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    Summary
    EudraCT Number:2015-004991-31
    Sponsor's Protocol Code Number:INCB24360-301/MK3475-252/Keynote252
    National Competent Authority:Italy - Italian Medicines Agency
    Clinical Trial Type:EEA CTA
    Trial Status:Completed
    Date on which this record was first entered in the EudraCT database:2020-11-10
    Trial results View results
    Index
    A. PROTOCOL INFORMATION
    B. SPONSOR INFORMATION
    C. APPLICANT IDENTIFICATION
    D. IMP IDENTIFICATION
    D.8 INFORMATION ON PLACEBO
    E. GENERAL INFORMATION ON THE TRIAL
    F. POPULATION OF TRIAL SUBJECTS
    G. INVESTIGATOR NETWORKS TO BE INVOLVED IN THE TRIAL
    N. REVIEW BY THE COMPETENT AUTHORITY OR ETHICS COMMITTEE IN THE COUNTRY CONCERNED
    P. END OF TRIAL
    Expand All   Collapse All
    A. Protocol Information
    A.1Member State ConcernedItaly - Italian Medicines Agency
    A.2EudraCT number2015-004991-31
    A.3Full title of the trial
    A Phase 3 Randomized, Double-Blind, Placebo-Controlled Study of Pembrolizumab (MK-3475) in Combination With Epacadostat or Placebo in Subjects with Unresectable or Metastatic Melanoma (Keynote-252 / ECHO-301)
    Studio di fase III, randomizzato, in doppio cieco, controllato con placebo su pembrolizumab (MK-3475) in associazione a epacadostat o placebo in soggetti con melanoma non resecabile o metastatico (Keynote-252/ECHO-301)
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    Phase 3 Study of Epacadostat and Pembrolizumab in Melanoma
    Studio di fase 3 di epacadostat e pembrolizumab nel melanoma.
    A.3.2Name or abbreviated title of the trial where available
    Phase 3 Study of Epacadostat and Pembrolizumab in Melanoma
    Studio di fase 3 di epacadostat e pembrolizumab nel melanoma
    A.4.1Sponsor's protocol code numberINCB24360-301/MK3475-252/Keynote252
    A.5.4Other Identifiers
    Name:-Number:INCB 24360-301
    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 SponsorINCYTE CORPORATION
    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 supportIncyte Corporation
    B.4.2CountryUnited States
    B.4.1Name of organisation providing supportMerck Sharp & Dohme Corp.
    B.4.2CountryUnited States
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationMSD Italia Srl
    B.5.2Functional name of contact pointDivisione Ricerca Clinica
    B.5.3 Address:
    B.5.3.1Street AddressVia Vitorchiano, 151
    B.5.3.2Town/ cityRoma
    B.5.3.3Post code00189
    B.5.3.4CountryItaly
    B.5.4Telephone number00390636191371
    B.5.5Fax number00390636380371
    B.5.6E-mailgcto.italy@merck.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 namePembrolizumab
    D.3.2Product code [MK-3475]
    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 INNPembrolizumab
    D.3.9.1CAS number 1374853-91-4
    D.3.9.2Current sponsor codeMK-3475
    D.3.9.4EV Substance CodeSUB167136
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    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 No
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) Yes
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    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) Yes
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product Yes
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.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
    Melanoma
    Melanoma
    E.1.1.1Medical condition in easily understood language
    melanoma
    melanoma
    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 10027481
    E.1.2Term Metastatic melanoma
    E.1.2System Organ Class 100000004864
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 21.1
    E.1.2Level LLT
    E.1.2Classification code 10053571
    E.1.2Term Melanoma
    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
    To compare the progression-free survival (PFS) of the combination of pembrolizumab and epacadostat versus pembrolizumab and placebo (i.e. 2 treatment groups) based on RECIST 1.1 by independent central review; and To compare overall survival (OS) of the 2 treatment groups.
    Confrontare la sopravvivenza libera da progressione (progression-free survival, PFS) della combinazione di pembrolizumab ed epacadostat rispetto a pembrolizumab e placebo (ovvero, i 2 gruppi di trattamento) mediante revisione centrale indipendente basata sui criteri RECIST 1.1; confrontare la sopravvivenza complessiva (overall survival, OS) dei 2 gruppi di trattamento.
