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    Summary
    EudraCT Number:2015-004467-36
    Sponsor's Protocol Code Number:SRA737-02
    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:2018-01-22
    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 number2015-004467-36
    A.3Full title of the trial
    A Phase 1/2 Trial of Oral SRA737 (a Chk1 Inhibitor) Given in Combination with Gemcitabine plus Cisplatin or Gemcitabine Alone in Subjects with Advanced Cancer
    Ensayo en fase I/II de SRA737 (un inhibidor de Chk1) administrado por vía oral en combinación con gemcitabina más cisplatino o gemcitabina únicamente en pacientes con cáncer avanzado.
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    A Phase 1/2 Trial of SRA737 in Combination with Gemcitabine plus Cisplatin or Gemcitabine Alone in Subjects with Advanced Cancer
    Ensayo en fase I/II de SRA737 administrado en combinación con gemcitabina más cisplatino o gemcitabina únicamente en pacientes con cáncer avanzado.
    A.4.1Sponsor's protocol code numberSRA737-02
    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 SponsorSierra Oncology, 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 supportSierra Oncology, Inc.
    B.4.2CountryUnited States
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationSierra Oncology, Inc.
    B.5.2Functional name of contact pointClinical Trial Information
    B.5.3 Address:
    B.5.3.1Street Address46701 Commerce Center Drive
    B.5.3.2Town/ cityPlymouth, MI
    B.5.3.3Post code48170
    B.5.3.4CountryUnited States
    B.5.4Telephone number+1604558-6575
    B.5.6E-mailsarbour@sierraoncology.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 nameSRA737 capsule
    D.3.2Product code SRA737
    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 INNSRA737
    D.3.9.2Current sponsor codeSRA737
    D.3.9.3Other descriptive nameSRA737 citrate
    D.3.9.4EV Substance CodeSUB180852
    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.IMP: 2
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation Yes
    D.2.1.2Country 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 nameGemcitabine
    D.3.2Product code Gemcitabine
    D.3.4Pharmaceutical form 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 INNGEMCITABINE
    D.3.9.1CAS number 95058-81-4
    D.3.9.2Current sponsor codeGemcitabine
    D.3.9.3Other descriptive nameGemcitabine
    D.3.9.4EV Substance CodeSUB07892MIG
    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 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 nameSRA737 capsule
    D.3.2Product code SRA737
    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 INNSRA737
    D.3.9.2Current sponsor codeSRA737
    D.3.9.3Other descriptive nameSRA737 citrate
    D.3.9.4EV Substance CodeSUB180852
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number50
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin 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 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 nameSRA737 capsule
    D.3.2Product code SRA737
    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 INNSRA737
    D.3.9.2Current sponsor codeSRA737
    D.3.9.3Other descriptive nameSRA737 citrate
    D.3.9.4EV Substance CodeSUB180852
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    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 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 nameSRA737 capsules
    D.3.2Product code SRA737
    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 INNSRA737
    D.3.9.2Current sponsor codeSRA737
    D.3.9.3Other descriptive nameSRA737 citrate
    D.3.9.4EV Substance CodeSUB180852
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number25
    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
    Histologically or cytologically proven solid tumours where treatment with gemcitabine plus cisplatin or gemcitabine alone is considered appropriate by the Investigator.
    Tumor sólido histológica o citológicamente comprobado donde el tratamiento con gemcitabina más cisplatino o gemcitabina sola se considera apropiado por el Investigador.
    E.1.1.1Medical condition in easily understood language
    Patients with advanced solid tumours.
    Pacientes con tumores sólidos avanzados.
    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 LLT
    E.1.2Classification code 10049280
    E.1.2Term Solid tumour
    E.1.2System Organ Class 100000004864
    E.1.3Condition being studied is a rare disease No
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    1) To establish the safety profile of SRA737 administered in combination with gemcitabine +/- cisplatin.

