Flag of the European Union EU Clinical Trials Register Help

Clinical trials

The European Union Clinical Trials Register   allows you to search for protocol and results information on:
  • interventional clinical trials that were approved in the European Union (EU)/European Economic Area (EEA) under the Clinical Trials Directive 2001/20/EC
  • clinical trials conducted outside the EU/EEA that are linked to European paediatric-medicine development

  • EU/EEA interventional clinical trials approved under or transitioned to the Clinical Trial Regulation 536/2014 are publicly accessible through the
    Clinical Trials Information System (CTIS).


    The EU Clinical Trials Register currently displays   43871   clinical trials with a EudraCT protocol, of which   7290   are clinical trials conducted with subjects less than 18 years old.   The register also displays information on   18700   older paediatric trials (in scope of Article 45 of the Paediatric Regulation (EC) No 1901/2006).

    Phase 1 trials conducted solely on adults and that are not part of an agreed paediatric investigation plan (PIP) are not publicly available (see Frequently Asked Questions ).  
     
    Examples: Cancer AND drug name. Pneumonia AND sponsor name.
    How to search [pdf]
    Search Tips: Under advanced search you can use filters for Country, Age Group, Gender, Trial Phase, Trial Status, Date Range, Rare Diseases and Orphan Designation. For these items you should use the filters and not add them to your search terms in the text field.
    Advanced Search: Search tools
     

    < Back to search results

    Print Download

    Summary
    EudraCT Number:2016-001779-54
    Sponsor's Protocol Code Number:GEICAM/2015-04
    National Competent Authority:Spain - AEMPS
    Clinical Trial Type:EEA CTA
    Trial Status:Completed
    Date on which this record was first entered in the EudraCT database:2016-11-18
    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 number2016-001779-54
    A.3Full title of the trial
    A multicenter phase II trial to evaluate the efficacy and safety of
    pembrolizumab and gemcitabine in patients with HER2-negative Advanced Breast Cancer (ABC). “PANGEA-Breast”
    Ensayo multicéntrico fase II para evaluar la eficacia y seguridad de pembrolizumab y gemcitabina en pacientes con Cáncer de Mama Avanzado (CMA) HER2 negativo. “PANGEA-Breast”
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    A clinical trial to evaluate the efficacy and safety of
    pembrolizumab and gemcitabine in patients with HER2-negative Advanced Breast Cancer. “PANGEA-Breast”
    Ensayo clínico para evaluar la eficacia y seguridad de pembrolizumab y gemcitabina en pacientes con Cáncer de Mama Avanzado HER2 negativo. “PANGEA-Breast”
    A.3.2Name or abbreviated title of the trial where available
    PANGEA-Breast
    PANGEA-Breast
    A.4.1Sponsor's protocol code numberGEICAM/2015-04
    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 SponsorGEICAM (Fundación Grupo Español de Investigación en Cáncer de Mama)
    B.1.3.4CountrySpain
    B.3.1 and B.3.2Status of the sponsorNon-Commercial
    B.4 Source(s) of Monetary or Material Support for the clinical trial:
    B.4.1Name of organisation providing supportMERCK SHARP & DOHME DE ESPAÑA, S.A (“MSD”)
    B.4.2CountrySpain
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationGEICAM (Fundación Grupo Español de Investigación en Cáncer de Mama)
    B.5.2Functional name of contact pointClinical Operations Department
    B.5.3 Address:
    B.5.3.1Street AddressAv. de Los Pirineos, 7, 1-14
    B.5.3.2Town/ citySan Sebastián De Los Reyes (Madrid)
    B.5.3.3Post code28703
    B.5.3.4CountrySpain
    B.5.4Telephone number+34916592870
    B.5.5Fax number+34916510406
    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.3.9.3Other descriptive nameAnti-PD-1 monoclonal antibody
    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 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) 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.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 nameGemcitabina
    D.3.4Pharmaceutical form Solution for injection/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.3.9.4EV Substance CodeSUB07892MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number200
    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 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 nameGemcitabina
    D.3.4Pharmaceutical form Solution for injection/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.3.9.4EV Substance CodeSUB07892MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number1000
    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 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 nameGemcitabina
    D.3.4Pharmaceutical form Solution for injection/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.3.9.4EV Substance CodeSUB07892MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number2000
    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
    Patients with HER2-negative advanced breast cancer.