    E.2.2Secondary objectives of the trial
    To compare the objective response rate (ORR) of the 2 treatment groups based on RECIST 1.1 by independent central review; To evaluate the safety and tolerability of the 2 treatment groups; To evaluate the duration of response (DOR) of the 2 treatment groups based on RECIST 1.1 by independent central review; and To evaluate the pharmacokinetics (PK) and anti-pembrolizumab antibodies of pembrolizumab and epacadostat administered concomitantly. **Samples for PK and antidrug antibody (ADA) assessments areno longer being collected**
    confrontare il tasso di risposta obiettiva (objective response rate, ORR) dei 2 gruppi di trattamento mediante revisione centrale indipendente sulla base sui criteri RECIST 1.1; valutare la sicurezza e la tollerabilità dei 2 gruppi di trattamento; valutare la durata della risposta (duration of response, DOR) dei 2 gruppi di trattamento mediante revisione centrale indipendente sulla base dei criteri RECIST 1.1; valutare la farmacocinetica (pharmacokinetics, PK) e gli anticorpi anti-pembrolizumab della somministrazione concomitante di pembrolizumab ed epacadostat. **I campioni per le valutazioni di PK e anti-anticorpi anti-ADA non vengono più raccolti**
    E.2.3Trial contains a sub-study Yes
    E.2.3.1Full title, date and version of each sub-study and their related objectives

    Other types of substudies
    Specify title, date and version of each substudy with relative objectives: Future Biomedical Research will be conducted on DNA (blood) specimens collected during this clinical trial. Such research is for biomarker testing
    to address emergent questions not described elsewhere in the protocol(as part of the main trial) and will only be conducted on specimens from appropriately consented subjects. The objective of collecting specimens
    for Future Biomedical Research is to explore and identify biomarkers that inform the scientific understanding of diseases and/or their therapeutic treatments. The overarching goal is to use such information to develop safer, more effective drugs, and/or to ensure that subjectsreceive the correct dose of the correct drug at the correct time.

    Altre tipologie di sottostudi
    specificare il titolo, la data e la versione di ogni sottostudio con i relativi obiettivi: Una Ricerca Biomedica Futura sarà condotta su campioni di DNA (estratti dal sangue) raccolti nel corso di questo studio clinico. Tale ricerca ha lo scopo di esaminare vari biomarcatori per rispondere a domande che stanno emergendo e che non sono descritte in altre parti del protocollo (nell ambito dello studio principale), e verrà condotta solo su campioni di soggetti che abbiano rilasciato apposito consenso. L'obiettivo della raccolta dei campioni per la Ricerca Biomedica Futura è quello di esplorare e identificare biomarcatori che contribuiscano scientificamente alla comprensione delle malattie e/o delle relative terapie. L'obiettivo ultimo è quello di utilizzare tali informazioni per sviluppare farmaci più sicuri e più efficaci, e/o per garantire che i soggetti ricevano la dose giusta del giusto farmaco al momento giusto.
    E.3Principal inclusion criteria
    1. Have histol or cytol confirmed melan2. Have unresect Stage III or Stage IV melan, as per AJCC staging system not amenable to local therap3. Have been untreated for advanced or metastatic disease except as follows. a. BRAF V600 mutant melan may have received standard of care target therapy (e.g. BRAF/MEK inhib, alone or in combin) and be eligible for this study b. Prior adjuv or neoadjuv melan therapy is permitted if it was completed at least 4 weeks before randomiz and all related adverse events have either returned to baseline or stabilized (resolution of toxic effect(s) of the most recent prior therap to Grade 1 or less (except alopecia).c.Prior adjuvant therap containing immunotherap such as interf or anti-CTLA-4 therap will only be permitted if relapse did not occur during treatment or within 6 months of treatment discontin. d. Prior anti-PD-1, anti-PD-L1, or IDO1 inhib are excluded4. Have document of V600-activating BRAF mut status or consent to BRAF V600 mut testing during the screening period5.Have lab parameters within Protocol-defined range. The screening lab tests below must be = 7 days before treatment initiation6. Have the presence of at least one measurable lesion by CT or MRI per RECIST 1.1 criteria as determined by the local site investig/radiology assessment. Cutaneous lesions and other superf lesions are not considered measurable lesions for the purposes of this protocol, but may be considered as non-target lesions.a. If subjects have only 1 measurable lesion per RECIST 1.1, the biopsy specimen should be obtained from the non-target lesion or archival tissue.b. If subjects have only 1 measurable lesion per RECIST 1.1, this