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    Summary
    EudraCT Number:2016-002453-38
    Sponsor's Protocol Code Number:15-102-14
    National Competent Authority:Italy - Italian Medicines Agency
    Clinical Trial Type:EEA CTA
    Trial Status:Prematurely Ended
    Date on which this record was first entered in the EudraCT database:2021-02-09
    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 number2016-002453-38
    A.3Full title of the trial
    A Phase 3 Open-Label, Randomized, Multicenter Study of NKTR-102 versus Treatment of Physician's Choice (TPC) in Patients with Metastatic Breast Cancer Who Have Stable Brain Metastases and Have Been Previously Treated with an Anthracycline, a Taxane, and Capecitabine
    Studio di Fase 3, in aperto, randomizzato, multicentrico sul confronto tra NKTR-102 e il trattamento scelto dal medico (TPC) in pazienti affetti da cancro al seno metastatico che presentano metastasi cerebrali stabili e che sono stati precedentemente trattati con un'antraciclina, un taxano e capecitabina
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    A study to compare the study drug NKTR-102 with standard treatments in breast cancer patients with stable brain metastases
    Uno studio per confrontare il farmaco in studio NKTR-102 con la terapia standard in pazienti con cancro al seno con metastasi celebrali stabili
    A.3.2Name or abbreviated title of the trial where available
    ATTAIN
    ATTAIN
    A.4.1Sponsor's protocol code number15-102-14
    A.5.1ISRCTN (International Standard Randomised Controlled Trial) NumberISRCTN00000000
    A.5.2US NCT (ClinicalTrials.gov registry) numberNCT02915744
    A.5.3WHO Universal Trial Reference Number (UTRN)U0000-0000-0000
    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 SponsorNEKTAR THERAPEUTICS
    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 supportNektar Therapeutics
    B.4.2CountryUnited States
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationNektar Therapeutics Contact Center
    B.5.2Functional name of contact pointClinical Trial Information Desk
    B.5.3 Address:
    B.5.3.1Street Address455 Mission Bay Boulevard South
    B.5.3.2Town/ citySan Francisco
    B.5.3.3Post codeCA 94158
    B.5.3.4CountryUnited States
    B.5.6E-mailStudyInquiry@nektar.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 nameetirinotecan pegol drug product
    D.3.2Product code NKTR-102
    D.3.4Pharmaceutical form Powder for 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 INNetirinotecan pegol
    D.3.9.1CAS number 1193151-06-2
    D.3.9.2Current sponsor codeNKTR-102
    D.3.9.4EV Substance CodeSUB129291
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number100
    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 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) 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: 2
    D.1.2 and D.1.3IMP RoleComparator
    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.2.1.1.1Trade name Halaven
    D.2.1.1.2Name of the Marketing Authorisation holderEisai Europe Ltd
    D.2.1.2Country which granted the Marketing AuthorisationEuropean Union
    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 nameEribulin
    D.3.2Product code [Eribulin]
    D.3.4Pharmaceutical form Solution for injection
    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 INNERIBULINA
    D.3.9.1CAS number 441045-17-6
    D.3.9.2Current sponsor code
    D.3.9.3Other descriptive nameERIBULIN MESYLATE
    D.3.9.4EV Substance CodeSUB31126
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number44
    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 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) 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 RoleComparator
    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.2.1.1.1Trade name VINORELBINE
    D.2.1.1.2Name of the Marketing Authorisation holder
    D.2.1.2Country which granted the Marketing AuthorisationItaly
    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 nameVinorelbine
    D.3.2Product code [Vinorelbine]
    D.3.4Pharmaceutical form Concentrate for 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 INNVINORELBINE TARTRATE
    D.3.9.1CAS number 125317-39-7
    D.3.9.2Current sponsor code
    D.3.9.3Other descriptive nameVinorelbine tartrate
    D.3.9.4EV Substance CodeSUB20777
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number10
    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 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) 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 RoleComparator
    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.2.1.1.1Trade name GEMCITABINA
