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    Summary
    EudraCT Number:2015-004214-14
    Sponsor's Protocol Code Number:P311-201
    National Competent Authority:Spain - AEMPS
    Clinical Trial Type:EEA CTA
    Trial Status:Prematurely Ended
    Date on which this record was first entered in the EudraCT database:2016-07-15
    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 number2015-004214-14
    A.3Full title of the trial
    A Phase 1/2 Dose-escalation of USL311 as Single Agent and in Combination with Lomustine (CCNU) in Subjects with Advanced Solid Tumors, with Subsequent Single Agent and Combination Phase 2 Cohorts for Subjects with Relapsed/Recurrent Glioblastoma Multiforme (GBM).
    Fase I/II con escala de dosis de USL311 en monoterapia y en combinación con lomustina (CCNU) en sujetos con tumores sólidos avanzados, con cohortes posteriores fase II, en monoterapia y en combinación, en sujetos con glioblastoma multiforme (GBM) recidivante/recurrente.
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    A combined phase1/Phase 2 study: In Phase 1 Subjects with Advanced Solid Tumors receive different doses of the new investigational drug USL311 alone or in Combination with Lomustine (CCNU) . In the Subsequent Phase 2 the subjects with Relapsed/Recurrent Glioblastoma Multiforme (GBM) receive fixed doses of USL311 alone or in Combination with Lomustine.
    Un estudio combinado de fase I/II: En la fase I los pacientes con tumores sólidos avanzados reciben diferentes dosis del nuevo medicamento en investigación USL311 solo o en combinación con Lomustina (CCNU). En la subsiguente fase II los pacientes con glioblastoma multiforme (GBM) recidivante/recurrente reciben dosis fijas de USL311 solo o en combinación con Lomustina.
    A.4.1Sponsor's protocol code numberP311-201
    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 SponsorUpsher-Smith Laboratories, 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 supportUpsher-Smith Laboratories, Inc.
    B.4.2CountryUnited States
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationUpsher-Smith Laboratories, Inc.
    B.5.2Functional name of contact pointLindy L. Bancke
    B.5.3 Address:
    B.5.3.1Street Address6701 Evenstad Drive
    B.5.3.2Town/ cityMaple Grove
    B.5.3.3Post codeMN 55369
    B.5.3.4CountryUnited States
    B.5.4Telephone number+1763315 2193
    B.5.5Fax number+1763315 2195
    B.5.6E-maillindy.bancke@upsher-smith.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 nameUSL311
    D.3.2Product code USL311
    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 INNUSL311
    D.3.9.1CAS number 1373268-67-7
    D.3.9.2Current sponsor codeUSL311
    D.3.9.3Other descriptive nameUSL311
    D.3.9.4EV Substance CodeSUB182363
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    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 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: 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 Lomustine
    D.2.1.1.2Name of the Marketing Authorisation holderNextsource Biotechnology
    D.2.1.2Country which granted the Marketing AuthorisationUnited States
    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 nameGLEOSTINE
    D.3.4Pharmaceutical form Capsule
    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 INNLomustine
    D.3.9.1CAS number 13010-47-4
    D.3.9.2Current sponsor codeGleostine
    D.3.9.3Other descriptive nameLOMUSTINE
    D.3.9.4EV Substance CodeSUB08567MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typerange
    D.3.10.3Concentration number10 to 100
    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 Solid Tumors/Relapsed/Recurrent Glioblastoma Multiforme (GBM)
    Tumores sólidos avanzados/ glioblastoma multiforme (GBM) recidivante/recurrente
    E.1.1.1Medical condition in easily understood language
    Advanced form of cancer or a specific type of cancer in the brain
    Forma avanzada de cáncer o un tipo específico de cáncer en el cerebro
    E.1.1.2Therapeutic area Diseases [C] - Cancer [C04]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 19.0
    E.1.2Level LLT
    E.1.2Classification code 10065252
    E.1.2Term Solid tumor
    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 19.0
    E.1.2Level PT
    E.1.2Classification code 10018337
    E.1.2Term Glioblastoma multiforme
    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 1 dose-escalation:
    • Determine the maximum tolerated dose (MTD) and recommended Phase 2 dose (RP2D) of USL311 as a single agent in subjects with advanced solid tumors for which no SoC treatment is recognized or who have failed or are intolerant to the SoC treatment (Part 1).
