E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Extensive Disease Small Cell Lung Cancer |
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E.1.1.1 | Medical condition in easily understood language |
Extensive Disease Small Cell Lung Cancer |
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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 | 20.0 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10041068 |
E.1.2 | Term | Small cell lung cancer extensive stage |
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 |
Cohort 1: To estimate the Overall Response Rate (ORR) when a dose of 105 mg/m2 LY2606368 every 14 days is administered to patients with ED-SCLC that have platinum-sensitive disease.
Cohort 2: To estimate the ORR when a dose of 105 mg/m2 LY2606368 every 14 days is administered in patients with Extensive-stage Disease Small Cell Lung Cancer (ED-SCLC) that have platinum resistant/refractory disease. |
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E.2.2 | Secondary objectives of the trial |
-To characterize the safety and toxicity profile of LY2606368
-To characterize the pharmacokinetics (PK) of LY2606368
-To estimate secondary efficacy measures including disease control rate (DCR), duration of response (DoR), progression free survival (PFS), and overall survival (OS)
- To evaluate the association between best tumor response and change from baseline in lung cancer-specific symptoms, symptomatic distress, activity status, overall quality of life, total Lung Cancer Symptom Scale (LCSS) score and Average Symptom Burden Index (ABSI) for patients who have platinum-sensitive or platinum-resistant/refractory SCLC |
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E.2.3 | Trial contains a sub-study | Yes |
E.2.3.1 | Full title, date and version of each sub-study and their related objectives |
Protocol Addendum I4D-MC-JTJH(2) - Approval Date: 10-Jul-2017 - A
Phase 2 Study of LY2606368 in Patients with Extensive Stage Disease
Small Cell Lung Cancer
Objectives:
- To document any antitumor activity when LY2606368 is administered
on Days 1, 2, and 3 of a 14-day cycle in patients with ED-SCLC that have
platinum-sensitive disease
- To characterize the safety and toxicity profile of LY2606368 when
administered on Days 1, 2, and 3 of a 14-day cycle
- To characterize the PK of LY2606368 when administered on Days 1, 2,
and 3 of a 14-day cycle
- To explore the biomarkers associated with the efficacy and safety of
LY2606368, the exposure (PK) of LY2606368, the mechanism of action
of CHK1, DNA damage response pathways or downstream effects, cell
cycle markers, immune
function, or cancer pathobiology
15 patients in total will be enrolled in the addendum. 10 patients
planned in Spain. The other 5 patients will be in the US.
Participating sites in Spain will be site 603- Dr Olmedo and site 604- Dr
Navarro |
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E.3 | Principal inclusion criteria |
-Have histological or cytological diagnosis of ED-SCLC and received a prior platinum-based regimen. Cohort 1 must have had an objective response to prior platinum-based therapy with subsequent progression >= 90 days after the last dose of platinum. Cohort 2 must either have had an objective response to prior platinum based therapy or had progression < 90 days after the last dose of platinum
-Have a performance status of 0 to 1 on the Eastern Cooperative Oncology Group (ECOG) scale
-Have at least 1 measurable lesion using standard techniques by Response Evaluation Criteria in Solid Tumors (RECIST) 1.1
-Have adequate organ function, including:
Hematologic: Absolute Neutrophil Count (ANC) >= 1.5x 10^9/L, platelets >= 100 x 10^9/L, Hemoglobin >= 8 g/dL or >=5 mmol
Hepatic: direct bilirubin <= 1.5 x ULN, ALT and AST <= 2.5 x ULN or <= 5 x ULN (if the liver has involvement)
Renal: Serum creatinine, or measured creatinine clearance, or calculated creatine clearance (using the Chronic Kidney Disease Epidemiology Collaboration (CKP-EPI) equation) < 1.5 x ULN or >= 50 mL/min/1.73 m^2
-Men must be sterile or agree to use an effective method of birth control during the study and for at least 12 weeks following the last dose of LY2606368
-Women must have a negative serum pregnancy test at screening, have another negative urine pregnancy test within 7 days prior to the first dose of LY2606368, and agree to use a highly effective method of birth control during the study and for 12 weeks following the last dose of LY2606368. Women on study must also not breastfeed. |
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E.4 | Principal exclusion criteria |
-Have received more than 2 prior therapies for ED-SCLC (including immunotherapy, targeted therapies, or chemotherapy)
-Have symptomatic central nervous system (CNS) malignancy or metastasis. Asymptomatic patients with treated CNS metastases should be stable for at least 14 days by clinical assessment, and patients should not have received corticosteroids to treat CNS metastases within 14 days of the first dose of study drug.
-Have a second primary malignancy that may affect the results of the study (investigator and study sponsor discretion)
-Have previously completed or withdrawn from this study or any other study investigating LY2606368 or a CHK 1 Inhibitor
-Have serious pre-existing medical conditions (left to the discretion of the investigator)
-Have a serious cardiac condition
- Have QTc interval of > 470 msec on more than one screening ECG
-Have a family history of long QT-syndrome
-Have symptomatic human immunodeficiency virus (HIV) infection or symptomatic activated/reactivated hepatitis A, B, or C (screening is not required). If the medical history, symptoms, and/or laboratory values suggest the patient may have HIV or hepatitis A, B, or C, appropriate assessment should be conducted to determine whether the patient should be excluded. |
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E.5 End points |
E.5.1 | Primary end point(s) |
Best overall response as determined by RECIST 1.1 |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
Disease assessment starting at 6 weeks and continuing every 6 weeks until disease progression or participant discontinuation (estimated 14 weeks) |
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E.5.2 | Secondary end point(s) |
-AEs and laboratory measurements
-PK profile of LY2606368: maximum concentration (Cmax) and time of maximal concentration (tmax)
-Disease control rate
-Duration or response
-Progression free survival
-Overall survival
-Lung cancer symptoms and global quality of life |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
-Weekly during treatment and 30 days after treatment (estimated 18 weeks)
-Cmax and tmax: either post dose and/or predose LY2606368 (estimated 14 weeks)
-Best overall response: radiologic assessment starting at 6 weeks and continuing every 6 weeks until disease progression (estimated at 14 weeks)
-Time from an objective response assessment until disease progression or death from any cause in absence of progressive disease (estimated at 14 weeks)
-Time from enrollment until the first radiographic documentation of progressive disease or death from any cause in absence on progressive disease (estimated at 18 weeks)
-Time from enrollment until death from any cause (estimated at 15 months)
-Lung cancer symptoms, total LCSS and ASBI (estimated at 42 weeks) |
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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 | No |
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 |
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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) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | No |
E.8.1.1 | Randomised | No |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | No |
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 | No |
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 | 26 |
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 |
France |
Germany |
Greece |
Korea, Republic of |
Netherlands |
Spain |
Turkey |
Ukraine |
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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|
E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 2 |
E.8.9.1 | In the Member State concerned months | 0 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 2 |
E.8.9.2 | In all countries concerned by the trial months | 0 |
E.8.9.2 | In all countries concerned by the trial days | 0 |