    Pacientes con cáncer de mama avanzado HER2 negativo.
    E.1.1.1Medical condition in easily understood language
    Patients with HER2-negative advanced breast cancer.
    Pacientes con cáncer de mama avanzado HER2 negativo.
    E.1.1.2Therapeutic area Diseases [C] - Cancer [C04]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 19.0
    E.1.2Level LLT
    E.1.2Classification code 10072737
    E.1.2Term Advanced breast cancer
    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
    Run-in-phase: To determine the Recommended Phase II Dose (RP2D) of gemcitabine in combination with fixed doses of pembrolizumab.
    · Phase II: To assess the efficacy of pembrolizumab in combination with gemcitabine in terms of Objective Response Rate (ORR) in patients with HER2-negative ABC.
    Fase inicial: Determinar la Dosis Recomendada para la Fase II (DRF2) de gemcitabina en combinación con dosis fijas de pembrolizumab.
    · Fase II: Evaluar la eficacia de pembrolizumab en combinación con gemcitabina en cuanto a la Tasa de respuestas objetivas (TRO) en pacientes con CMA HER2 negativo.
    E.2.2Secondary objectives of the trial
    The following secondary objectives will be studied:
    · To assess other efficacy measures of the combination in patients included in the phase II (including those in the run-in-phase at the same dose that in the phase II).
    · To determine safety and tolerability of the combination in all patients included in the study.
    Se estudiarán los siguientes objetivos secundarios:
    · Evaluar otras medidas de eficacia de la combinación en las pacientes incluidas en la fase II (incluyendo a aquellas que participen en la fase inicial con el mismo nivel de dosis que el utilizado en la fase II).
    · Determinar la seguridad y la tolerabilidad de la combinación en todas las pacientes incluidas en el estudio.
    E.2.3Trial contains a sub-study Yes
    E.2.3.1Full title, date and version of each sub-study and their related objectives
    This trial includes a translational sub-study that will pursue to analyze a set of immune
    biomarkers in peripheral blood, looking at their basal level and monitoring their evolution at
    different time points during treatment with gemcitabine and pembrolizumab. In ABC, immune
    response assessment in tissue is challenging as biopsies are at many times not easily accessible
    or/and risky for the patients. At this point, there exist a set of immune biomarkers in peripheral
    blood as myeloid derived suppressor cells (MDSC), regulatory T cells (Treg), cytokines and
    others that can be highly informative with respect to the immune activation status of the host
    (49,50). This translational research may shed light on the putative mechanisms of the eventual
    efficacy of this combination and ultimately identify immune biomarkers that may predict
    clinical activity.
    Este ensayo clínico incluirá una investigación traslacional cuyo objetivo será analizar el grupo de biomarcadores inmunológicos anteriormente mencionados
    en el entorno clínico, determinando sus niveles basales y monitorizando su evolución en distintos puntos durante el tratamiento con gemcitabina y pembrolizumab.
    Existen varios biomarcadores inmunológicos que pueden determinarse en sangre periférica, como las células supresoras derivadas de la línea mieloide (MDSC), los linfocitos T reguladores (Treg), ciertas citocinas y otros marcadores, que pueden aportar mucha información respecto al estado de la activación inmunitaria del huésped.
    Esta investigación traslacional podrá aportar información sobre los posibles mecanismos de
    actividad clínica de la combinación empleada e identificar criterios de valoración que puedan
    predecir la actividad clínica
    E.3Principal inclusion criteria
    1. The patient has signed and dated the informed consent document and it has been obtained before conducting any procedure specifically for the study.