    • Determine the MTD and RP2D of USL311 in combination with lomustine in subjects with advanced solid tumors for which no SoC treatment is recognized or who have failed or are intolerant to the SoC treatment (Part 2).
    Phase 2 dose-expansion:
    • Determine the percentage PFS-6m of USL311 as a single agent in subjects with relapsed/recurrent GBM who previously received SoC treatment in the first-line setting and who are candidates for re-resection (Part 3).
    • Determine the percentage PFS-6m of USL311 in combination with lomustine in subjects with relapsed/recurrent GBM who previously received SOC treatment in the first-line setting and who are candidates for re-resection (Part 4).
    Fase I escala de dosis: Determinar la DMT y DRFII de USL311 en monoterapia en sujetos con tumores sólidos avanzados para los que no hay ningún tratamiento reconocido según la práctica clínica habitual (PCH) o han fracasado o no toleran el tratamiento según la PCH (parte1)/Determinar la DMT y DRFII de USL311 en combinación con lomustina en sujetos con tumores sólidos avanzados para los que no hay ningún tratamiento reconocido según la PCH o han fracasado o no toleran el tratamiento según la PCH (parte2)
    Fase II ampliación de dosis: Determinar el % de SLP-6m con USL311 en monoterapia en sujetos con GBM recidivante/recurrente que recibieron previamente tratamiento según la PCH como 1ª línea de tratamiento y que son candidatos para re-resección (parte3)/ Determinar el % de SLP-6m con USL311 en combinación con lomustina en sujetos con GBM recidivante/recurrente que recibieron previamente tratamiento según la PCH como 1ª línea de tratamiento y que son candidatos para re-resección (parte4)
    E.2.2Secondary objectives of the trial
    Parts 1 and 2 (Phase 1 Dose-Escalation in Subjects with Advanced Solid Tumors):
    • Assess the safety and tolerability of USL311 as a single agent and in combination with lomustine
    • Determine preliminary efficacy parameters of USL311 as a single agent and in combination with lomustine
    • Determine the pharmacokinetic (PK) profile of USL311 in plasma and whole blood and of lomustine in plasma (prior to and with concomitant USL311 administration)
    • Evaluate the drug interaction potential between USL311 and lomustine

    Parts 3 and 4 (Phase 2 Dose-Expansion in Subjects with Relapsed/Recurrent GBM):
    • Assess the safety and tolerability of USL311 as a single agent and in combination with lomustine
    • Assess ORR%, PFS, DCR and OS of USL311 as single agent and in combination with lomustine
    • Determine the PK profile of USL311 and of lomustine
    Parte 1 y 2 (Fase I Escalado de dosis en pacientes con tumores avanzados sólidos):
    • Evaluar la seguridad y la tolerabilidad de USL311 en monoterapia y en combinación con lomustina
    • Determinar los parámetros de eficacia preliminares de USL311 en monoterapia y en combinación con lomustina
    • Determinar el perfil farmacocinético (FC) de USL311 en plasma y sangre entera y de lomustina en plasma (antes de la administración y con la administración concomitante de USL311)
    • Evaluar el potencial de interacciones fármacos entre USL311 y lomustina

    Parte 3 y 4 (fase II de ampliación de dosis en pacientes con GBM recidivante/recurrente:
    • Evaluar la seguridad y la tolerabilidad de USL311 en monoterapia y en combinación con lomustina
    • Evaluar TRO%, SLP, TCE y SG con USL311 en monoterapia y en combinación con lomustina
    • Determinar el perfil FC de USL311 en plasma y sangre entera y de lomustina en plasma
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    Criteria for both Phase 1 dose-escalation and Phase 2 dose-expansion:
    1. Provide signed and dated informed consent prior to study-specific screening procedures
    2. ≥18 years old
    3. Karnofsky performance score (KPS) ≥ 70
    4. Must have adequate bone marrow and renal/hepatic function at the Screening Visit, defined as:
    a. Absolute neutrophil count ≥ 1,500/mm3 without granulocyte colony-stimulating factor
    (G-CSF) support within 7 days preceding the lab assessment
    b. Platelet count ≥ 100,000/mm3 , without transfusion within 7 days preceding the lab assessment
    c. Hemoglobin ≥ 9 g/dL, without transfusion support within 7 days preceding the lab assessment
    d. Aspartate aminotransferase (AST) or alanine aminotransferase (ALT) ≤ 3 times upper limit of normal (ULN)
    e. Total serum bilirubin ≤ 1.5 times ULN, except in subjects with known Gilbert’s Syndrome ≤ 3 times ULN
    f. Serum creatinine ≤ 1.5 times ULN with an estimated creatinine clearance of ≥ 60 mL/min (calculated by the Cockcroft-Gault equation), or creatinine clearance corrected for BSA≥ 60 mL/min/1.73 m2
    g. Activated partial thromboplastin time/ partial thromboplastin time (aPTT/PTT) and prothrombin time (PT) ≤ 1.5 times ULN
    h. Baseline potassium, sodium, calcium (corrected for albumin) and magnesium levels within the normal rangeor above the ULN if considered not clinically significant. Baseline potassium, sodium, calcium (corrected for albumin) and magnesium levels below lower limit of normal must be corrected to within the normal range by supplementation prior to starting study drug(s).