    2) To determine the maximum tolerated dose (MTD) of SRA737 administered in combination with gemcitabine

    3) To define a recommended Phase 2 dose (RP2D) of SRA737 in combination with gemcitabine
    1) Establecer el perfil de seguridad de SRA737 administrado en combinación con gemcitabina ± cisplatino.
    2) Determinar la dosis máxima tolerable (DMT) de SRA737 administrada en combinación con gemcitabina.
    3) Definir una dosis recomendada para la fase II (DRF2) de SRA737 en combinación con gemcitabina.
    E.2.2Secondary objectives of the trial
    1) To characterize the pharmacokinetic (PK) profile of SRA737 administered in combination with gemcitabine ± cisplatin

    2) To assess clinical activity of SRA737 in combination with gemcitabine. Activity of SRA737 in combination with gemcitabine + cisplatin will also be explored as feasible based on the number of subjects enrolled.
    1) Caracterizar el perfil farmacocinético (FC) de SRA737 administrado en combinación con gemcitabina ± cisplatino.
    2) Evaluar la actividad clínica de SRA737 en combinación con gemcitabina. También se explorará la actividad de SRA737 en combinación con gemcitabina + cisplatino en la medida en que sea factible en función del número de pacientes incluidos.
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    Dose-Escalation and Cohort Expansion:
    1) Written (signed and dated) informed consent and be capable of co-operating with treatment and follow up.

    2) In the Dose Escalation Phase, subjects with a locally advanced or metastatic, histologically or cytologically proven solid tumor, relapsed after or progressing despite conventional treatment for which no conventional therapy is considered appropriate by the Investigator or is declined by the subject.

    3) Life expectancy of at least 12 weeks.

    4) World Health Organization (WHO) performance status of 0-1.

    5) Hematological and biochemical indices within the ranges shown below, measured within 1 week prior to the subject receiving their first dose of IMP.
    Hemoglobin - ≥ 90 g/L
    Absolute neutrophil count - ≥ 1.5 × 10^9/L
    Platelet count - ≥ 100 × 10^9/L
    Bilirubin - ≤ 1.5 × upper limit of normal (ULN) unless due to Gilbert’s syndrome in which case up to 3 × ULN is permissible
    Alanine aminotransferase and/or aspartate aminotransferase and Alkaline Phosphatase - ≤ 2.5 × ULN unless raised due to tumor in which case up to 5 × ULN is permissible
    Serum Creatinine - ≤ 1.5 × ULN

    6) Subjects who are 18 years or older at the time consent is given.

    7) Subjects must have archival tumor tissue available for tumor profiling OR accessible tumor and willingness to consent to a biopsy for the collection of tumor tissue.

    Cohort Expansion:
    8) Subjects in the indication specific cohort expansion must have histologically or cytologically proven advanced malignancy of the types specified in Inclusion Criterion 11, for which no conventional therapy is considered appropriate by the Investigator or is declined by the subject.

    9) Have measurable disease according to Response Evaluation Criteria in Solid Tumors, Version 1.1 (RECIST v1.1) criteria.

    10) Have tumor tissue or ctDNA evidence that their tumor harbors one or more mutations that are expected to confer sensitivity to Chk1 inhibition. Eligibility will be determined by the sponsor’s review of genetic abnormalities detected in genes in the following categories, as detailed in Appendix 6:
    a) Key tumor suppressor genes regulating G1 cell cycle progression/arrest such as RB1, TP53, etc. For relevant cancers, positive human papilloma virus (HPV) status is also considered for eligibility.
    b) The DNA damage response pathway including ATM, BRCA1, BRCA2, mismatch repair genetic alterations and/or high microsatellite instability.
    c) Genetic indicators of replicative stress such as gain of function/amplification of Chk1 or ATR or other related gene.
    d) Oncogenic drivers such as MYC, KRAS, etc.


    11) Subjects must meet one of the following criteria:
    a) Urothelial Carcinoma
    i) Histologically confirmed locally advanced and unresectable or metastatic urothelial carcinoma of the bladder, upper urinary tract or urethra
    ii) Must have received at least 1 but no more than 3 prior regimens for advanced disease
    b) Small Cell Lung Cancer
    i) Must have received at least 1 but no more than 3 prior regimens for advanced disease
    c) Soft Tissue Sarcoma
    i) Including undifferentiated pleiomorphic sarcoma / malignant fibrous histiocytoma (MFH) (including high-grade spindle cell sarcoma / pleomorphic liposarcomas), leiomyosarcoma, and dedifferentiated liposarcomas.
    ii) Must have received at least 1 but no more than 3 prior regimens for advanced disease
    d) Cervical/Anogenital Cancer
    i) Including all cervical carcinoma and advanced/metastatic squamous cell carcinoma of the anus, penis, vagina, and vulva.
    ii) Must have received at least 1 but no more than 3 prior regimens for advanced disease
    Escalada de dosis y ampliación de cohortes:
    1) Consentimiento informado por escrito (firmado y fechado) y capacidad de cooperar en el tratamiento y el seguimiento.

