E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Subjects with Previously Untreated, Unresectable or Metastatic Melanoma |
Sujetos con melanoma irresecable o metastásico, no tratado previamente |
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E.1.1.1 | Medical condition in easily understood language |
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E.1.1.2 | Therapeutic area | Diseases [C] - Cancer [C04] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 18.1 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10025671 |
E.1.2 | Term | Malignant melanoma stage IV |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 18.1 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10025670 |
E.1.2 | Term | Malignant melanoma stage III |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
The primary objective is to compare the incidence of drug-related Grade 3 - 5 AEs of nivolumab 3 mg/kg combined with ipilimumab 1 mg/kg to nivolumab 1 mg/kg combined with ipilimumab 3 mg/kg in treatment-naive subjects with unresectable or metastatic melanoma. |
El objetivo principal es comparar la incidencia de AA de grado 3 5 relacionados con el fármaco con nivolumab 3 mg/kg combinado con ipilimumab 1 mg/kg con la de nivolumab 1 mg/kg combinado con ipilimumab 3 mg/kg en sujetos con melanoma irresecable o metastásico que no hayan recibido tratamiento previo. |
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E.2.2 | Secondary objectives of the trial |
-To evaluate the objective response rate (ORR), as determined by investigators, of nivolumab 3 mg/kg combined with ipilimumab 1 mg/kg and nivolumab 1 mg/kg combined with ipilimumab 3 mg/kg in treatment-naive subjects with unresectable or metastatic melanoma. -To evaluate progression free survival (PFS) of nivolumab 3 mg/kg combined with ipilimumab 1 mg/kg and nivolumab 1 mg/kg combined with ipilimumab 3 mg/kg in treatment-naive subjects with unresectable or metastatic melanoma. -To assess overall survival (OS) -To assess Health Related Quality of Life (HRQoL) using the European Organisation for Research and Treatment of Cancer (EORTC QLQ-C30). |
- Evaluar la tasa de respuesta objetiva (TRO), determinada por los investigadores, de nivolumab 3 mg/kg combinado con ipilimumab 1 mg/kg y nivolumab 1 mg/kg combinado con ipilimumab 3 mg/kg en sujetos con melanoma irresecable o metastásico que no hayan recibido tratamiento previo. - Evaluar la supervivencia libre de progresión (SLP) de nivolumab 3 mg/kg combinado con ipilimumab 1 mg/kg y nivolumab 1 mg/kg combinado con ipilimumab 3 mg/kg en sujetos con melanoma irresecable o metastásico que no hayan recibido tratamiento previo. - Evaluar la supervivencia global (SG) - Evaluar la calidad de vida relacionada con la salud (CdVRS) usando el QLQ-C30 de la Organización Europea para la Investigación y el Tratamiento del Cáncer (QLQ-C30 de la EORTC). |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
-Adult subjects (>=18 years) with histologically confirmed unresectable Stage III or Stage IV Melanoma as per AJCC staging system. -Eastern Cooperative Oncology Group (ECOG) performance status of 0-1 -No prior systemic anticancer therapy for unresectable or metastatic melanoma. Prior adjuvant or neoadjuvant melanoma therapy is permitted if it was completed at least 6 weeks prior to date of first dose, and all related adverse events have either returned to baseline or stabilized. -Measurable disease as per Response Evaluation Criteria in Solid Tumors version 1.1 (RECIST) criteria -Tumor tissue from an unresectable or metastatic site of disease must be provided for biomarker analyses. In order to be randomized, a subject must be classified as PD-L1 positive, PD-L1 negative, or PD-L1 indeterminate. If an insufficient amount of tumor tissue from an unresectable or metastatic site is available prior to the start of the screening phase, subjects must consent to allow the acquisition of additional tumor tissue for performance of biomarker analyses. -Known BRAF V600 mutation status as determined by local institutional standard or subject to consent to BRAF V600 mutation testing per local institutional standards during the Screening Period, the results of which must be reported within 3 months of randomization. All BRAF statuses (BRAF wild-type or BRAF 600 mutation positive) are eligible. |
- Sujetos adultos (>=18 años) con melanoma confirmado histológicamente, irresecable en estadio III o IV según el sistema de estadificación del AJCC. - Estado funcional del Eastern Cooperative Oncology Group (ECOG) de 0?1 - Ningún tratamiento oncológico sistémico previo para melanoma irresecable o metastásico. Se permite tratamiento previo adyuvante o neoadyuvante previo para el melanoma si se terminó al menos 6 semanas antes de la fecha de la primera dosis y todos los acontecimientos adversos relacionados han vuelto a la situación basal o se han estabilizado. - Enfermedad medible según los Criterios de Evaluación de la Respuesta en Tumores Sólidos, versión 1.1 (RECIST) - Debe facilitarse tejido tumoral de una localización irresecable o metastásica de la enfermedad para análisis de biomarcadores. Para ser aleatorizado, un sujeto debe ser clasificado como PD?L1 positivo, PD?L1 negativo o PD?L1 indeterminado. Si se dispone de una cantidad insuficiente de tejido tumoral de una localización irresecable o metastásica antes del comienzo de la fase de selección, los sujetos deben dar su consentimiento para permitir la obtención de tejido tumoral adicional para la realización de análisis de biomarcadores. - Estado conocido en cuanto a mutación BRAF V600 determinado por la norma institucional local o consentimiento del sujeto para una prueba de mutación de BRAF V600 según las normas del centro durante el periodo de selección, cuyos resultados deben notificarse en el plazo de 3 meses después de la aleatorización. Son elegibles todos los estados de BRAF (BRAF sin mutación o BRAF 600 con mutación). |
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E.4 | Principal exclusion criteria |