lesion should not have been in the field of prior irradiation unless there is documented progression of the lesion(s)7. Provide a baseline tumor biopsy a. Subjects must submit the tumor sample during screening for PD-L1 expression testing at a central pathology lab. Subjects will be eligible to participate regardless of the level of PD-L1 expression, but will be stratified by PD-L1 expression level. Subjects who do not submit a sample adequate for PD-L1 determination will not be random. The biopsy may not be obtained from a lone target lesion. b. Newly-obtained tissue is preferred (no intervening treatment [local or systemic] involving the site of tissue biopsy once tissue biopsy is obtained at time of study enrollment). The only exception to this is a sample that was collected prior to BRAF +/- MEK targeted treatm,where the subject progressed on this targeted treatm, in cases where 1) fresh tissue or 2) archival tissue with no intervening local or systemic therap is not possible to provide8. Have resolution of toxic effect(s) of the most recent prior therap to Grade 1 or less (except alopecia). If subject received major surgery or radiation therap of > 30 Gy, they must have recovered from the toxicity and/or complications from the intervention9. Be male or female subjects, age 18 years or older on day of signing consent.10. Provide written informed consent/assent for the study. The subject may also provide consent/assent for FBR. However, the subject may particip in the main trial without particip in FBR.11. Have an Eastern Cooperative Oncology Group (ECOG) performance status 0 to 1.12. If female of childbearing potential, must have a negative urine or serum pregnancy test within 72 hours prior to receiving the first dose of study medication. If the urine test is posit or cannot be confirmed as negat, a serum pregnancy test will be required.13. If female of childbearing potential must be willing to use an adequate method of contraception – Contraception, for the course of the study through 120 days after the last dose of study medication.14. If male of childbearing potential must agree to use an adequate method of contraception- Contraception, and not to donate sperm starting with the first dose of study therapy through 120 days after the last dose of study therapy
    1 Avere un melan confermato istologicamente o citologicamente2 Avere un melan non resecabile in stadio III o IV,come da sistema di stadiaz dell’American Joint Committee on Cancer(AJCC),non suscett di terap locale3 Non essere stato tratt per malatt avanzata o metastatica,eccetto che per quanto segue:
    a Il sogg affetto da melan posit per la mutaz BRAFV600 può aver ricevuto una terap mirata sec lo standard di cura(ad es.inib di BRAF/MEK,da solo o in combin)ed essere idoneo per questo stu
    b Una preced terap adiuv o neoadiuv per melan è consentita se completata almeno 4 sett. prima della randomizzazione e se tutti gli eventi avversi correlati sono ritornati al basale o si sono stabilizz(risoluzione degli effetti tossici, della terap preced più recente, di grado minore o uguale a 1 (ad accezione dell’alopecia)
    c Una preced terap adiuv contenente un agente immunoterap come interferone o terap anti-CTLA-4 sarà consentita solo se durante il trattam o entro 6 mesi dall’interr del trattam non si è verif una recidiva
    d È esclusa la preced somminis di inib anti-PD-1,anti-PD-L1 o di IDO1
    4 Avere docum di uno stato posit per la mutaz attivante V600 di BRAF,o acconsentire all’analisi mutaz per BRAFV600 durante il periodo di screening5 Avere parametri lab entro l’interval definito dal protoc.Gli esami di lab di screening di cui sotto devono risalire a=7gg prima dell’inizio del trattam6 Present almeno una lesio misurab mediante TC o RM sec i criteri RECIST1.1,come determ dalla valutaz dello speriment/con esame radiol eseguita local dai centri.Le lesio cutanee e altre lesio superf non sono considerate lesio misurabili ai fini di questo protoc, ma possono essere considerate come lesio non-target
    a Se i sogg present 1 sola lesio misurab sec i criteri RECIST1.1,il campione bioptico deve essere ottenuto dalla lesio non-target o da tess archiviato
    b Se i sogg present 1 sola lesio misurab sec i criteri RECIST1.1,tale lesio non deve essere stata contenuta nel campo di una preced radioterap,a meno che non vi sia una progress documentata della/e lesio/i
    7 Fornire una biopsia tum basale
    a. I sogg devono fornire il campione tum durante lo screening per l’analisi dell’espress di PD-L1 presso un lab centrale di patologia.I sogg saranno idonei alla partecipazione a prescindere dal livello di espress di PD-L1,ma verranno stratificati in base a tale livello.I sogg che non forniscono un campione adeguato per la determin di PD-L1 non verranno random. La biopsia non può essere ottenuta da una lesio target solitaria.
