mature woman who has not undergone surgical sterilization or who has not been naturally postmenopausal for at least 12 consecutive months (i.e., who has had menses any time in the preceding 12 consecutive months) must agree to use effective contraceptive methods (examples include oral, parenteral, or implantable hormonal contraceptive, intra-uterine device, barrier contraceptive with spermicide, partner?s latex condom or vasectomy) while on study treatment and for at least twelve weeks after the last dose of study drug.
    14. WCBP must have a negative pregnancy test prior to the first dose of study treatment.
    1. Los pacientes deben tener uno de los siguientes tipos de tumores diagnosticado definitivamente y confirmado patológicamente:
    a. CEO avanzado
    b. Cáncer peritoneal primario
    c. Cáncer de las trompas de Falopio
    2. Los pacientes deben tener al menos una lesión que cumpla con la definición de medible según RECIST v1.1.
    3. Los pacientes deben haber recibido al menos tres, pero no más de cuatro pautas de tratamiento sistémico anteriormente
    - Adyuvante +/- Neoadyuvante se considerarán una pauta
    - El tratamiento de mantenimiento se considerará parte de una pauta anterior
    4. Los pacientes deben estar dispuestos a facilitar un bloque de tejido tumoral de archivo o cortes histológicos, o una biopsia nueva. La elegibilidad se determina según la inmunohistoquímica
    (IHQ) realizada en el tejido tumoral de archivo. Si no se dispone de tejido de archivo, puede utilizarse una biopsia nueva del tumor, recogida mediante una biopsia sin riesgo significativo, en
    vez de tejido tumoral de archivo (consulte el apartado 7.1). Los pacientes que no tienen tejido de archivo y en los que la enfermedad se encuentra en zonas que requerirían biopsias consideradas
    de riesgo significativo no deben reclutarse en el estudio.
    5. Los pacientes deben tener la confirmación de positividad para el FR-alfa mediante IHQ (> 50% de tinción tumoral a >2+ intensidad)
    6. > o = 18 años de edad
    7. Estado funcional (EF) según el Grupo Oncológico Cooperativo del Este (Eastern Cooperative Oncology Group, ECOG) de 0 o 1
    8. Tiempo de tratamiento previo:
    a. Tratamiento antineoplásico sistémico: cinco semividas o cuatro semanas, lo que sea más corto
    b. Radioterapia: radioterapia de campo amplio (p. ej., > 30% de la médula ósea) finalizada al menos en cuatro semanas, o radiación focal finalizada al menos en dos semanas, antes de empezar con el fármaco del estudio
    9. Los pacientes deben haberse estabilizado o recuperado (Grado 1 o inicio) de la toxicidad asociada al tratamiento
    10. Cirugía mayor (que no incluya la colocación de un dispositivo de acceso vascular o biopsias en sacabocados/ por raspado del tumor) realizada cuatro semanas antes del Día 1. Los pacientes
    deben haberse recuperado o estabilizado de los efectos adversos antes de recibir el tratamiento del estudio
    11. Los pacientes deben tener una función hematológica, hepática y renal adecuada según se define en los siguientes parámetros:
    a. Recuento absoluto de neutrófilos (RAN) > o = 1,5 x 10^9/L (1.500/?l)
    b. Recuento plaquetario ? 100 x 10^9/L (100.000/?l); ninguna transfusión durante los 10 días anteriores
    c. Hemoglobina > o = 9,0 g/dl
    d. Creatinina sérica < o =1,5 x límite superior de la normalidad (LSN) o aclaramiento de creatinina 24 horas > o = 60 ml/minuto
    e. AST < o = 2,5 x LSN; ALT < o = 2,5 x LSN
    f. Bilirrubina sérica < o = 1,5 x LSN (los pacientes con diagnóstico confirmado de síndrome de Gilbert son idóneos si tienen una bilirrubina total < 3,0 x LSN)
    12. Los pacientes deben estar dispuestos y en condiciones de firmar un formulario de consentimiento informado, y cumplir con la programación de las visitas de estudio y otros requisitos del
    protocolo.