    2) En la fase de escalada de dosis, pacientes con tumor sólido localmente avanzado o metastásico, histológica o citológicamente comprobado que recayeron o progresaron a pesar del tratamiento habitual para los cuales el investigador no considera adecuado el tratamiento habitual o es rechazado por el paciente.

    3) Esperanza de vida de al menos 12 semanas.

    4) Estado funcional de la Organización Mundial de la Salud (OMS) de 0-1.

    5) Índices hematológicos y bioquímicos dentro de los intervalos que se muestran a continuación medidos en la semana antes de que el paciente recibiera su primera dosis del producto en investigación (PEI).
    Hemoglobina - ≥ 90 g/L
    Recuento absoluto de neutrófilos - ≥ 1.5 × 10^9/L
    Recuento de trombocitos - ≥ 100 × 10^9/L
    Bilirrubina - ≤ 1.5 × límite superior de la normalidad (LSN) a menos que se deba al síndrome de Gilbert, en cuyo caso se permite hasta 3 × ULN.
    Alanina aminotransferasa o aspartato aminotransferasa y fosfatasa alcalina - ≤ 2.5 × ULN a menos que se haya elevado debido a un tumor, en cuyo caso se permite hasta 5 × ULN
    Creatinina sérica - ≤ 1.5 × ULN.

    6) Pacientes que tienen 18 años o más en el momento en que se otorga el consentimiento.

    7) Los pacientes deben tener tejido tumoral de archivo disponible para el perfil tumoral O un tumor accesible y la voluntad de otorgar su consentimiento para someterse a una biopsia para la recogida de tejido tumoral.

    Ampliación de cohortes:
    8) Los pacientes en la expansión de cohortes de indicación específica deben tener una neoplasia maligna avanzada histológica o citológicamente comprobada de los tipos especificados en el criterio de inclusión 11, para los cuales el investigador no considera apropiado el tratamiento habitual o es rechazado por el paciente.

    9) Tener una enfermedad medible de acuerdo con los criterios de evaluación de la respuesta de tumores sólidos, criterios de la versión 1.1 (RECIST v1.1).

    10) Tener tejido tumoral o indicios de ADNtc de que su tumor alberga una o más mutaciones que se prevé que confieran sensibilidad a la inhibición de Chk1. La aptitud se determinará mediante la revisión del promotor de las anomalías genéticas detectadas en los genes de las siguientes categorías, como se detalla en el ”Appendix 6”:
    a) Principales genes supresores de tumores que regulan la progresión/detención del ciclo celular G1, tales como RB1, TP53, etc. En los cánceres pertinentes, también se considera para la elegibilidad el estado del virus del papiloma humano (VPH) positivo.
    b) Vía de respuesta al daño del ADN que incluye ATM, BRCA1, BRCA2, alteraciones genéticas de la reparación del desajuste o alta inestabilidad de los microsatélites.
    c) Indicadores genéticos de estrés replicativo, como la ganancia de la función/amplificación de Chk1 o ATR u otro gen relacionado.
    d) Impulsores oncogénicos como MYC, KRAS, etc.