    b.la biopsia recente è preferibile [se essa è raccolta al momento dell’arruolamento, nessun trattam interv (locale o sistemico) deve essere attuato nella zona interessata dalla biopsia]. Ad eccezione per i sogg che con progress a seguito del trattam target per BRAF +/- MEK, se non è possibile raccogliere nuova biopsia o un campione d’archivio preced al trattam interv sistemico o locale.
    8 Essersi ripreso dall’effet o dagli effetti tossici della terap preced più recente fino a un grado 1 o inferiore (eccetto alopecia).Se il sogg ha subito un intervento chirurgico importante o è stato sottoposto a radioterap a una dose >30 Gy,deve essersi ripreso dalla tossicità e/o dalle complicanze dell’intervento
    9 Essere un sogg di sesso maschile o femminile di età =a 18 anni il giorno della firma del cons
    10 Fornire assen/cons informato scritto per lo stu.Il sogg può inoltre fornire il cons/assen per la ricerca biomedica futura Tuttavia,il sogg può partecipare alla sperimentazione principale senza prendere parte alla ricerca biomedica futura11 Present uno stato di validità sec l’Eastern Cooperative Oncology Group (ECOG) [Gruppo cooperativo orientale di oncologia] da 0 a 1.12 Se si tratta di una donna in età fertile,deve present un test di gravidanza sulle urine o sul siero negativo entro 72 ore prima di ricevere la prima dose del farmaco dello stu.In caso di test sulle urine posit o la cui negatività non possa essere confermata,sarà richiesto un test di gravidanza
    E.4Principal exclusion criteria
    1. Has received prior systemic treatm for unresectable or metastatic melan.2. Has received prior therap with an antiPD-1, antiPDL1, antiPDL2, antiCD137, or IDO1 inhib or any other antib or drug specifically targeting checkpoint pathways other than antiCTLA4 which is permitted in the adjuvant setting.3. Has received prior adjuvant therapy, monoclonal antib, chemotherapy, or an investigational agent or device within 4 weeks or 5 half-lives before administration of study drug or not recovered from AEs due to previously administered agents. Exception to this rule would be use of denosumab, which is not excluded.4. Has a diagnosis of immunodeficiency or is receiving chronic systemic steroid therapy or any other form of immunosuppr therap within 7 days before the first dose of stu treatm.5. Has a known additional malignancy that is progress or requires active treatm. Exceptions include early stage cancers treated with curative intent, basal cell carcinom of the skin, squamous cell carcinom of the skin, in situ cervical cancer, or in situ breast cancer that has undergone potentially curative therap. 6. Has known active central nervous system metastas and/or carcinom meningitis. Subjects with previously treated brain metastases may participate provided they are stable have no evidence of new or enlarging brain metastases confirmed by repeat imaging, and have not required steroids for at least 14 days before study treatment.7. Has ocular melanoma.8. Has known hypersensitivity to active substances or any of their excipients including previous clinically significant hypersensitivity reaction to treatment with another monoclonal antibody. For a list of excipients, refer to the respective Investigator Brochure.9. Has an active autoimmune disease that has required systemic treatment in past 2 years. Replacement therapy is not considered a form of systemic treatment.10. Has an active infection requiring systemic therapy.11. Has known history of human immunodeficiency virus (HIV).12. Has known history of or is positive for Hepatitis B or Hepatitis C.13. Has history evidence of (non-infectious) pneumonitis that required steroids or current pneumonitis.14. Has received prior radiotherapy within 2 weeks of therapy. Subjects must have recovered from all radiation-related toxicities, not require corticosteroids, and not have had radiation pneumonitis. A 1-week washout is permitted for palliative radiation to non-CNS disease.15. Is pregnant or breastfeeding or expecting to conceive or father children within the projected duration of the study, starting with the screening visit through 120 days after the last dose of study treatment.16. Has received live vaccine within 30 days before the first dose of study treatment. 17. Has received monoamine oxidase inhibitors within 21 days prior to starting study treatment.18. Has any history of Serotonin Syndrome after receiving serotonergic drugs.19. Has presence of a gastrointestinal condition that may affect drug absorption.20. Has a history or presence of an abnormal electrocardiogram (ECG) that, in the investigator's opinion, is clinically meaningful. Screening QTc interval > 480 msec is excluded. In the event that a single QTc is > 480 milliseconds, the subject may enroll if the average QTc for the 3 ECGs is < 480 milliseconds. 21. Has clinically significant cardiac disease, including unstable angina, acute myocardial infarction within 6 months from Day 1 of study drug administration, New York Heart Association Class III or IV congestive heart failure, and arrhythmia requiring therapy. Medically controlled arrhythmia would be permitted.22. Has a history or current evidence of any condition, therapy, or laboratory abnormality that might confound the results of the study, interfere with the subject's participation for the full duration of the study, or is not in the best interest of the subject to participate, in the opinion of the treating investigator.