    13. Las mujeres en edad fértil (MEF), que se definen como mujeres sexualmente maduras que no se han sometido a una esterilización quirúrgica o mujeres que no han sido postmenopáusicas
    de forma natural durante al menos 12 meses consecutivos (p. ej., que han tenido la menstruación en cualquier momento durante los 12 meses consecutivos anteriores) deben aceptar usar métodos anticonceptivos eficaces (por ejemplo, anticonceptivo hormonal oral, parenteral o implantable, dispositivo intrauterino, anticonceptivo de barrera con espermicida, preservativos de látex o vasectomía para la pareja) mientras reciben el tratamiento del estudio y durante al menos doce semanas después de la última dosis del fármaco del estudio.
    14. Las MEF deben tener una prueba de embarazo negativa antes de recibir la primera dosis del tratamiento del estudio.
    E.4Principal exclusion criteria
    1. Patients with clear cell or low grade ovarian cancer
    2. Patients with > Grade 1 peripheral neuropathy
    3. Active or chronic corneal disorder, including but not limited to the following: Sjogren?s syndrome, Fuchs corneal dystrophy (requiring treatment), history of corneal transplantation, active herpetic keratitis, and also active ocular conditions requiring on-going treatment/monitoring such as wet age-related macular degeneration requiring intravitreal injections, active diabetic retinopathy with macular edema, presence of papilledema, and acquired monocular vision.
    4. Serious concurrent illness or clinically-relevant active infection, including, but not limited to the following:
    a. Known active hepatitis B or C
    b. Human Immunodeficiency Virus (HIV) infection
    c. Varicella-zoster virus (shingles)
    d. Cytomegalovirus infection
    e. Any other known concurrent infectious disease, requiring IV antibiotics within 2 weeks of starting study treatment
    5. Clinically-significant cardiac disease such as recent myocardial infarction (< o = 6 months prior to day 1), unstable angina pectoris, uncontrolled congestive heart failure (New York Heart Association > class II), uncontrolled hypertension (> o = CTCAE v4.03 Grade 3), prior history of hypertensive crisis or hypertensive encephalopathy, uncontrolled cardiac arrhythmias, clinically-significant vascular disease (e.g., aortic aneurysm, or dissecting aneurysm), severe aortic stenosis, clinically significant peripheral vascular disease, or > o =Grade 3 cardiac toxicity following prior chemotherapy
    6. History of multiple sclerosis or other demyelinating disease and/or Eaton-Lambert syndrome (para-neoplastic syndrome)
    7. History of hemorrhagic or ischemic stroke within the last 6 months
    8. History of cirrhotic liver disease
    9. Previous clinical diagnosis of non-infectious pneumonitis
    10. Required use of folate ?containing supplements (e.g. folate deficiency)
    11. Prior hypersensitivity to monoclonal antibodies
    12. Current or recent treatment with another investigational drug within four weeks before first study dose
    13. Prior treatment with IMGN853
    1. Pacientes con cáncer de ovario de células claras o de bajo grado
    2. Pacientes con neuropatía periférica > Grado 1
    3. Enfermedad corneal activa o crónica, que incluye pero no se limita a lo siguiente: síndrome de Sjogren, distrofia corneal de Fuchs (que requiere tratamiento), antecedentes de trasplante de córnea, queratitis herpética activa y, también, afecciones oculares activas que requieren tratamiento continuo/seguimiento como la degeneración macular húmeda relacionada con la edad, que requiere inyecciones intravítreas, la retinopatía diabética activa con edema macular, la presencia de papiledema y la visión monocular adquirida.