    D.2.1.1.2Name of the Marketing Authorisation holder
    D.2.1.2Country which granted the Marketing AuthorisationItaly
    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 nameGemcitabine
    D.3.2Product code [Gemcitabine]
    D.3.4Pharmaceutical form Powder for 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 INNGemcitabine hydrochloride
    D.3.9.1CAS number 122111-03-9
    D.3.9.2Current sponsor code
    D.3.9.3Other descriptive name
    D.3.9.4EV Substance CodeSUB02324MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number38
    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 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) 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: 5
    D.1.2 and D.1.3IMP RoleComparator
    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.2.1.1.1Trade name PACLITAXEL
    D.2.1.1.2Name of the Marketing Authorisation holder
    D.2.1.2Country which granted the Marketing AuthorisationItaly
    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 namePaclitaxel
    D.3.2Product code [Paclitaxel]
    D.3.4Pharmaceutical form Concentrate for 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 INNPACLITAXEL
    D.3.9.1CAS number 33069-62-4
    D.3.9.2Current sponsor code
    D.3.9.3Other descriptive name
    D.3.9.4EV Substance CodeSUB09583MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number6
    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 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) 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: 6
    D.1.2 and D.1.3IMP RoleComparator
    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.2.1.1.1Trade name DOCETAXEL
    D.2.1.1.2Name of the Marketing Authorisation holder
    D.2.1.2Country which granted the Marketing AuthorisationItaly
    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 nameDocetaxel
    D.3.2Product code [Docetaxel]
    D.3.4Pharmaceutical form Concentrate for 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 INNDOCETAXEL
    D.3.9.1CAS number 114977-28-5
    D.3.9.2Current sponsor codeNA
    D.3.9.4EV Substance CodeSUB12492MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number20
    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 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) 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: 7
    D.1.2 and D.1.3IMP RoleComparator
    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.2.1.1.1Trade name Abraxane
    D.2.1.1.2Name of the Marketing Authorisation holderCelgene Europe Limited
    D.2.1.2Country which granted the Marketing AuthorisationEuropean Union
    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 nameNab-paclitaxel
    D.3.2Product code [Nab-paclitaxel]
    D.3.4Pharmaceutical form Powder for suspension for injection
    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 INNNab-paclitaxel
    D.3.9.2Current sponsor code
    D.3.9.3Other descriptive namePACLITAXEL ALBUMIN-BOUND
    D.3.9.4EV Substance CodeSUB127678
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number5
    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) 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
    Metastatic breast cancer with stable brain metastases
    cancro al seno metastatico con metastasi cerebrali stabili
    E.1.1.1Medical condition in easily understood language
    Breast cancer which has spread to the brain
    Cancro al seno che si ¿ diffuso al cervello
    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 PT
    E.1.2Classification code 10006198
    E.1.2Term Breast cancer recurrent
    E.1.2System Organ Class 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 20.1
    E.1.2Level PT
    E.1.2Classification code 10055113
    E.1.2Term Breast cancer metastatic
    E.1.2System Organ Class 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    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 overall survival (OS) of patients who receive 145 mg/m2 NKTR-102 given once every 21 days (q21d) with OS of patients who receive Treatment of Physician's Choice (TPC) selected from the
    following list of 7 single-agent intravenous (IV) therapies: eribulin, ixabepilone, vinorelbine, gemcitabine, paclitaxel, docetaxel, or nabpaclitaxel.
    TPC drugs will be administered per the standard of care.
    Confrontare la sopravvivenza generale (SG) dei pazienti che ricevono 145 mg/m2 di NKTR-102 una volta ogni 21 giorni (q21d) con la SG dei pazienti che ricevono il trattamento scelto dal medico (TPC) selezionato dal seguente elenco di 7 terapie endovenose (EV) ad agente singolo: eribulina, ixabepilone, vinorelbina, gemcitabina, paclitaxel, docetaxel o nab-paclitaxel. I farmaci TPC saranno somministrati in base allo standard di cura.