    .Ha ricevuto un preced. tratt sist per melan non resecabile o metastat.2.Ha ricev una preced. terap con agente antiPD1,antiPD-L1,antiPD-L2,antiCD137 o un inib di IDO1 o con altro anticorp o farm mirato in modo spec contro pathway del checkpoint diversi da un agente anti-CTLA-4,che è consentito in setting adiuvan.3.Ha ricevut una preced terap adiuvan,un antic.monoclon,chemioterap,o un agent o un disposit speriment entro4sett o5emivite prima del Giorno1dello stu o non si è ripreso da EA dovuti ad agenti somm in preced.Può essere un’eccezione l’uso di denosumab che non è escluso. 4.Ha diagnosi di immunodef o sta ricev una terap cronica con steroidi per via sistem o altra forma di terapia immunosoppr nei7giorni precedenti la1°dose del tratt dello stu.5.Ha altro tumore maligno noto in progress o che richiede un tratt attivo.Le eccez. sono tumori in stadio precoce trattati con intento curativo, carcinoma basocell della cute,carcinoma a cell squamose della cute,carcinoma in situ della cervice o carcinoma in situ della mammella che sia stato sottoposto a terap potenz curativa. 6.Ha metastasi attive al sistema nervoso centrale note e/o meningite carcinomatosa. I sogg con metastasi cerebrali già trattate in prec possono partecipare purché siano stabili non abbiano evidenza di metastasi cerebrali nuove o ingrossate confermata da ripetizione degli esami di diagnostica per im e non abbiano richiesto l’assunzione di steroidi da almeno14giorni prima del tratt dello stu.7.Ha un melanoma oculare.8.Ha un’ipersensibilità nota ai principi attivi o a uno qualsiasi dei relativi eccipienti,incl una preced reaz da ipersensibilità al tratt con un altro antico monoclonal che sia stata clini significat. Per la lista degli eccipienti fare riferimento alla Brochure per lo Sperimentat.9.Ha una malattia autoimm in fase attiva che ha richiesto un tratt sistemico negli ultimi2anni. La terapia di sostit non è considerata una forma di tratt sistemico.10.Ha un’infezione attiva che richiede una terapia per via sistemica.11.Ha un’anamnesi nota di infezione da virus dell’immunodeficienza umana (HIV).12.Ha anamnesi nota o è positivo per epatiteB o epatiteC.13.Ha evidenza di anamnesi di polmonite non infettiva che ha richiesto uso di steroidi o polmonite attiva.14.Ha ricevuto un tratt radioterapico precedente entro2settimane prima della terapia.I sogg devono essersi ripresi da tutte le tossicità correlate alla radioterap non richiedere corticosteroidi e non presentare una polmonite da radiazioni.È consentito un wash-out di1settimana per radioterapia palliativa su malattia non-SNC.15.È in gravid. o allatta al seno o prevede generare figli nell’arco della durata stimata dello stu, a partire dalla visita di screening fino a120giorni dopo l’ultima dose del tratt. in stu.16.Ha ricevuto un vaccino vivo nei30giorni prec la prima dose del tratt dello stu. 17.Ha ricevuto inibitori della MAO nei21giorni preced. l’inizio di tratt.to di studio.18.Ha quals anamnesi di sindrome da serotonina successiva all’assunzione di farmaci serotoninergici.19.Ha una pato gastroint che può influire sull’assorbimento dei farmaci.20.Ha un’anamnesi o presenta un ECG anormale che, a giudizio dello sperimentatore,è clinicamente significativo,escluso il riscontro di un intervallo QTc allo screening>480 msec. Nel caso in cui un singolo QTc sia >480 millisecondi, il sogg può essere arruolato se il QTc medio per i3 ECG è<480 millisecondi.21Ha una cardiopatia clinicamente significativa, compresi angina instabile,infarto miocardico acuto entro6mesi prima del Giorno1della somm del farmaco dello studio,insufficienza cardiaca congestizia di classe III o IV secondo la NY Heart Assoc.e aritmia che richiede terap.22.ha un’anamnesi o un’attuale evidenza di quals condiz, terap o valore di lab non norm che potreb infic i ris dello stu o interfer con la partecipaz del sogg per tutta la durat dello stu o tale partecipaz non è nell’interes del pz, secondo l’opinione dello speriment.