    4. Enfermedad concomitante grave o infección activa clínicamente relevante, que incluye pero no se limita a lo siguiente:
    a. Hepatitis B o C activa conocida
    b. Infección por el virus de inmunodeficiencia humana (VIH)
    c. Virus varicela-zóster (herpes)
    d. Infección por citomegalovirus
    e. Cualquier otra enfermedad infecciosa concomitante conocida, que requiera antibióticos i.v. a las 2 semanas de iniciar el tratamiento del estudio
    5. Cardiopatía clínicamente significativa como infarto de miocardio reciente (< o = 6 meses antes del Día 1), angina de pecho inestable, insuficiencia cardíaca congestiva no controlada (Asociación Cardíaca Estadounidense > clase II), hipertensión no controlada (> o = CTCAE v4.03 Grado 3), antecedentes previos de crisis hipertensiva o encefalopatía hipertensiva, arritmias cardíacas no controladas, vasculopatía clínicamente significativa (p.ej., aneurisma aórtico o aneurisma disecante), estenosis aórtica grave, vasculopatía periférica clínicamente significativa o toxicidad cardíaca > o = Grado 3 después del tratamiento con quimioterapia previo.
    6. Antecedentes de esclerosis múltiple u otra enfermedad desmielinizante y/o síndrome de Eaton-Lambert (síndrome paraneoplásico)
    7. Antecedentes de ictus hemorrágico o isquémico en los últimos seis meses
    8. Antecedentes de hepatopatía cirrótica
    9. Diagnóstico clínico previo de neumonía no infecciosa
    10. Necesidad de usar suplementos que contengan folato (p.ej. insuficiencia de folato)
    11. Hipersensibilidad previa a anticuerpos monoclonales
    12. Tratamiento actual o reciente con otro fármaco en estudio en los 30 días antes de la primera dosis de estudio
    13. Tratamiento previo con IMGN853
    E.5 End points
    E.5.1Primary end point(s)
    Stage 1
    Primary Endpoints
    ? Treatment-emergent adverse events and clinically significant ? Grade 3 changes in laboratory test results, physical examination, ECGs or vital signs
    ? Anti-tumor activity as assessed by the number of patients with RECIST 1.1 criteria clinical responses and number of patients with GCIG CA-125 criteria clinical responses
    ? Objective response rate (ORR)
    ? Progression free survival (PFS)
    ? Duration of response (DOR)
    ? Overall Survival (OS)

    Stage 2
    Number of patients with RECIST 1.1 criteria clinical responses and number of patients with GCIG CA-125 criteria clinical responses (Arm 1 and Arm 2)
    ? Objective response rate (ORR)
    Etapa 1:
    Variable principal:
    - acontecimientos adversos surgidos durante el tratamiento y clínicamente significativos de grado 3 o superior que sean relacionados con cambios en resultados de analíticas, exploración física, ECG o constantes vitales
    - actividad antitumoral evaluada según el número de pacientes con respuesta clínica según RECIST 1.1 y el número de pacientes que cumplan criterios de respuesta clínica según GCIG CA-125
    - tasa de respuesta global (TGR)
    - supervivencia sin progresión (SSP)
    - duración de la respuesta (DR)
    - supervivencia global (SG)

    Etapa 2:
    Número de pacientes con respuesta clínica según RECIST 1.1 y número de pacientes (brazos 1 y 2) que cumplan criterios de respuesta clínica según GCIG CA-125
    - tasa de respuesta global (TGR)
    E.5.1.1Timepoint(s) of evaluation of this end point
    Stage 1:
    Treatment-emergent adverse events - At each study visit
    ECG: D1 of C1 and C3, End of Treatment and 30-Day Follow up
    Anti-tumor activity: Evaluation at every 6 weeks (+/- 1 week) for first 24 weeks then every 12 weeks (+/- 1 week)
    CA-125: At day 1 of each cycle and at every 6 weeks (+/- 1 week) for first 24 weeks then every 12 weeks (+/- 1 week)

    Stage 2:
    Anti-tumor activity: Evaluation at every 6 weeks (+/- 1 week) for first 24 weeks then every 12 weeks (+/- 1 week)
    CA-125: At day 1 of each cycle and at every 6 weeks (± 1 week) for first 24 weeks then every 12 weeks (+/- 1 week)