    2. Female ≥ 18 years of age on day of signing informed consent.
    3. Histological/cytological confirmation of breast cancer with evidence of advanced disease, not amenable to resection or radiation therapy with curative intent.
    4. Documented luminal A, luminal B (HER2-negative) or triple negative disease by
    immunohistochemistry (IHQ) and/or in situ hybridization (FISH/CISH/SISH) based on
    local testing on the most recent tumour biopsy defined as follows:
    o Luminal A: tumour with positive oestrogen receptor (ER) status (>1% of tumour cells with ER expression) and HER2-negative status (IHQ score 0/1+ or negative by in situ hybridization defined as a HER2/CEP17 ratio < 2 or for single probe assessment a HER2 copy number < 4) and high progesterone receptor (PgR) (> 20% of tumour cells with PgR expression) and low Ki67 (< 14%).
    o Luminal B (HER2-negative): tumour with positive ER status (>1% of tumour cells with ER expression) and HER2-negative status (IHQ score 0/1+ or negative by in situ hybridization defined as a HER2/CEP17 ratio < 2 or for single probe assessment a HER2 copy number < 4) and either low or negative PgR (< 20% of tumour cells with PgR expression) and/or high Ki67 (≥ 14%).
    o Triple negative: tumour with negative hormone receptor status (<1% of tumour
    cells with ER and PgR expression) and HER2-negative status (IHQ score 0/1+ or negative by in situ hybridization defined as a HER2/CEP17 ratio < 2 or for single probe assessment a HER2 copy number < 4).
    5. Have at least one unidimensionally measurable lesion by RECIST 1.1.
    6. Have a performance status of 0, 1 or 2 on the Eastern Cooperative Oncology Group
    (ECOG) Performance Scale.
    7. Demonstrate adequate organ function as follows (all screening labs should be performed within 7 days of study treatment initiation):
    o Bone marrow:
    Absolute Neutrophil Count (ANC) ≥ 1,500/mm3 (1.5x109/l)
    Platelets ≥ 100,000/mm3 (100x109/l)
    Hemoglobin ≥ 9g/dl or ≥ 5.6 mmol/l without transfusion or EPO dependency (within 7 days of assessment)
    o Hepatic:
    Serum total bilirubin ≤ 1.5 x Upper Limit of Normal (ULN)
    Alkaline Phosphatase ≤ 2.5 x ULN
    AST (SGOT) and ALT (SGPT) ≤ 2.5 x ULN or ≤ 5 x ULN for patients with liver metastases
    Albumin ≥ 2.5 g/dl
    o Renal:
    Serum creatinine ≤ 1.5 x ULN or creatinine clearance ≥ 60 ml/min for patients with creatinine levels > 1.5 x ULN
    o Coagulation:
    International Normalized Ratio (INR) or Prothrombin Time (PT) ≤ 1.5 x ULN unless patient is receiving anticoagulant therapy as long as PT or PTT is within therapeutic range of intended use of anticoagulants.
    Activated Partial Thromboplastin Time (aPTT) ≤ 1.5 x ULN unless patient is receiving anticoagulant therapy as long as PT or PTT is within therapeutic range of intended use of anticoagulants.
    8. Prior treatment with anthracyclines and taxanes (unless clinically contraindicated) and two or more prior lines of hormone therapy in hormone receptor positive disease.
    9. At least 3 months life expectancy.
    10. Patient of childbearing potential should have a negative urine or serum pregnancy within 72 hours prior to receiving the first dose of study drug/medication. If the urine test is positive or cannot be confirmed as negative, a serum pregnancy test will be required.
    11. Patients of childbearing potential (see section 4.4. for definition) must be willing to use an adequate method of contraception as outlined in Section 4.4. – Contraception, for the course of the study through 120 days after the last dose of study medication.
    Note: Abstinence is acceptable if this is the usual lifestyle and preferred contraception for the subject.
    12. Willingness and ability to comply with scheduled visits, treatment plan, laboratory tests and other study procedures.
    1. La paciente ha firmado y fechado el documento de consentimiento informado, que se habrá obtenido antes de realizar cualquier procedimiento específico para el estudio.