    E.5 End points
    E.5.1Primary end point(s)
    The dual primary endpoints are PFS and OS. • Progression-free survival, defined as the time from date of randomization until the earliest date of disease progression, as determined by independent central review of objective radiographic disease assessments per RECIST 1.1, or death from any cause, whichever comes first. • Overall survival, defined as the time from date of randomization to date of death due to any cause. The study is considered to have met its study objective if the combination is superior to pembrolizumab and placebo in either PFS or OS. *NOTE: As of Amendment 10, central imaging vendor assessment will no longer be required.
    I due endpoint primari sono la PFS e l’OS. • Sopravvivenza libera da progressione, definita come l’intervallo di tempo dalla data di randomizzazione alla prima data di progressione della malattia, determinata mediante revisione centrale indipendente delle valutazioni radiologiche obiettive della malattia secondo i criteri RECIST 1.1, o alla data di decesso dovuto a qualsiasi causa, a seconda di quale evento si verifica prima. • Sopravvivenza complessiva, definita come l’intervallo di tempo dalla data di randomizzazione alla data di decesso dovuto a qualsiasi causa. Si riterrà che questo studio abbia soddisfatto il proprio obiettivo laddove la combinazione sia superiore a pembrolizumab e placebo in termini di PFS od OS. *NOTA: A partire dall'emendamento 10, la valutazione del vendor per le immagini centralizzate non sarà più richiesto.
    E.5.1.1Timepoint(s) of evaluation of this end point
    Two interim analyses (IA1, IA2) will be performed in this study: • IA1 to be performed when ~331 PFS events have been observed • IA 2 to be performed when ~420 PFS events have been observed • Final Analysis to be performed when ~293 OS events have occurred.
    In questo studio saranno effettuate due analisi ad interim (IA1, IA2): •IA1 sarà effettuata quando sono stati osservati circa 331 eventi di PFS •IA2 sarà effettuata quando si sono verificati circa 420 eventi di PFS •L’analisi finale sarà effettuata quando si sono verificati circa 293 eventi di OS.
    E.5.2Secondary end point(s)
    Objective response rate, defined as the proportion of subjects who have best response as complete response (CR) or partial response (PR).
    Responses are based on independent central review using RECIST 1.1.
    Duration of response (DOR) determined by disease assessment defined as the time from the earliest date of qualifying response until earliest date of disease progression or death from any cause, whichever comes first. Response will be determined by independent central review using
    RECIST 1.1.
    Tasso di risposta obiettiva, definito come la proporzione di soggetti che presenta una risposta
    completa (RC) o una risposta parziale (RP) come miglior risposta. Le risposte si basano sulla revisione centrale indipendente secondo i criteri RECIST 1.1.
    Durata della risposta (DOR) determinata in base alla valutazione della malattia, definita come l'intervallo di tempo dalla prima data di risposta valida alla prima data di progressione della malattia o alla data di decesso dovuto a qualsiasi causa, a seconda di
    quale evento si verifichi prima. La risposta verrà determinata mediante revisione centrale indipendente secondo i criteri RECIST 1.1.