    11) Los pacientes deben cumplir con uno de los siguientes criterios:
    a) Carcinoma urotelial
    i) Carcinoma urotelial confirmado histológicamente, localmente avanzado e irresecable o metastásico, de vejiga, vías urinarias superiores o uretra.
    ii) Deben haber recibido al menos 1 pero no más de 3 tratamientos previos para el cáncer avanzado.
    b) Cáncer de pulmón microcítico
    i) Deben haber recibido al menos 1 pero no más de 3 tratamientos previos para el cáncer avanzado.
    c) Sarcoma de tejidos blandos
    i) Como sarcoma pleiomórfico indiferenciado/histiocitoma fibroso maligno (HFM) (incluido el sarcoma de células fusiformes de grado alto/liposarcomas pleomórficos), leiomiosarcoma y liposarcomas desdiferenciados.
    ii) Deben haber recibido al menos 1 pero no más de 3 tratamientos previos para el cáncer avanzado.
    d) Cáncer cervical/anogenital
    i) Incluido todo carcinoma de cérvix y el carcinoma de células escamosas avanzado/metastásico de ano, pene, vagina y vulva.
    iii) Deben haber recibido al menos 1 pero no más de 3 tratamientos previos para el cáncer avanzado.
    E.4Principal exclusion criteria
    1) Have received the following prior or current anticancer therapy:
    a) Radiotherapy within 6 weeks prior to receiving first dose of SRA737 (except for symptom control and where the lesions will not be used as measurable disease),
    b) Endocrine therapy during the 4 weeks prior to receiving SRA737 except for luteinizing hormone releasing hormone agonists for prostate cancer,
    c) Chemotherapy during the 4 weeks prior to receiving SRA737,
    d) Immunotherapy during the 6 weeks prior to receiving SRA737,
    e) Nitrosoureas or Mitomycin C during the 6 weeks prior to receiving SRA737,
    f) Other IMPs during the 4 weeks prior to SRA737 treatment, or
    g) Prior treatment with a Chk1 at any point or ATR inhibitor within 6 months prior to receiving SRA737.

    2) No more than 3 previous lines of cytotoxic chemotherapy for metastatic disease.

    3) Other malignancies within the past 2 years with the exception of adequately treated tumors that are associated with an expected 5 year disease-free survival of ≥ 95%.

    4) If, in the opinion of the Investigator, the subject is highly likely to experience clinically significant myelosuppression, based on previous experience with chemotherapy.

    5) Ongoing toxic manifestations of previous treatments greater than National Cancer Institute – Common Terminology Criteria for Adverse Events (NCI-CTCAE) Grade 1. Exceptions to this are alopecia or certain toxicities, which in the opinion of the Investigator and the sponsor’s Medical Monitor should not exclude the subject.

    6) History of allergy to gemcitabine.

    7) New or progressing brain metastases. Subjects with brain metastases that have been asymptomatic and radiologically stable over an 8-week period and have not been treated with steriods during that time may be included with approval from the sponsor.

    8) Women of childbearing potential (WOCBP) or women who are already pregnant or lactating. However, those subjects who have a negative serum or urine pregnancy test before enrollment and agree to use 2 forms of contraception or agree to sexual abstinence, effective from the first administration of SRA737, throughout the trial and for 6 months afterwards are considered eligible.

    9) Male subjects with partners of child bearing potential, unless they agree to take measures not to father children by using a barrier method of contraception defined, effective from the first administration of SRA737 through the trial and for 6 months after their final SRA737 dose. Men with pregnant or lactating partners must be advised to use barrier method contraception (eg, condom plus spermicidal gel) to prevent exposure of the fetus or neonate.

    10) Major surgery from which the subject has not yet recovered.

    11) At high medical risk because of nonmalignant systemic disease including active uncontrolled infection.

    12) Known to be serologically positive for hepatitis B, hepatitis C or human immunodeficiency virus.

    13) Serious cardiac condition, such as concurrent congestive heart failure, prior history of class III/ IV cardiac disease (New York Heart Association [NYHA]), left ventricular ejection fraction < 45% at baseline, history of cardiac ischemia within the past 6 months, or prior history of cardiac arrhythmia requiring treatment.

    14) Prior bone marrow transplant or have had extensive radiotherapy to greater than 25% of bone marrow within the previous 8 weeks.

    15) Peanut allergy (unless this restriction is removed by the sponsor).

    16) QTcF > 450 msec in adult males and > 470 msec in adult females.

    17) Impairment of gastrointestinal (GI) function or GI disease that may significantly alter the absorption of SRA737 (eg, ulcerative diseases, uncontrolled nausea, vomiting, diarrhea, or malabsorption syndrome).

