E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Patients with unresectable malignant pleural mesothelioma |
Pacientes con mesotelioma pleural maligno irresecable |
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E.1.1.1 | Medical condition in easily understood language |
Patients with unresectable malignant pleural mesothelioma |
Pacientes con mesotelioma pleural maligno irresecable |
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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 | LLT |
E.1.2 | Classification code | 10049280 |
E.1.2 | Term | Solid tumour |
E.1.2 | System Organ Class | 100000004864 |
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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 |
To determine the safety and tolerability of ONCOS-102 in combination with pemetrexed/cisplatin. |
Determinar la seguridad y tolerabilidad de ONCOS-102 en combinación con pemetrexed/cisplatino. |
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E.2.2 | Secondary objectives of the trial |
? To determine and compare tumour-specific immunological activation in the peripheral blood in the experimental group (ONCOS 102 in combination with pemetrexed/cisplatin) and the control group (pemetrexed/cisplatin). ? To determine and compare immunological activation in tumour mass in the experimental group and the control group. ? To determine and compare overall response rate and progression-free survival (PFS) in the experimental group and the control group. ? To determine and compare overall survival (OS) in the experimental group and the control group. ? To analyse the correlation between immunological activation and clinical outcome. |
?? Determinar y comparar la activación inmunológica específica del tumor en sangre periférica en el grupo experimental (ONCOS-102 en combinación con pemetrexed/cisplatino) y el grupo de control (pemetrexed/cisplatino). ?? Determinar y comparar la activación inmunológica en la masa tumoral en el grupo experimental y el grupo de control. ?? Determinar y comparar la tasa de respuesta global y la supervivencia sin progresión (SSP) en el grupo experimental y el grupo de control. ?? Determinar y comparar la supervivencia global (SG) en el grupo experimental y el grupo de control. ?? Analizar la correlación entre la activación inmunológica y los resultados clínicos. |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1.? Written informed consent. 2.? Male or female, ?18 years of age. 3.? Histologically confirmed unresectable (advanced) malignant pleural mesothelioma in patients who are not candidates for curative surgery and for whom therapy with pemetrexed/cisplatin is considered appropriate. o This includes patients who are naïve to chemotherapy, o and those who have already received pemetrexed/cisplatin to which their tumour initially responded, but they have relapsed after at least 6 months. 4.? Measurable disease according to Response Evaluation in Solid Tumour (RECIST) 1.1. 5.? Tumour must be accessible to intratumoural (i.t.) injections and to tumour core needle biopsy or thoracoscopy for tissue sampling and immunohistochemistry analysis. 6.? Eastern Cooperative Oncology Group (ECOG)/World Health Organization (WHO) performance score 0 to 1. 7.? Acceptable liver, renal, and haematological functions. 8.? All women of childbearing potential must have a negative urine or serum pregnancy test at screening and all patients must agree to use barrier contraception (i.e. condom) during study treatment and for 2 months after the last virus treatment and 6 months after the last dose of pemetrexed/cisplatin. |
1.? Consentimiento informado por escrito. 2.? Varones o mujeres con una edad mínima de 18 años. 3.? Pacientes con mesotelioma pleural maligno irresecable (avanzado) confirmado mediante histología que no sean candidatos a cirugía curativa y para los que se considere adecuado un tratamiento con pemetrexed/cisplatino. o Esto incluye pacientes que no han sido previamente tratados con quimioterapia o y los que ya hayan recibido pemetrexed/cisplatino y hayan experimentado una respuesta tumoral inicial, pero hayan sufrido una recaída tras, por lo menos, 6 meses. 4.? Enfermedad mensurable según los «Criterios de evaluación de la respuesta de tumores sólidos» (RECIST) 1.1. 5.? El tumor debe ser accesible mediante inyecciones intratumorales (i.t.), punción biópsica con aguja gruesa del tumor o toracoscopia para la toma de muestras del tejido y los análisis inmunohistoquímicos. 6.? Estado funcional 0-1 según la escala del Grupo Oncológico Cooperativo del Este [Eastern Cooperative Oncology Group (ECOG)]/ la Organización Mundial de la Salud (OMS). 7.? Función hepática, renal y hematológica aceptables. 8.? Las mujeres en edad fértil deberán tener resultados negativos en una prueba de embarazo en suero en la visita de selección y todos los pacientes deberán aceptar el uso de métodos anticonceptivos de barrera (p. ej., preservativos) durante el tratamiento del estudio y durante los 2 meses siguientes al último tratamiento con el virus y los 6 meses siguientes a la última dosis de pemetrexed/cisplatino. |
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E.4 | Principal exclusion criteria |