    2. Mujeres ≥ 18 años el día de la firma del consentimiento informado.
    3. Confirmación histológica/citológica de cáncer de mama con evidencias de enfermedad avanzada, no susceptible de resección o radioterapia con intención curativa.
    4. Documentación por inmunohistoquímica (IHQ) y/o por hibridación in situ (FISH/CISH/SISH) de enfermedad tipo luminal A, luminal B (HER2 negativo) o triple
    negativa, según los análisis realizados localmente en el centro utilizando la biopsia
    tumoral más reciente, definida como:
    - Luminal A: tumor con receptores estrogénicos (RE) positivos (>1% de las
    células tumorales con expresión de RE) y estado de HER2 negativo (puntuación
    IHQ de 0/1+ o negativo en la hibridación in situ, definido como un cociente
    HER2/CEP17 < 2 o, en la evaluación con una única sonda, un número de copias
    de HER2 < 4), niveles elevados de receptores de progesterona (RPg) (> 20% de las células tumorales con expresión de RPg) y niveles bajos de Ki67 (< 14%).
    - Luminal B (HER2 negativo): tumor con receptores estrogénicos (RE) positivos
    (>1% de las células tumorales con expresión de RE) y estado de HER2 negativo
    (puntuación IHQ de 0/1+ o negativo en la hibridación in situ, definido como un
    cociente HER2/CEP17 < 2 o, en la evaluación con una única sonda, un número de copias de HER2 < 4) y, bien niveles bajos o negativos de RPg (< 20% de las células tumorales con expresión de RPg), y/o niveles elevados de Ki67 (≥ 14%).
    - Triple negativo: tumor con receptores hormonales negativos (<1% de las células tumorales con expresión de RE o RPg) y estado de HER2 negativo (puntuación IHQ de 0/1+ o negativo en la hibridación in situ, definido como un cociente HER2/CEP17 < 2 o, en la evaluación con una única sonda, un número de copias de HER2 < 4).
    5. Existencia de al menos una lesión medible en una dimensión según RECIST 1.1.
    6. Estado funcional de 0, 1 o 2 según la Escala Funcional del Eastern Cooperative Oncology Group (ECOG).
    7. Demostrar un funcionamiento adecuado de los distintos órganos, según las siguientes
    pautas (todos los análisis de laboratorio de la visita basal deberán realizarse dentro de los 7 días previos al inicio del tratamiento del estudio):
    o Médula ósea:
    Recuento absoluto de neutrófilos (RAN) ≥ 1.500/mm3 (1,5 x 109/l)
    Plaquetas ≥ 100.000/mm3 (100 x109/l)
    Hemoglobina ≥ 9 g/dl o ≥ 5,6 mmol/l sin transfusiones ni dependencia de
    EPO (dentro de los 7 días previos a la determinación)
    o Perfil hepático:
    Bilirrubina total sérica ≤ 1,5 x límite superior de normalidad (LSN)
    Fosfatasa alcalina ≤ 2,5 x LSN
    AST (SGOT) y ALT (SGPT) ≤ 2,5 x LSN o ≤ 5 x LSN en las pacientes con metástasis hepáticas
    Albúmina ≥ 2,5 g/dl
    o Riñón:
    Creatinina sérica ≤ 1,5 x LSN o aclaramiento de creatinina ≥ 60 ml/min en las pacientes con niveles de creatinina > 1,5 x LSN
    o Coagulación:
    Índice internacional normalizado (INR) o tiempo de protrombina (TP) ≤1,5 x LSN, a menos que la paciente esté recibiendo tratamiento anticoagulante, en cuyo caso el TP o el TTP deberán situarse dentro del rango terapéutico para los anticoagulantes utilizados.
    Tiempo de tromboplastina parcial activado (TTPa) ≤ 1,5 x LSN, a menos que la paciente esté recibiendo tratamiento anticoagulante, en cuyo caso el TP o el TTP deberán situarse dentro del rango terapéutico para los anticoagulantes utilizados.