    18) Not able to swallow capsules without chewing or crushing.

    19) Is a participant or plans to participate in another interventional clinical trial, whilst taking part in this Phase 1/2 study of SRA737. Participation in an observational trial or interventional clinical trial which does not involve administration of an IMP and which would not place an unacceptable burden on the subject in the opinion of the Investigator and sponsor would be acceptable.

    20) Any other condition which in the Investigator’s opinion would not make the subject a good candidate for the clinical trial.
    1) Recibir actualmente o haber recibido anteriormente alguno de los siguientes tratamientos contra el cáncer:
    a) Radioterapia en las 6 semanas previas a la administración de la primera dosis de SRA737 (excepto para el control de los síntomas y cuando las lesiones no se empleen como enfermedad medible),
    b) Tratamiento endocrino durante las 4 semanas previas a la administración de SRA737, a excepción de los agonistas de la hormona liberadora de la hormona luteinizante para el cáncer de próstata,
    c) Quimioterapia durante las 4 semanas previas a la administración de SRA737,
    d) Inmunoterapia durante las 6 semanas previas a la administración de SRA737,
    e) Nitrosoureas o mitomicina C durante las 6 semanas previas a la administración de SRA737.
    f) Otros PEI durante las 4 semanas anteriores al tratamiento con SRA737, o
    g) Tratamiento previo con un Chk1 en cualquier punto, o un inhibidor de ATR en los 6 meses previos a la administración de SRA737.
    2) No más de 3 líneas previas de quimioterapia citotóxica para el cáncer metastásico.
    3) Otras neoplasias malignas en los últimos 2 años, a excepción de tumores tratados adecuadamente que estén asociados con una supervivencia sin enfermedad prevista a los 5 años de ≥ 95%.
    4) Si, en opinión del investigador, es muy probable que el paciente experimente mielosupresión de importancia clínica, según la experiencia previa con la quimioterapia.
    5) Manifestaciones tóxicas en curso de tratamientos anteriores superiores al grado 1 según los criterios comunes de terminología para acontecimientos adversos del Instituto Nacional del Cáncer (National Cancer Institute – Common Terminology Criteria for Adverse Events, NCI-CTCAE). Son excepciones a esto la alopecia o ciertas toxicidades que, en opinión del investigador y del monitor médico del promotor, no deberían excluir al paciente.
    6) Antecedentes de alergia a la gemcitabina.
    7) Metástasis cerebrales nuevas o en progresión. Podrá incluirse, con la aprobación del promotor, a los pacientes con metástasis cerebrales que hayan estado asintomáticos y radiológicamente estables durante un período de 8 semanas y no hayan recibido tratamiento con esteroides durante ese tiempo.
    8) Mujeres en edad fértil (MEF) o mujeres que ya están embarazadas o en periodo de lactancia. Sin embargo, se consideran aptas aquellas mujeres con un resultado negativo en la prueba de embarazo en suero u orina antes de la inscripción que acepten usar 2 métodos anticonceptivos o que acepten la abstinencia sexual, efectiva desde la primera administración de SRA737, durante todo el ensayo y durante 6 meses después.
    9) Pacientes masculinos con parejas en edad fértil, a menos que accedan a tomar medidas para no engendrar hijos utilizando un método anticonceptivo de barrera definido, efectivo desde la primera administración de SRA737, a lo largo del ensayo y durante 6 meses después de su dosis final de SRA737. Se debe aconsejar a los hombres con parejas embarazadas o en periodo de lactancia que utilicen métodos anticonceptivos de barrera (p. ej., preservativo más gel espermicida) para evitar la exposición a los fármacos del feto o del neonato.
    10) Cirugía mayor de la cual el paciente aún no se haya recuperado.
    11) Pacientes en alto riesgo médico debido a una enfermedad sistémica no maligna, incluida una infección activa no controlada.
    12) Conocimiento de serología positiva para la hepatitis B, la hepatitis C o el virus de la inmunodeficiencia humana.
    13) Cardiopatía grave, como insuficiencia cardíaca congestiva concurrente, antecedentes de cardiopatía de clase III/IV (Asociación Cardíaca de Nueva York [New York Heart Association, NYHA], fracción de eyección del ventrículo izquierdo <45 % al inicio, antecedentes de isquemia cardíaca en los últimos 6 meses o antecedentes de arritmia cardíaca que requiera tratamiento.
    14) Trasplante previo de médula ósea o haber recibido radioterapia extensiva < 25% de la médula ósea en las últimas 8 semanas.
    15) Alergia al cacahuete (a menos que el promotor elimine esta restricción).
    16) QTcF >450 ms en hombres adultos y >470 ms en mujeres adultas.
    17) Deterioro de la función gastrointestinal (GI) o enfermedad gastrointestinal que pueda alterar significativamente la absorción de SRA737 (p. ej., enfermedades ulcerativas, náuseas no controladas, vómitos, diarrea o síndrome de malabsorción).
    18) Imposibilidad de tragar cápsulas sin masticarlas ni aplastarlas.
    19) Estar participando o tener intención de participar en otro ensayo clínico intervencionista durante la participación en este estudio de SRA737 en fase I/II. Sería aceptable la participación en un ensayo observacional o ensayo clínico intervencionista que no implique la administración de un PEI y que no suponga una carga inaceptable para el paciente en opinión del investigador y del promotor.
    20) Cualquier otra afección que, en opinión del investigador, haría que el paciente no fuera un buen candidato para el ensayo clínico.
    E.5 End points
    E.5.1Primary end point(s)
    1) Safety parameters (referencing National Cancer Institute – Common Terminology Criteria for Adverse Events [NCI-CTCAE] v4.03) including: incidence, seriousness, severity and causality of each adverse event (AE) to SRA737, cisplatin, and/or gemcitabine, timing of AE onset, AE duration, and AEs leading to interruption, modification, or discontinuation of study treatment, and primary reason for discontinuation of study treatment if other than disease progression [PD], laboratory (eg, clinical chemistry, hematology, urinalysis) and vital sign data.