- Active brain metastases or leptomeningeal metastases. Subjects with brain metastases are eligible if these have been treated and there is no evidence of progression via magnetic resonance imaging (MRI, except where contraindicated in which CT scan is acceptable) for at least 8 weeks after treatment is complete and within 28 days prior to first dose of study drug administration. There must also be no requirement for high doses of systemic corticosteroids that could result in immunosuppression (> 10 mg/day prednisone equivalents) for at least 2 weeks prior to study drug administration. -Ocular melanoma -Subjects with active, known or suspected autoimmune disease. Subjects with vitiligo, type I diabetes mellitus, residual hypothyroidism due to autoimmune condition only requiring hormone replacement, psoriasis not requiring systemic treatment, or conditions not expected to recur in the absence of an external trigger are permitted to enroll |
- Metástasis cerebrales activas o metástasis leptomeníngeas. Son elegibles los sujetos con metástasis cerebrales si han sido tratadas y no hay pruebas de progresión mediante resonancia magnética (RM, excepto cuando esté contraindicada, en cuyo caso es aceptable TC) durante al menos 8 semanas después de que se termine el tratamiento y en el plazo de 28 días antes de la administración de la primera dosis del fármaco del estudio. Tampoco debe haber requisito de dosis elevadas de corticosteroides sistémicos que puedan conducir a inmunosupresión (> 10 mg/día de prednisona o equivalente) durante al menos 2 semanas antes de la administración del fármaco del estudio. - Melanoma ocular - Sujetos con enfermedad autoinmunitaria activa, conocida o de sospecha. Se permite reclutar a sujetos con vitiligo, diabetes mellitus de tipo I, hipotiroidismo residual debido a un problema autoinmunitario que sólo precisa sustitución hormonal, psoriasis que no requiere tratamiento sistémico o problemas que no se espera que recurran en ausencia de un desencadenante externo. |
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E.5 End points |
E.5.1 | Primary end point(s) |
The primary endpoint is the incidence of drug-related Grade 3 - 5 AEs. |
El objetivo principal es la incidencia de AA de grado 3-5 relacionados con mediamento. |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
After 6 months from the first dose of study treatment |
Después de 6 meses desde la primera dosis del tratamiento en estudio |
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E.5.2 | Secondary end point(s) |
-To evaluate the objective response rate (ORR), as determined by investigators, of nivolumab 3 mg/kg combined with ipilimumab 1 mg/kg and nivolumab 1 mg/kg combined with ipilimumab 3 mg/kg in treatment-naive subjects with unresectable or metastatic melanoma. -To evaluate progression free survival (PFS) of nivolumab 3 mg/kg combined with ipilimumab 1 mg/kg and nivolumab 1 mg/kg combined with ipilimumab 3 mg/kg in treatment-naive subjects with unresectable or metastatic melanoma. -To assess overall survival (OS) -To assess Health Related Quality of Life (HRQoL) using the European Organisation for Research and Treatment of Cancer (EORTC QLQ-C30). |
- Evaluar la tasa de respuesta objetiva (TRO), determinada por los investigadores, de nivolumab 3 mg/kg combinado con ipilimumab 1 mg/kg y nivolumab 1 mg/kg combinado con ipilimumab 3 mg/kg en sujetos con melanoma irresecable o metastásico que no hayan recibido tratamiento previo. - Evaluar la supervivencia libre de progresión (SLP) de nivolumab 3 mg/kg combinado con ipilimumab 1 mg/kg y nivolumab 1 mg/kg combinado con ipilimumab 3 mg/kg en sujetos con melanoma irresecable o metastásico que no hayan recibido tratamiento previo. - Evaluar la supervivencia global (SG) - Evaluar la calidad de vida relacionada con la salud (CdVRS) usando el QLQ-C30 de la Organización Europea para la Investigación y el Tratamiento del Cáncer (QLQ-C30 de la EORTC). |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
-After 6 months from the first dose of study treatment -The first date of documented progression -After 6 months from the first dose of study treatment -After 6 months from the first dose of study treatment |
- Después de 6 meses desde la primera dosis del tratamiento en estudio - La primera fecha documentada de progresión - Después de 6 meses desde la primera dosis del tratamiento en estudio - Después de 6 meses desde la primera dosis del tratamiento en estudio |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | Yes |
E.6.7 | Pharmacodynamic | Yes |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | Yes |
E.6.11 | Pharmacogenomic | Yes |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | Yes |
E.6.13.1 | Other scope of the trial description |
Immunogenicity Assessments, Biomarker Assessments, Outcomes Research Assessments |
Evaluaciones de investigación de resultados, evaluaciones de inmunogenicidad y evaluaciones de biomarcadores |
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E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
E.7.4 | Therapeutic use (Phase IV) | Yes |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | Yes |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | Yes |
E.8.2.3.1 | Comparator description |
Diferentes dosis de la misma combinación de medicamentos |
different dosage of the same combination of drugs |
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E.8.2.4 | Number of treatment arms in the trial | 2 |
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.8.4.1 | Number of sites anticipated in Member State concerned | 6 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 45 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
Australia |
Canada |
Denmark |
France |
Germany |
Israel |
Italy |
Netherlands |
Poland |
Russian Federation |
Spain |
United Kingdom |
United States |
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E.8.7 | Trial 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
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Last follow-up visit of the last patient |
Última visita de seguimiento del último paciente |
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 5 |
E.8.9.1 | In the Member State concerned months | 10 |
E.8.9.1 | In the Member State concerned days | 15 |
E.8.9.2 | In all countries concerned by the trial years | 6 |