    8. Tratamiento previo con antraciclinas y taxanos (excepto si está médicamente contraindicado) y, en la enfermedad con receptores hormonales positivos, dos o más líneas previas de terapia hormonal.
    9. Esperanza de vida de al menos 3 meses.
    10. Las pacientes en edad fértil deberán presentar un resultado negativo en la prueba de embarazo en orina o en suero en las 72 horas previas a la administración de la primera dosis del fármaco/medicación del estudio. Si la prueba en orina es positiva o no se puede confirmar su negatividad, será necesario efectuar una prueba en suero.
    11. Las pacientes en edad fértil (véase la sección 4.4. para consultar la definición) deberán estar dispuestas a utilizar un método anticonceptivo adecuado, tal como se describe en la sección 4.4. Anticoncepción, durante toda la duración del estudio y durante los 120 días posteriores a la última administración de la medicación del estudio.
    Nota: La abstinencia es aceptable, siempre y cuando sea el método anticonceptivo usual y
    de preferencia de la paciente.
    12. Voluntad y capacidad para cumplir con las visitas programadas, el plan de tratamiento, las pruebas de laboratorio y el resto de procedimientos del estudio.
    E.4Principal exclusion criteria
    1. HER2-positive disease by immunohistochemistry or in situ hybridation (FISH-SISHCISH).
    2. Patient is currently participating or has participated in a study of an investigational agent and received study therapy or used an investigational device within 4 weeks of the first dose of study drug/medication.
    3. Has had a prior anti-cancer monoclonal antibody (mAb) within 4 weeks prior to study day 1 or who has not recovered (i.e., ≤ grade 1 or at baseline) from adverse events due to
    agents administered more than 4 weeks earlier.
    4. Has had prior chemotherapy, targeted small molecule therapy, or radiation therapy within 2 weeks prior to study day 1 or who has not recovered (i.e., ≤ grade 1 or at baseline) from adverse events due to a previously administered agent.
    o Note: Patients with ≤ grade 2 neuropathy are an exception to this criterion and may
    qualify for the study.
    o Note: If patient received major surgery, they must have recovered adequately from
    the toxicity and/or complications from the intervention prior to starting therapy.
    5. Has received prior therapy with an anti-PD-1, anti-PD-L1, or anti-PD-L2 agent.
    6. Has received a live vaccine within 30 days of planned start of study therapy.
    o Note: Seasonal influenza vaccines for injection are generally inactivated flu
    vaccines and are allowed; however, intranasal influenza vaccines (e.g., Flu-Mist®)
    are live attenuated vaccines, and are not allowed.
    7. Has hypersensitivity to pembrolizumab, gemcitabine or any of theirs excipients.
    8. Has known active central nervous system (CNS) metastases and/or carcinomatous
    meningitis. Patients with previously treated brain metastases may participate provided
    they are stable (without evidence of progression by imaging for at least four weeks prior to the first dose of trial treatment and all neurologic symptoms have returned to baseline), have no evidence of new or enlarging brain metastases, and are not using steroids for at least 7 days prior to trial treatment. This exception does not include carcinomatous meningitis which is excluded regardless of clinical stability.
    9. Has a diagnosis of immunodeficiency or is receiving systemic steroid therapy or any other form of immunosuppressive therapy within 7 days prior to the first dose of study
    drug/medication.
    10. Has an active autoimmune disease that has required systemic treatment in the past 2 years (i.e. with use of disease modifying agents, corticosteroids or immunosuppressive drugs). Replacement therapy (e.g., thyroxine, insulin, or physiologic corticosteroid replacement therapy for adrenal or pituitary insufficiency, etc.) is not considered a form of systemic treatment.
    11. Has a current or prior malignancy within the previous 5 years (other than breast cancer or adequately treated basal cell or squamous cell carcinoma of the skin or in-situ carcinoma of the cervix).
    12. Has a history of (non-infectious) pneumonitis that required steroids or current
    pneumonitis.