    Etapa 1:
    acontecimientos adversos surgidos durante el tratamiento - en todas las visitas
    ECG: día 1 de los ciclos 1 y 3, final de tratamiento y seguimiento a los 30 día
    Actividad antitumoral: evaluación cada 6 semanas (+/- 1 semana) durante las primeras 24 semanas. Posteriormente cada 12 semanas (+/- 1 semana)
    CA-125: día 1 de cada ciclo durante 6 semanas (+/- 1 semana) durante las primeras 24 semanas. Posteriormente cada 12 semanas (+/- 1 semana)

    Etapa 2:
    Actividad antitumoral: evaluación cada 6 semanas (+/- 1 semana) durante las primeras 24 semanas. Posteriormente cada 12 semanas (+/- 1 semana)
    CA-125: día 1 de cada ciclo durante 6 semanas (+/- 1 semana) durante las primeras 24 semanas. Posteriormente cada 12 semanas (+/- 1 semana)
    E.5.2Secondary end point(s)
    Stage 1:
    ? PK parameters, such as Cmax, Tmax, AUC, terminal half-life (t½?), clearance (Cl), and volume of distribution at steady state (Vss), for IMGN853 will be calculated if feasible. Otherwise, summary statistics of the concentration of each time point will be presented.
    ? Immunogenicity of IMGN853: Presence of Anti-drug antibodies, ADA
    ? Quality of life as assessed using Fact-O Questionnaire

    Stage 2:
    ? Treatment-emergent adverse events and clinically significant ? Grade 3 changes in laboratory test results, physical examination, ECGs or vital signs
    ? Calculation of time to event parameters
    ? Duration of response (DOR): the time from first objective response (CR/PR) to the time of PD or death among those who have achieved a PR or CR
    ? Progression-free survival (PFS): the time from the date of first dose until the time of death or PD
    ? Overall survival (OS): the time from the date of first dose until the date of death
    ? PK parameters, such as Cmax, Tmax, AUC, t½?, clearance (Cl) and volume of distribution at steady state (Vss), for IMGN853 will be calculated if feasible. Otherwise, summary statistics of the concentration for each time point will be presented.
    ? Immunogenicity of IMGN853: Presence of Anti-drug antibodies, ADA
    ? Quality of life as assessed using Fact-O Questionnaire
    Etapa 1:
    - parámetros farmacocinéticos tales como Cmax, Tmax, ABC, vida media termina, aclaramiento (CI), y volumen de distribución en steady state (Vss), de IMGN853 y se calculará cuando sea posible. Si no lo es, se presentará un resumen estadístico de la concentración en cada punto temporal
    - immunogenicidad a IMGN853: presencia de anticuerpos antimedicamento, ADA
    - calidad de vida según cuestionario FACT-O

    Etapa 2:
    - acontecimientos adversos surgidos durante el tratamiento y clínicamente significativos de grado 3 o superior que sean relacionados con cambios en resultados de analíticas, exploración física, ECG o constantes vitales
    -cálculo de parámetros temporales:
    *duración de la respuesta (DR): tiempo desde la primera respuesta objetiva (RP/RC) hasta progresión o muerte en los pacientes que han alcanzado RP o RC
    *supervivencia sin progresión (SSP): tiempo desde la fecha de la primera dosis hasta la muerte o progresión
    *supervicencia global (OS): tiempo desde la primera dosis hasta la muerte
    - parámetros farmacocinéticos tales como Cmax, Tmax, ABC, vida media termina, aclaramiento (CI), y volumen de distribución en steady state (Vss), de IMGN853 y se calculará cuando sea posible. Si no lo es, se presentará un resumen estadístico de la concentración en cada punto temporal
    - immunogenicidad a IMGN853: presencia de anticuerpos antimedicamento, ADA
    - calidad de vida según cuestionario FACT-O
    E.5.2.1Timepoint(s) of evaluation of this end point
    Stage 1:
    PK parameters: C1 (D1, D8 and D15), C2 (D1), C3 (D1, D8 and D15), C4 (D1), End of Treatment and 30-Day Follow up
    Immunogenicity: C1, C2 , C4 and C6 (D1), End of Treatment and 30 Day Follow up