    5. Disease-free period of > 2 years from any other previous malignancies, excluding curatively treated basal cell carcinoma, squamous cell carcinoma of the skin, or carcinoma in situ of the cervix. Subjects with prostate cancer Stage 1 that do not require treatment may also be included.
    6. Women of childbearing potential (WOCBP) must have two negative pregnancy tests, the first during Screening and the second within 24 hours prior of first administration of study drug(s) and must agree to use highly effective physician-approved contraception (see Appendix 2) from Screening to 90 days following the last study drug administration. Male subjects must be surgically sterile or must agree to use highly effective physician-approved contraception from Screening to 90 days following the last study drug administration (a barrier method of contraception must be employed by all subjects [male and female], when having sexual intercourse, regardless of other methods).
    a. Females are considered not of childbearing potential if they meet any of the following criteria:
    • Postmenopausal with > 1 year since last menses and:
    − If younger than 65 years old, with a follicle-stimulating hormone (FSH) > 40 mIU/mL
    − If ≥ 65 years old and not on hormone replacement therapy (HRT), with a FSH > 30 mIU/mL
    − If ≥ 65 years old and on HRT, the FSH requirement in not applicable. Postmenopausal females on HRT will be allowed if the treatment is stable for at least 6 months prior to dosing of study drug(s)
    • Written medical documentation of being sterilized (e.g. hysterectomy, double oophorectomy, bilateral salpingectomy) Note: Tubal ligation is not considered a form of permanent sterilization
    7. Must be able and willing to comply with the study visit schedule and study procedures
    8. Must be able to take oral medications
    9. Must have available archived tumor tissue and willing and able to provide consent for study access to such tissue
    10. For subjects with seizures, must be adequately controlled on a stable regimen of anti-epileptic drugs
    Criteria for Phase 1 only, dose-escalation in advanced solid tumors:
    11. Histologically or cytologically documented diagnosis of a solid tumor for which no standard therapy is recognized or have failed or are intolerant to the standard-of-care treatment
    12. Inoperable metastatic or locally advanced, unresectable disease
    13. Subjects must have either evaluable or measurable disease
    14. Subjects with treated (surgically excised or irradiated) and stable brain metastases are eligible as long as the subject has adequately recovered from treatment and the treatment was ≥ 28 days prior to initiation of study drug(s) and baseline brain computed tomography (CT) with contrast or magnetic resonance imaging (MRI) within 14 days of initiation of study drug(s) is negative for new brain metastases
    Criteria for Phase 2 only, dose-expansion in relapsed/recurrent GBM:
    15. Histologically confirmed diagnosis of GBM
    16. Subjects must have documented recurrence after first-line treatment
    17. Prior first-line treatment must have included radiation and temozolomide
    18. Subject is suitable for surgical re-resection, per Investigator discretion, as a component of their clinical care
    19. Not more than one prior resection (Note: biopsy does not count as prior resection)
    Fase(F)1 escala de dosis y F2 ampliación de dosis:
    1.Otorgar el consentimiento informado firmado y fechado antes de cualquier procedimiento de selección específico del estudio
    2.≥18 años
    3.Puntuación KPS≥70