    E.5.2.1Timepoint(s) of evaluation of this end point
    Two interim analyses (IA1, IA2) will be performed in this study:
    IA1 to be performed when ~331 PFS events have been observed
    IA 2 to be performed when ~420 PFS events have been observed
    Final Analysis to be performed when ~293 OS events have occurred
    In questo studio saranno effettuate due analisi ad interim (IA1, IA2):
    IA1 sarà effettuata quando sono stati osservati circa 331 eventi di PFS
    IA2 sarà effettuata quando si sono verificati circa 420 eventi di PFS
    L'analisi finale sarà effettuata quando si sono verificati circa 293 eventi di OS
    E.6 and E.7 Scope of the trial
    E.6Scope of the trial
    E.6.1Diagnosis Yes
    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 No
    E.6.10Pharmacogenetic Yes
    E.6.11Pharmacogenomic Yes
    E.6.12Pharmacoeconomic No
    E.6.13Others No
    E.7Trial type and phase
    E.7.1Human pharmacology (Phase I) No
    E.7.1.1First administration to humans No
    E.7.1.2Bioequivalence study No
    E.7.1.3Other No
    E.7.1.3.1Other trial type description
    E.7.2Therapeutic exploratory (Phase II) No
    E.7.3Therapeutic confirmatory (Phase III) Yes
    E.7.4Therapeutic use (Phase IV) No
    E.8 Design of the trial
    E.8.1Controlled Yes
    E.8.1.1Randomised Yes
    E.8.1.2Open No
    E.8.1.3Single blind No
    E.8.1.4Double blind Yes
    E.8.1.5Parallel group 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 Yes
    E.8.2.3Other No
    E.8.2.4Number of treatment arms in the trial2
    E.8.3 The trial involves single site in the Member State concerned No
    E.8.4 The trial involves multiple sites in the Member State concerned Yes
    E.8.4.1Number of sites anticipated in Member State concerned6
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA44
    E.8.6 Trial involving sites outside the EEA
    E.8.6.1Trial being conducted both within and outside the EEA Yes
    E.8.6.2Trial being conducted completely outside of the EEA Information not present in EudraCT
    E.8.6.3If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned
    Australia
    Belgium
    Canada
    Chile
    Denmark
    France
    Germany
    Ireland
    Israel
    Italy
    Korea, Republic of
    Mexico
    Netherlands
    New Zealand
    Poland
    Russian Federation
    South Africa
    Spain
    Sweden
    Switzerland
    United Kingdom
    United States
    E.8.7Trial has a data monitoring committee Yes
    E.8.8 Definition of the end of the trial and justification where it is not the last visit of the last subject undergoing the trial
    The overall trial ends when the last subject completes the last study-related phone-call or visit, discontinues from the trial or is lost to follow-up (i.e. the subject is unable to be contacted by the investigator).
    La sperimentazione termina quando l'ultimo soggetto completa l'ultima visita o chiamata telefonica dello studio, discontinua dallo studio o è lost to follow-up (per es. il soggetto risulta non rintracciabile dallo sperimentatore).
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years4
    E.8.9.1In the Member State concerned months0
    E.8.9.1In the Member State concerned days0
    E.8.9.2In all countries concerned by the trial years4
    E.8.9.2In all countries concerned by the trial months0
    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: 500
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 200
    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 state45
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 252
    F.4.2.2In the whole clinical trial 700
    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)
    The treatment period with the combination therapy will continue every 21 days for up to 35 infusions (approximately 2 years) as long as subjects are receiving benefit from treatment and have not had disease progression or met any criteria for study withdrawal. Subjects who stop study treatment with SD or better may be eligible for up to 1 year (17 infusions) of additional combination therapy if they experience disease progression after stopping the combination study treatment.
    Il periodo di trattam con la terap combin continuerà ogni 21 giorni fino ad un massimo di 35 cicli ( circa 2 anni) finchè i sogg riceveranno beneficio dal trattam e non abbiano progress della patologia o soddisfino qualsiasi criterio di discontin. i sogg che terminano il trattam in studio e presentano SD o do più, potrebbero essere elegibili per una terap addiz combin per un mass di 1 anno (17 infusioni) se dopo l'interruz della terap in stud dovessero manifestare progressione della patologia.
    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 Decision2016-06-24
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2016-05-12
    P. End of Trial
    P.End of Trial StatusCompleted
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    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

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