    Quality of Life: C1 (D1) and C ?4 every 12 weeks and End of Treatment

    Stage 2:
    Treatment-emergent adverse events - At each study visit; ECG: D1 of C1 and C3, End of Treatment and 30-Day Follow up
    Anti-tumor activity: Evaluation at every 6 weeks (± 1 week) for first 24 weeks then every 12 weeks (± 1 week);
    CA-125: At day 1 of each cycle and at every 6 weeks (± 1 week) for first 24 weeks then every 12 weeks (± 1 week)
    PK parameters: Same as above
    Immunogenicity: Same as above
    Quality of Life: Same as above
    Etapa 1:
    parámetros FC:Ciclo 1 (días 1, 8 y 15), ciclo 2 día 1, ciclo 3 (días 1, 8 y 15), ciclo 4 día 1, final de tratamiento y seguimiento a los 30 días
    Immunogenicidad:ciclos 1, 2, 4 y 6 (día 1), final tratamiento y seguimiento a 30 días
    Calidad vida:Ciclo2 día 1 y del ciclo 4 en adelante cada 12 semanas y final de tratamiento
    Etapa 2:
    acontecimientos adversos durante el tratamiento:en cada visita; ECG: día 1 del ciclo 1 y 3, final de tratamiento y seguimiento a 30 días
    Actividad antitumoral:cada 6 semanas (+/- 1 sem) durante las primeras 24 semanas.Después cada 12 semanas (+/- 1 sem)
    CA-125:día 1 de cada ciclo durante 6 semanas (+/- 1 sem) durante las primeras 24 semanas. Posteriormente cada 12 semanas (+/- 1 sem)
    parámetros FC, Immunogenicidad calidad vida : como en etapa 1
    E.6 and E.7 Scope of the trial
    E.6Scope of the trial
    E.6.1Diagnosis No
    E.6.2Prophylaxis No
    E.6.3Therapy Yes
    E.6.4Safety Yes
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic Yes
    E.6.7Pharmacodynamic Yes
    E.6.8Bioequivalence No
    E.6.9Dose response Yes
    E.6.10Pharmacogenetic 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) No
    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 Yes
    E.8.1.3Single blind No
    E.8.1.4Double blind No
    E.8.1.5Parallel group No
    E.8.1.6Cross over No
    E.8.1.7Other No
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) Yes
    E.8.2.2Placebo No
    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 concerned6
    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
    Belgium
    France
    Germany
    Italy
    Netherlands
    Poland
    Spain
    United Kingdom
    United States
    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
    End of study is defined as the date when the last patient on study has withdrawn or been discontinued from the study and all necessary follow up visits have been completed in order to complete safety and anti-tumor activity assessments.
    Se define el final del estudio como la fecha en la que se retire el último paciente del estudio o se detenga el estudio y todas las visitas de seguimiento se hayan realizado para completar las evaluaciones de seguridad y de actividad antitumoral
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years
    E.8.9.1In the Member State concerned months48
    E.8.9.1In the Member State concerned days
    E.8.9.2In all countries concerned by the trial months48
    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: 150
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 97
    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 Yes
    F.3.3.6.1Details of subjects incapable of giving consent
    If the patient is not able to give consent, the patient's legally authorized representative may give consent.
    Si el paciente no es capaz de dar el consentimeinto, el representante legal autorizado lo dará
    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 80
    F.4.2.2In the whole clinical trial 247
    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)
    Standard of care
    tratamiento habitual
    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 Decision2016-04-25
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2016-04-15
    P. End of Trial
    P.End of Trial StatusCompleted
    P.Date of the global end of the trial2020-01-21
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