    13. Has an active infection requiring systemic therapy.
    14. Has a known history of active TB (Bacillus Tuberculosis) or Human Immunodeficiency Virus (HIV) (HIV 1/2 antibodies) or a known active Hepatitis B (e.g., HBsAg reactive) or Hepatitis C (e.g., HCV RNA [qualitative] is detected).
    15. Has a history or current evidence of any condition, therapy, or laboratory abnormality that might confound the results of the trial, interfere with the patient’s participation for the full duration of the trial, or is not in the best interest of the patient to participate, in the opinion of the treating investigator.
    16. Has known psychiatric or substance abuse disorders that would interfere with cooperation with the requirements of the trial.
    17. Patient is pregnant or breastfeeding, or expecting to conceive within the projected
    duration of the trial, starting with the baseline visit through 120 days after the last dose of trial treatment.
    1. Enfermedad HER2 positiva, determinada por inmunohistoquímica o hibridación in situ (FISH-SISH-CISH).
    2. La paciente está participando actualmente o ha participado en un estudio con un agente en investigación y ha recibido el tratamiento de ese estudio o ha utilizado un dispositivo en investigación dentro de las 4 semanas previas a la administración de la primera dosis del fármaco/medicación del estudio.
    3. Tratamiento con un anticuerpo monoclonal (Acm) como terapia antineoplásica dentro de las 4 semanas previas al día 1 del estudio, o bien la paciente no se ha recuperado (es decir,
    no ha regresado a ≤ grado 1 o al nivel basal) de los acontecimientos adversos debidos a
    los agentes administrados con más de 4 semanas de anterioridad.
    4. Tratamiento con quimioterapia previa, terapia dirigida de molécula pequeña o radioterapia dentro de las 2 semanas previas al día 1 del estudio, o bien la paciente no se ha recuperado (es decir, no ha regresado a ≤ grado 1 o al nivel basal) de los acontecimientos adversos debidos a un agente administrado con más de 4 semanas de anterioridad.
    o Nota: Las pacientes con neuropatía ≤ grado 2 constituyen una excepción a este criterio, pudiendo ser elegibles para participar en el estudio.
    o Nota: Si una paciente se ha sometido a cirugía mayor, deberá haberse recuperado
    adecuadamente de la toxicidad y/o las complicaciones de la intervención quirúrgica antes de iniciar el tratamiento.
    5. Tratamiento previo con un agente anti-PD-1, anti-PD-L1 o anti-PD-L2.
    6. La paciente ha recibido una vacuna con microorganismos vivos dentro de los 30 días
    previos al inicio previsto del tratamiento del estudio.
    o Nota: En general, las vacunas inyectadas de la gripe estacional son de virus inactivados, por lo que están permitidas; no obstante, las vacunas de la gripe administradas por vía intranasal (p. ej, Flu-Mist®) contienen virus vivos atenuados y no están permitidas en este estudio.
    7. Hipersensibilidad a pembrolizumab, gemcitabina o a cualquiera de sus excipientes.
    8. Presencia de metástasis activas conocidas en el sistema nervioso central (SNC) y/o
    meningitis carcinomatosa. Las pacientes con metástasis cerebrales previamente tratadas
    podrán participar si las metástasis permanecen estables (sin evidencias de progresión en las pruebas de imagen durante al menos las 4 semanas previas a la primera dosis del tratamiento del ensayo, y siempre que todos los síntomas neurológicos hayan regresado a la situación basal), no presenten evidencias de aparición de nuevas metástasis o aumento de tamaño de las preexistentes y no han utilizado corticoides durante como mínimo los 7 días anteriores al tratamiento del ensayo. Esta excepción no incluye la meningitis
    carcinomatosa, que quedará excluida independientemente de su estabilidad clínica.
    9. Diagnóstico de inmunodeficiencia o tratamiento con corticoides sistémicos o cualquier otra forma de terapia inmunosupresora dentro de los 7 días previos a la primera dosis del
    fármaco/medicación del estudio.