1. Receipt of oncolytic virus treatment, or vaccination with a vaccine containing live virus within 4 weeks before Day 1. 2. Use of significant immunosuppressive medication, including high dose corticosteroid (defined as the equivalent of >10 mg/day prednisone) within 4 weeks before Day 1. 3. Patients who participated in a study with an investigational drug or device within 4 weeks prior to Day 1. 4. Active bacterial, viral, or fungal infections, requiring systemic therapy. 5. Severe arrhythmia, heart failure, previous cardiac infarction, or acute inflammatory heart disease. 6. Concomitant disease or condition that could interfere with the conduct of the study, or that would, in the opinion of the investigator, pose an unacceptable risk to the patient, if included in this study. 7. Known infection with HIV, hepatitis B, or hepatitis C. 8. Known brain metastases. 9. History of organ transplant. 10. Females who are pregnant or breast feeding. 11. Unwillingness or inability to comply with the study protocol for any reason. 12. Patients with pre-existing hearing loss or neuropathy that may worsen due to potential neurotoxicity from cisplatin. 13. Patients with a history of hypersensitivity to cisplatin or pemetrexed or cyclophosphamide (or any of its metabolites). 14. Patients who are taking phenytoin for prophylactic use. 15. History of malignant tumour, unless the patient has been without evidence of disease for at least 3 years, or the tumour was a non-melanoma skin tumour, cervical carcinoma in situ, or prostatic carcinoma in situ. |
1. Tratamiento con virus oncolítico o vacuna con un virus vivo en las 4 semanas anteriores al día 1. 2.? Uso significativo de inmunosupresores, incluida una dosis alta de corticoesteroides (definida como el equivalente a >10 mg/día de prednisona) en las 4 semanas anteriores al día 1. 3. Participación en un estudio con un medicamento o producto sanitario en fase de investigación en las 4 semanas anteriores al día 1. 4.? Infecciones bacterianas, víricas o micosis activas que requieran tratamiento sistémico. 5.? Arritmia grave, insuficiencia cardíaca, infarto de miocardio previo o cardiopatía inflamatoria aguda. 6.? Enfermedad o afección concomitante que pueda interferir con la realización del estudio o que pueda, en opinión del investigador, suponer un riesgo inaceptable para el paciente en caso de participación. 7.? Infección conocida por el VIH, virus de la hepatitis B o de la hepatitis C. 8.? Metástasis cerebrales conocidas. 9.? Antecedentes de trasplante de órgano. 10.? Mujeres embarazadas o lactantes. 11.? Incapacidad o falta de disposición para cumplir los requisitos del protocolo del estudio por cualquier motivo. 12.? Pacientes con hipoacusia o neuropatía preexistentes que puedan empeorar por la neurotoxicidad potencial del cisplatino. 13.? Pacientes con antecedentes de hipersensibilidad al cisplatino, al pemetrexed o a la ciclofosfamida (o a cualquiera de sus metabolitos). 14.? Pacientes que toman fenitoína para uso profiláctico. 15.? Antecedentes de tumor maligno, salvo si el paciente lleva sin enfermedad por lo menos 3 años, o si el tumor consistió en un cáncer de piel diferente del melanoma, un carcinoma localizado de cuello uterino o un carcinoma localizado de próstata. |
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E.5 End points |
E.5.1 | Primary end point(s) |
Safety and tolerability profile of ONCOS 102 and pemetrexed/cisplatin after 2 cycles of chemotherapy (Day 64). |
Perfil de seguridad y tolerabilidad de ONCOS-102 y pemetrexed/cisplatino luego de 2 ciclos de quimioterapia (Día 64) |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
This will be assessed in an ongoing basis |
Esto se evaluará de forma continua |
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E.5.2 | Secondary end point(s) |
? Biological correlates by means of cellular and humoral immune responses in blood as well as biological changes in tumour biopsies of injected and non-injected tumours. ? Response rate and PFS according to Response Evaluation Criteria In Solid Tumors (RECIST) 1.1, modified immunologically relevant RECIST (iRECIST ) and PERCIST 1.0 PET criteria (PERCIST). ? Overall survival. |
? Correlación biológica relacionada con la respuesta imunológica humoral y celular en sangre así como cambios biológicos dados en biopsias de tumor ? Tasa de respuesta global y la supervivencia sin progresión (SSP) según los «Criterios de evaluación de la respuesta de tumores sólidos» (RECIST) 1.1, RECIST inmunológicamente relevante modificado ( iRECIST ) y PERCIST 1.0 criterios de PET ( PERCIST ). ? Supervivencia total |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
Points 1 and 2 will be done on an ongoing basis Third point ? will continue until the last treated patient has died. |
Los puntos 1 y 2 se hará de forma continua Tercer punto - continuará hasta que el último paciente tratado ha muerto . |
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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 | No |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | Yes |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | Yes |
E.7.1.3.1 | Other trial type description |
Phase I to study safety of ONCOS-102 with standard chemotherapy in mesothelioma |
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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 | Yes |
E.8.1.1 | Randomised | Yes |
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) | Yes |
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 | 2 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 10 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | No |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.7 | Trial 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
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End of trial is defined as last visit last patient |
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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 | |
E.8.9.1 | In the Member State concerned months | 18 |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial months | 18 |