    2) The highest dose at which ≤ 33% of subjects have a dose limiting toxicity (DLT) in a cohort of up to 6 subjects.

    3) A safe and well tolerated dose and schedule that provides high exposure, based on all available PK, PDn, and safety parameter data from all cycles of therapy.
    1) Parámetros de seguridad (referenciados por el Instituto Nacional del Cáncer, National Cancer Institute – Common Terminology Criteria for Adverse Events, [NCI-CTCAE] v4.03) incluyendo: incidencia, seriedad, gravedad, y causalidad de cada acontecimiento adverso (AA) para SRA737, cisplatino, y/o gemcitabina, momento de aparición del AA, duración del AA, y manejo del AA interrumpiendo, modificando o suspendiendo el tratamiento del estudio, y razón principal para la retirada del estudio si no es por progresión de la enfermedad (PE), laboratorio (por ej., química clínica, hematología, uroanálisis) y datos de las constantes vitales.

    2) La dosis más alta a la cual ≤ 33% de los pacientes tienen una toxicidad limitante de dosis (DLT) en una cohorte de hasta 6 pacientes.

    3) Una dosis segura que se tolere bien y un esquema que proporcione una alta exposición, basada en todos los datos de los parámetros de FC, farmacodinámica (FD) y seguridad de los ciclos de la terapia.
    E.5.1.1Timepoint(s) of evaluation of this end point
    1) For eligible patients, SAE and AE collection and monitoring commences from the time the patient gives their written consent to participate in the trial and continues for 30 days after the last administration of the trial IMP or until the patient starts another anti-cancer therapy. Monthly follow up of AEs and SAEs considered drug-related.

    2) At the end of the dose escalation phase.

    3) At the end of the trial.
    1) Para pacientes elegibles, se recogerán y monitorizarán Acontecimientos Adversos Graves (AAGs) y
    AAs iniciados desde que el paciente da su consentimiento en participar en el ensayo y continúa durante 30 días tras la última administración del PEI del ensayo o hasta que el paciente comience otra terapia anticancerígena. El seguimiento mensual de AAs y AAG se consideró relacionado con el medicamento.

    2) Al final de la fase de dosis de escalado.