    10. Enfermedad autoinmune activa que haya requerido tratamiento sistémico en los últimos 2 años (es decir, utilización de agentes modificadores de la enfermedad, corticoides o fármacos inmunosupresores). La terapia de sustitución (p. ej., tiroxina, insulina o tratamiento de reemplazo con corticoides a dosis fisiológicas debido a insuficiencia suprarrenal o hipofisaria, etc.) no se considera una forma de tratamiento sistémico.
    11. Neoplasia maligna actual o dentro de los 5 años previos (a excepción del cáncer de mama, el carcinoma escamoso o de células basales de la piel tratados correctamente o el carcinoma in situ de cérvix).
    12. Antecedentes de neumonitis (no infecciosa) que requirió el uso de esteroides o presentar neumonitis activa.
    13. Infección activa que requiera tratamiento sistémico.
    14. Antecedentes conocidos de TB (tuberculosis) activa, de infección por el virus de la inmunodeficiencia humana (VIH) (anticuerpos del VIH 1/2), o presencia de hepatitis B activa conocida (p. ej., HBsAg reactivo) o de Hepatitis C activa (p. ej., detección de RNA VHC [cualitativa]).
    15. Antecedentes o evidencias actuales de cualquier patología, tratamiento o anormalidad de laboratorio que pueda confundir los resultados del ensayo clínico, interferir con la participación de la paciente durante la duración completa del ensayo o cuando el hecho de participar en el estudio no sea lo mejor para la paciente, en opinión del investigador responsable de su tratamiento.
    16. Trastornos psiquiátricos o de consumo de sustancias de abuso conocidos que puedan interferir con la cooperación en cuanto a los requisitos del ensayo clínico.
    17. Paciente que está embarazada o en período de lactancia, o bien tiene previsto quedarse embarazada dentro de la duración prevista del ensayo a partir de la visita basal y hasta haber transcurrido 120 días después de la última dosis del tratamiento del ensayo.
    E.5 End points
    E.5.1Primary end point(s)
    Run-in-phase: To determine the incidence rate of Dose Limiting Toxicity (DLT) within the first cycle of the combination.
    Phase II: Objective Response Rate (ORR) is defined as Complete Response (CR) plus Partial Response (PR) according to Response Evaluation Criteria in Solid Tumours
    (RECIST) version 1.1.
    Fase inicial: Determinar la tasa de incidencia de toxicidad limitante de dosis (TLD) dentro del primer ciclo de tratamiento con la combinación.
    · Fase II: La Tasa de respuestas objetivas (TRO) se define como las respuestas completas (RC) más las respuestas parciales (RP), según los Criterios de Evaluación de la Respuesta en los Tumores Sólidos (RECIST), versión 1.1.
    E.5.1.1Timepoint(s) of evaluation of this end point
    This study will be considered complete following the data cut-off date and datalock for the final analysis. The data cut-off date for the final analysis will occur after all enrolled patients have died or withdraw of the informed consent or there is sufficient data to achieve the primary nd secondary objectives, whatever occurs first.
    Este estudio se considera completo después de la fecha de corte de datos para el análisis final. La fecha de corte para el análisis final se producirá cuando todos los pacientes incluidos hallan fallecido o hayan retirado el consentimiento informado o no haya datos suficientes para alcanzar el objetivo primario n i los objetivos secundarios, lo que ocurra primero
    E.5.2Secondary end point(s)
    · Efficacy:
    - Progression-Free Survival (PFS) assessed according to RECIST version 1.1 by the investigator.
    - Clinical Benefit Rate (CBR) defined as Complete Response (CR) plus Partial Response (PR) plus Stable Disease (SD) lasting ≥ 24 weeks according to RECIST version 1.1.
    - Response Duration (RD) assessed according to RECIST version 1.1.
    - Overall Survival (OS). With special interest on long term responders (i.e. alive at 24 months).
    · Safety will be assessed by standard clinical and laboratory tests (haematology, serum chemistry). Adverse Events (AE) grade will be defined by the NCI CTCAE (National
    Cancer Institute Common Terminology Criteria for Adverse Events) version 4.0.