    4.Función de la médula ósea y renal/hepática adecuada en visita de selección, definida como: a.Recuento absoluto de neutrófilos ≥1500/mm3 sin factores estimulantes de colonias de granulocitos en los 7días anteriores a la evaluación de laboratorio/b.Recuento de plaquetas≥100 000/mm3, sin transfusiones en los 7días anteriores a la evaluación de laboratorio/ c.Hgb≥9 g/dl, sin transfusiones en los 7días anteriores a la evaluación de laboratorio / d.ASAT o ALAT≤3 veces el LSN/ e.Bilirrubina sérica total ≤1,5 veces el LSN, excepto en el caso de sujetos con síndrome de Gilbert conocido:≤3 veces el LSN/ f.Creatinina sérica≤1,5veces el LSN con un aclaramiento de creatinina estimado ≥60mL/min (calculada con la ecuación de Cockcroft-Gault), o aclaramiento de creatinina corregido conforme al ASC≥60mL/min/1,73m2 (determinado a partir de orina recogida en 24h)/ g.TPPa/TTP y TP≤1,5veces el LSN/ h.Niveles basales de K,Na,Ca(corregido para albúmina)y Mg dentro de los rangos de normalidad, o por encima del LSN si no son clínicamente significativos. Los niveles basales de K,Na,Ca(corregido para albúmina) y Mg por debajo del límite inferior de la normalidad se deben corregir dentro del rango de normalidad, o por encima del LSN si clínicamente significativos, utilizando suplementos antes de comenzar los fármacos del estudio.
    5.Periodo libre de enfermedad >2años con respecto a otras neoplasias malignas previas, excluye carcinoma basocelular, carcinoma cutáneo de células escamosas o carcinoma in situ del cuello uterino tratados de forma curativa. Se podrá incluir también a sujetos con cáncer de próstata en estadio1 que no requieren tratamiento.
    6.Las mujeres con capacidad de gestación deben tener resultados negativos en 2 pruebas de embarazo, la 1ª durante la selección y la 2ª en las 24h anteriores a la 1ª administración de los fármacos del estudio y deben aceptar utilizar anticonceptivos altamente eficaces aprobados por el médico desde la selección hasta 90 días después de la última administración del medicamento del estudio. Los hombres deben ser quirúrgicamente estériles o deben aceptar utilizar anticonceptivos altamente eficaces aprobados por el médico desde la selección hasta 90 días después de la última administración del medicamento del estudio (todos los sujetos [hombres y mujeres] deben utilizar un método anticonceptivo de barrera al mantener relaciones sexuales, independientemente de los otros métodos).
    a.Se considera que las mujeres no tienen capacidad de gestación si cumple cualquier de los criterios: •Posmenopáusica con >1año desde la última menstruación y:
    Si<65 años, un valor de FSH>40 mUI/mL
    Si≥65 años y no recibe THS, un valor de FSH>30 mUI/mL
    Si≥65 años y recibe THS, el requisito de FSH no procede. Las mujeres posmenopáusicas que reciben THS pueden participar si llevan al menos 6 meses en tratamiento estable antes de la administración de los fármacos del estudio
    •Documentación médica por escrito de haberse sometido a la esterilización (p.ej. histerectomía, ooforectomía bilateral, salpingectomía bilateral).Nota:Ligadura de trompas no se considera 1 forma de esterilización permanente
    7.Ser capaz y querer cumplir con el calendario de visitas y los procedimientos del estudio
    8.Ser capaz de tomar medicación oral
    9.Disponer de tejido tumoral de archivo y querer y ser capaz de otorgar el consentimiento para el acceso a este tejido para el estudio
    10.Si hay sujetos con crisis convulsivas, deben estar adecuadamente controlados con un régimen estable de antiepilépticos
    Solo Fase 1, escala de dosis en sujetos con tumores sólidos avanzados:
    11.Diagnóstico documentado histológico o citológicamente del tumor sólido para el que no hay ningún tratamiento reconocido según la PCH. 12.Enfermedad metastásica o localmente avanzada, no resecable e inoperable. 13.Los sujetos deben tener enfermedad evaluable o medible. 14.Los sujetos con metástasis cerebrales tratadas (extirpadas quirúrgicamente o irradiadas) y estables son elegibles siempre que se hayan recuperado de forma adecuada del tratamiento y el tratamiento se realizara ≥28 días antes de comenzar el tratamiento del estudio y el resultado basal de la TC cerebral con contraste o la RM realizadas en los 14días anteriores a comenzar el tratamiento del estudio sea negativo en cuanto a metástasis cerebrales nuevas.