    3) Al final del ensayo.
    E.5.2Secondary end point(s)
    1) Plasma concentration-time profiles of SRA737 based on PK parameters including but not limited to AUCinf, AUCtau, Cmin, Cmax, time to reach Cmax (Tmax), t½.

    2) ORR as measured by Response Evaluation Criteria in Solid Tumors, Version 1.1 (RECIST v1.1). Duration of response (DOR). Disease control rate (DCR). Time to response (TTR). PFS. Time to Progression (TTP). OS.
    1) Perfil de concentración-tiempo del plasma de SRA737 basado en los parámetros farmacocinéticos incluyendo, pero no limitados a, AUCinf, AUCtau, Cmín, Cmáx, tiempo en el que se alcanza la Cmáx (Tmáx), t½.
    2) Tasa de Respuesta Global medida por el Criterio de Evaluación de Respuesta en Tumores Sólidos, Versión 1.1 (RECIST v1.1). Duración de respuesta (DDR). Tasa de control de la enfermedad (TCE). Tiempo de respuesta (TDR). Progresión Libre de Enfermedad (PLE). Tiempo de Progresión (TDP). Supervivencia Global (SG).
    E.5.2.1Timepoint(s) of evaluation of this end point
    1) SRA737 PK: Blood samples will be taken at up to 11 timepoints over a 24 - 48 hour period following the PK dose (Day -7 to Day -4) and repeated on either Day 2 (Stage 1) or Day 9 (Stage 2). An additional sample will be taken on Day 1 prior to chemotherapy dosing.
    Gemcitabine & Cisplatin PK: Sample will be taken at the end of the gemcitabine infusion on Day 1 and then up to 6 further samples over a 24 - 48 hour time period.

    2) At the end of the trial.
    1) Farmacocinética (FC) de SRA737: las muestras de sangre serán recogidas no más de 11 veces en un periodo de 24 a 48 horas siguiendo la dosis de PC (del día -7 al día -4) y repitiéndolo en el Día 2 (estadio 1) o Día 9 (estadio 2). Se recogerá una muestra adicional de sangre en el Día 1 antes de la dosis de quimioterapia.
    FC de Gemcitabina & Cisplatino: una muestra será tomada al final de la infusión de gemcitabina del Día 1 y hasta 6 más durante un periodo de 24 a 48 horas.
    2) Al final del ensayo.
    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 No
    E.6.10Pharmacogenetic No
    E.6.11Pharmacogenomic No
    E.6.12Pharmacoeconomic No
    E.6.13Others No
    E.7Trial type and phase
    E.7.1Human pharmacology (Phase I) 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 No
    E.8.1.1Randomised Information not present in EudraCT
    E.8.1.2Open Information not present in EudraCT
    E.8.1.3Single blind Information not present in EudraCT
    E.8.1.4Double blind Information not present in EudraCT
    E.8.1.5Parallel group Information not present in EudraCT
    E.8.1.6Cross over Information not present in EudraCT
    E.8.1.7Other Information not present in EudraCT
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) Information not present in EudraCT
    E.8.2.2Placebo Information not present in EudraCT
    E.8.2.3Other Information not present in EudraCT
    E.8.3 The trial involves single site in the Member State concerned No
    E.8.4 The trial involves multiple sites in the Member State concerned Yes
    E.8.4.1Number of sites anticipated in Member State concerned5
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA24
    E.8.6 Trial involving sites outside the EEA
    E.8.6.1Trial being conducted both within and outside the EEA No
    E.8.6.2Trial being conducted completely outside of the EEA No
    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
    The ‘end of trial’ is defined as the date when the last patient has completed the Safety Follow-up visit or the final long-term follow-up visit (whichever is the latter).
    El ‘final del ensayo’ se define como la fecha cuando el último paciente ha completado la visita de seguimiento de seguridad o la visita de seguimiento final a largo plazo (la que sea más tarde).
    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 months7
    E.8.9.1In the Member State concerned days
    E.8.9.2In all countries concerned by the trial years2
    E.8.9.2In all countries concerned by the trial months7
    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: 75
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 65
    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 state15
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 140
    F.4.2.2In the whole clinical trial 140
    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 convencional
    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 Decision2018-04-19
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2018-03-15
    P. End of Trial
    P.End of Trial StatusPrematurely Ended
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