    Eficacia:
    - Supervivencia Libre de Progresión (SLP) evaluada por el investigador de acuerdo con la versión 1.1 de los criterios RECIST.
    - Tasa de beneficio clínico (TBC), definida como las respuestas completas (RC) más las respuestas parciales (RP) más los casos de enfermedad estable (EE) de ≥
    24 semanas de duración, según la versión 1.1 de los criterios RECIST.
    - Duración de la respuesta (DR), evaluada de acuerdo con la versión 1.1 de los criterios RECIST.
    - Supervivencia global (SG), poniendo especial atención en las pacientes respondedoras a largo plazo (es decir, aquellas que permanecen con vida tras 24
    meses).
    La seguridad se evaluará mediante pruebas clínicas convencionales y pruebas de laboratorio (hematología, bioquímica sérica). El grado de los acontecimientos adversos (AA) se definirá mediante la versión 4.0 de los NCI CTCAE (Criterios Terminológicos
    Comunes del Instituto Nacional del Cáncer para los Acontecimientos Adversos).
    E.5.2.1Timepoint(s) of evaluation of this end point
    This study will be considered complete following the data cut-off date and datalock for the final analysis. The data cut-off date for the final analysis will occur after all enrolled patients have died or withdraw of the informed consent or there is sufficient data to achieve the primary nd secondary objectives, whatever occurs first.
    Este estudio se considera completo después de la fecha de corte de datos para el análisis final. La fecha de corte para el análisis final se producirá cuando todos los pacientes incluidos hallan fallecido o hayan retirado el consentimiento informado o no haya datos suficientes para alcanzar el objetivo primario ni los objetivos secundarios, lo que ocurra primero
    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 Yes
    E.6.4Safety Yes
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic No
    E.6.7Pharmacodynamic Yes
    E.6.8Bioequivalence No
    E.6.9Dose response Yes
    E.6.10Pharmacogenetic No
    E.6.11Pharmacogenomic Yes
    E.6.12Pharmacoeconomic No
    E.6.13Others Yes
    E.6.13.1Other scope of the trial description
    Other exploratory biomarkers
    Otros biomarcadores exploratorios
    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) 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 No
    E.8.1.2Open Yes
    E.8.1.3Single blind No
    E.8.1.4Double blind No
    E.8.1.5Parallel group No
    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 No
    E.8.2.3Other No
    E.8.2.4Number of treatment arms in the trial1
    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 concerned10
    E.8.5The trial involves multiple Member States No
    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 date of study is date of last patient´s death or the date when there is sufficient data to achieve the primary and secondary objectives, whichever comes first.
    Performing exploratory objectives will be independent of the date of the end of the study.
    La fecha de finalización del estudio será la de la muerte de la última paciente o la fecha en que haya datos suficientes para alcanzar los objetivos principal y secundarios, lo que ocurra primero.
    La realización de los objetivos exploratorios será independiente de la fecha de finalización del estudio.
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years3
    E.8.9.1In the Member State concerned months5
    E.8.9.1In the Member State concerned days
    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: 65
    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 No
    F.3 Group of trial subjects
    F.3.1Healthy volunteers No
    F.3.2Patients Yes
    F.3.3Specific vulnerable populations No
    F.3.3.1Women of childbearing potential not using contraception No
    F.3.3.2Women of child-bearing potential using contraception No
    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 state65
    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)
    None. The Patients will receive the study treatment until disease progression. After, the treatment will be chosen by medical criteria
    Ninguno. Las pacientes recibirán el tratamiento del estudio hasta la progresión. Después el tratamiento será elegido por criterio médico
    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 Decision2017-01-05
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2016-12-16
    P. End of Trial
    P.End of Trial StatusCompleted
    P.Date of the global end of the trial2021-07-22
    For support, Contact us.
    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.

    European Medicines Agency © 1995-Sat May 04 12:28:07 CEST 2024 | Domenico Scarlattilaan 6, 1083 HS Amsterdam, The Netherlands
    EMA HMA