    Solo Fase 2, ampliación de dosis en sujetos con GBM recidivante/recurrente:
    15.Diagnóstico de GBM histológicamente confirmado. 16.Los sujetos deben tener una recidiva documentada tras el tratamiento de 1ªlínea. 17.Tratamiento de 1ªlínea previo debe haber incluido radiación y temozolomida. 18.Sujeto idóneo para re-resección quirúrgica, a discreción del investigador, como parte de la asistencia clínica. 19.Máx.1 resección previa.Nota:Biopsia no cuenta
    E.4Principal exclusion criteria
    Criteria for both Phase 1 dose-escalation and Phase 2 dose-expansion:
    1. Subjects who have had recent systemic anticancer therapies, interventional device treatment and/or radiotherapy either within 14 days prior to first dose of study drug(s) or have not recovered (to grade ≤ 1) from all clinically significant toxicities related to prior therapies
    2. Subjects who have had any major surgery (not including re-resection surgery required in Phase 2) within 28 days prior to first dose of study drug(s), or minor surgery within 14 days prior to first dose of study drug(s)
    3. For 14 days prior to first dose of study drugs(s) treatment, administration of any strong cytochrome P450 3A4 (CYP3A4) inducers including, but not limited to, the following: carbamazepine, ethotoin, mephenytoin, phenobarbital, phenytoin, primidone, rifabutin, rifampin, and St. John’s Wort
    4. For 14 days prior to first dose of study drug(s) treatment, administration of any strong cytochrome P450 3A4 (CYP3A4) inhibitors including, but not limited to, the following: amprenavir, ataznavir, boceprevir, clarithromycin, conivaptan, fosamprenavir, indinavir, itraconazole, ketoconazole, lopinavir, nefazodone, posaconazole, ritonavir, saquinavir, telaprevir, telithromycin, and voriconazole
    5. For 14 days prior to first dose of study drug(s) treatment, administration of any agent with moderate-to-high risk to prolong the QTc interval or to cause Torsades de Pointes (see Appendix 3)
    6. Subjects who have been treated with an investigational agent or investigational interventional device within 21 days prior to the first dose of study drug(s)
    7. Subjects is growth factor dependent or transfusion dependent, or has received growth factor support or transfusion support within 14 days prior to the first dose of study drug(s)
    8. History of significant cardiac disease. Significant cardiac diseases includes the following:
    a. Second/third degree heart block
    b. Significant ischemic heart disease (e.g. myocardial infarction, unstable angina, Grade 3 or 4 [Canadian Cardiovascular Society] angina, hospitalization for ischemic heart disease) within 2 years of first dose of study drug(s)
    c. Family history of long QT syndrome; mean Fridericia corrected QT interval (QTcF) > 450 msec on at least two separate ECGs prior to study start
    d. Poorly controlled hypertension per Investigator opinion
    e. Congestive heart failure of New York Heart Association (NYHA) Class II or worse (slight limitation of physical activity; comfortable at rest, but ordinary physical activity results in fatigue, palpitation, or dyspnea)
    9. Episode of status epilepticus within 1 year prior to the first dose of study drug(s)
    10. Pregnant or breastfeeding
    11. Any other significant co-morbid conditions that in the opinion of the Investigator would impair
    study participation or cooperation Criteria for Phase 1 only, dose-escalation in advanced solid tumors
    12. Subjects with lymphoma as primary cancer
    Criteria for Phase 2 only, dose-expansion in relapsed/recurrent GBM:
    13. Subjects unable or unwilling to consent to the provision of resected tissue after surgery
    14. Prior treatment with plerixafor or another CXCR4 inhibitor
    15. Prior treatment with bevacizumab
    16. Prior treatment with lomustine and/or carmustine
    Criterios para la fase I de escala de dosis y la fase II de ampliación de dosis:
    1. Sujetos que han recibido recientemente tratamientos antineoplásicos sistémicos, tratamiento con un dispositivo de intervención y/o radioterapia en los 14 días anteriores a la primera dosis de los fármaco(s) del estudio o que no se hayan recuperado (hasta un grado ≤1) de todas las toxicidades clínicamente significativas relacionadas con los tratamientos previos
    2. Sujetos que se han sometido a una cirugía mayor (no incluye la cirugía de re-resección requerida para la fase II) en los 28 días anteriores a la primera dosis de los fármaco(s) del estudio, o una cirugía menor en los 14 días anteriores a la primera dosis de los fármaco(s) del estudio
    3. Administración de cualquier inductor potente del citocromo P450 3A4 (CYP3A4) incluidos, entre otros, los siguientes fármacos: carbamazepina, etotoína, mefenitoína, fenobarbital, fenitoína, primidona, rifabutina, rifampina y hierba de San Juan en los 14 días anteriores a la primera dosis del tratamiento con los fármaco(s) del estudio
    4. Administración de cualquier inhibidor potente del citocromo P450 3A4 (CYP3A4) incluidos, entre otros, los siguientes fármacos: amprenavir, ataznavir, boceprevir, claritromicina, conivaptan, fosamprenavir, indinavir, itraconazol, ketoconazol, lopinavir, nefazodona, posaconazol, ritonavir, saquinavir, telaprevir, telitromicina y voriconazol en los 14 días anteriores a la primera dosis del tratamiento con los fármaco(s) del estudio
    5. Administración de cualquier medicamento con riesgo moderado o alto de prolongar el intervalo QTc o causar taquicardia ventricular en entorchado (ver el Anexo 3) en los 14 días anteriores a la primera dosis del tratamiento con los fármaco(s)del estudio
    6. Sujetos que han recibido tratamiento con un medicamento en investigación o un dispositivo de intervención en los 21 días anteriores a la primera dosis de los fármaco(s) del estudio
    7. Sujetos que han recibido factores de crecimiento o transfusiones, o que han recibido factores de crecimiento o en los 14 días anteriores a la primera dosis de los fármaco(s) del estudio
    8. Antecedentes de enfermedad cardiaca significativa. Se incluyen las siguientes enfermedades cardiacas significativas:
    a. Bloqueo cardiaco de segundo/tercer grado
    b. Enfermedad cardiaca isquémica significativa (p. ej., infarto de miocardio, angina instable, angina de grado 3 o 4 [Sociedad Cardiovascular Canadiense], hospitalización por enfermedad cardiaca isquémica) en los 2 años anteriores a la primera dosis de los fármacos del estudio
    c. Antecedentes familiares de síndrome de QT largo; intervalo QT medio corregido según Fridericia (QTcF) >450 mseg en al menos dos ECG distintos antes de comenzar el estudio
    d. Hipertensión mal controlada a opinión del investigador
    e. Insuficiencia cardiaca congestiva de clase II o peor según la New York Heart Association (NYHA) (ligera limitación de la actividad física; cómodo en reposo, pero la actividad física normal ocasiona fatiga, palpitaciones o disnea)
    9. Episodio de estado epiléptico en el año anterior a la primera dosis de los fármaco(s) del estudio
    10. Embarazo o en periodo de lactancia
    11. Cualquier otra co-mórbilidad significativa que en opinión del investigador pueda afectar a la participación o cooperación en el estudio
    Criterios únicamente para la fase I, escala de dosis en sujetos con tumores sólidos avanzados
    12. Sujetos con linfoma como neoplasia primaria
    Criterios únicamente para la fase II, ampliación de dosis en sujetos con GBM recidivante/recurrente:
    13. Sujetos incapaces o que no quieren otorgar el consentimiento para proporcionar el tejido reseccionado tras la cirugía
    14. Tratamiento previo con plerixafor u otro inhibidor de CXCR4
    15. Tratamiento previo con bevacizumab
    16. Tratamiento previo con lomustina y/o carmustina
    E.5 End points
    E.5.1Primary end point(s)
    Efficacy endpoint PFS-6m will be determined in all subjects with solid tumors utilizing Response
    Evaluation Criteria in Solid Tumors (RECIST) v.1.1 criteria and in subjects with primary brain
    tumors (e.g., GBM) utilizing Response Assessment in Neuro-Oncology (RANO) criteria.
    The safety endpoints of interest are incidence of treatment emergent adverse events (TEAEs),
    including DLTs and serious adverse events (SAEs); change in clinical laboratory tests (serum
    chemistry, hematology, coagulation assessments, urinalysis); change in vital signs; change in
    ECGs (including continuous cardiac telemetry); change in physical examination; change in
    neurological examination; change in concomitant medication use; and change in BMP levels
    (Parts 1 and 2).
    La variable de eficacia SLP-6m será determinada en todos los sujetos con tumores sólidos utilizando los criterios RECIST (Response Evaluation Criteria in Solid Tumors) v1.1 y en sujetos con tumores cerebrales primarios (por ej., GBM) utilizando los criterios RANO (Response Assessment in Neuro-Oncology)
    Las variables de seguridad de interés son la incidencia de acontecimientos adversos surgidos del tratamiento (AAST), incluidas las TLD y los AA graves (AAG); cambio en los análisis de laboratorio clínicos (evaluaciones de bioquímica sérica, hematología y coagulación); cambio en las constantes vitales; cambio en los ECG, incluida la telemetría cardiaca continua; cambio en la exploración física; cambio en la exploración neurológica; cambio en el uso de medicamentos concomitantes; cambio en los niveles de BMP (parte 1 y parte 2)
    E.5.1.1Timepoint(s) of evaluation of this end point
    For RECIST or RANO scans are required pt 1. Screening, end of cycle 2, every 6 weeks and at end of treatment. Pt 2. Scans requires at screening, end of cycle 1, every 6 weeks and at end of treatment. For phase 2 parts 3 and 4 RANO will be done at screening, surgery, every 6 weeks and at 6 months. AE’s are recorded from signing of informed consent until the follow up visit. ECGs are to be collected according to the scedule of Events tables 1-12 outlined in the protocol.
    Para los escáneres RECIST o RANO son requeridos pt 1. Selección, fin del ciclo 2, cada 6 semanas y al final del tratamiento. Pt 2. Escáneres requeridos en la selección, fin del ciclo 1, cada 6 semanas y al final del tratamiento. Para fase 2 parte 3 y 4 se hará RANO en selección, cirugía, cada 6 semanas y a los 6 meses. Se registrarán todos los AA desde el momento de firmar el consentimiento informado. ECG se recogerán de acuerdo al esquema de acontecimientos tablas 1-12 descritas en el protocolo.
    E.5.2Secondary end point(s)
    Pharmakokinetic endpoints (protocol section 8.5) and exploratory assessments (protocol section 8.7)
    Variables farmacocinéticas (protocolo sección 8.5) y procedimientos exploratorios (protocolo sección 8.7)
    E.5.2.1Timepoint(s) of evaluation of this end point
    As per protocol section: schedule of vistis and assessments
    Según la sección del protocolo: esquema de visitas y procedimientos
    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) Yes
    E.7.1.1First administration to humans Yes
    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 No
    E.8.1.2Open Yes
    E.8.1.3Single blind No
    E.8.1.4Double blind No
    E.8.1.5Parallel group Yes
    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 Yes
    E.8.2.3.1Comparator description
    PR2 - Lomustine
    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 concerned2
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA2
    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
    Spain
    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
    Last patient's last visit; Subjects who tolerate Cycle 1 treatment and do not have progressive disease, treatment failure or relapse are eligible to continue to receive treatment until they experience unacceptable toxicity, disease progression, meet any of the withdrawal criteria, or the study is terminated by the Sponsor. Long Term Follow-up Visits (quarterly visit or phone call until subject death or study termination)
    Última visita del último paciente; Los sujetos que toleran el tratamiento del ciclo 1 y no tienen enfermedad progresiva, fracaso terapéutico o recidiva son elegibles para continuar recibiendo el tratamiento hasta que presenten una toxicidad inaceptable, progresión de la enfermedad, cumplan cualquiera de los criterios de retirada o el promotor termine el estudio. Visitas de seguimiento a largo plazo (visita trimestral o llamada telefónica hasta que el sujeto muera o se acabe el estudio).
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years2
    E.8.9.1In the Member State concerned months10
    E.8.9.1In the Member State concerned days0
    E.8.9.2In all countries concerned by the trial years3
    E.8.9.2In all countries concerned by the trial months4
    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: 24
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 96
    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 state8
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 8
    F.4.2.2In the whole clinical trial 120
    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 remain on study drug /return to Standard treatment
    Los pacientes siguen con la medicación del estudio/ vuelven al tratamiento estándar.
    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 Decision2016-10-13
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2016-09-20
    P. End of Trial
    P.End of Trial StatusPrematurely Ended
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