    E.2.2Secondary objectives of the trial
    ¿Confrontare i tassi di risposta obiettiva del trattamento con NKTR-102 con quelli del TPC
    ¿Confrontare la sopravvivenza libera da progressione del trattamento con NKTR-102 con quella del TPC;
    ¿Confrontare il tasso di beneficio clinico del trattamento con NKTR-102 con quello del TPC
    ¿Confrontare la durata della risposta del trattamento con NKTR-102 con quella del TPC
    ¿Valutare i profili di sicurezza di NKTR-102 e TPC
    ¿Confrontare la qualit¿ della vita correlata alla salute del trattamento con NKTR-102 con quella TPC utilizzando il questionario EORTC QLQ con questionario BN-20,questionario EQ-5D-5LTM e Brief Fatigue Inventory
    ¿Valutare dati farmacocinetici (solo paz randomizzati NKTR-102)
    ¿Correlare presenza di varianti di ridotta attivit¿ UGT1A1 con la sicurezza di NKTR-102 (solo paz randomizzati NKTR-102)
    ¿Valutare le implicazioni farmacoeconomiche della terapia con NKTR-102 utilizzando le misure delle cure sanitarie
    ¿Valutare livello di beneficio utilizzando la scala ESMO-MCBS
    ¿Confrontare i tassi di risposta obiettiva del trattamento con NKTR-102 con quelli del TPC
    ¿Confrontare la sopravvivenza libera da progressione del trattamento con NKTR-102 con quella del TPC;
    ¿Confrontare il tasso di beneficio clinico del trattamento con NKTR-102 con quello del TPC
    ¿Confrontare la durata della risposta del trattamento con NKTR-102 con quella del TPC
    ¿Valutare i profili di sicurezza di NKTR-102 e TPC
    ¿Confrontare la qualit¿ della vita correlata alla salute del trattamento con NKTR-102 con quella TPC utilizzando il questionario EORTC QLQ con questionario BN-20,questionario EQ-5D-5LTM e rief Fatigue Inventory
    ¿Valutare dati farmacocinetici (solo paz randomizzati NKTR-102)
    ¿Correlare presenza di varianti di ridotta attivit¿ UGT1A1 con la sicurezza di NKTR-102 (solo paz randomizzati NKTR-102)
    ¿Valutare le implicazioni farmacoeconomiche della terapia con NKTR-102 utilizzando le misure delle cure sanitarie
    ¿Valutare livello di beneficio utilizzando la scala ESMO-MCBS

    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    - Female or male, age = 18 years.
    - Histologically-confirmed carcinoma of the breast (either the primary or metastatic lesions) for whom single-agent cytotoxic chemotherapy is indicated. Patients may have either measurable or non-measurable disease according to RECIST version 1.1.
    - History of brain metastases that are non-progressing.
    - For triple-negative breast cancer, a minimum of 1 prior cytotoxic chemotherapy regimen must have been administered for the indication of metastatic disease. For HER2-positive disease, a minimum of 2 cytotoxic chemotherapy regimens must have been administered for the indication of metastatic disease as well as at least 1 hormonal therapy.
    For HER2-positive disease, a minimum of 2 cytotoxic chemotherapy regimens must have been administered for the indication of metastatic disease as well as at least 1 HER2 targeted therapy (ado-trastuzumab emtansine is considered a cytotoxic chemotherapy regimen).
    - Have had prior therapy (administered in the neoadjuvant, adjuvant, and/or metastatic setting) with an anthracycline, a taxane, and capecitabine (prior anthracycline can be omitted if not medically appropriate or contraindicated for the patient).
    - Last dose of anticancer therapy must have been administered within 6 months of the date of randomization into this study.
    - All anticancer- and radiation therapy-related toxicities must be completely resolved or downgraded
    - ECOG performance status of 0 or 1.
    - Adequate organ function obtained within 14 days prior to randomization and analyzed by the central laboratory
    - Use highly effective methods of birth control throughout the duration of the study until 6 months following the last dose of study drug.
    -Femmina o maschio, età = 18 anni.
    -Carcinoma mammario confermato istologicamente (lesioni sia primarie sia metastatiche) per il quale è indicata la chemioterapia citotossica ad agente singolo. I pazienti possono presentare malattia misurabile o non misurabile secondo RECIST versione 1.1.
    -anamnesi di metastasi cerebrali non in progressione.
    -Per il cancro al seno triplo negativo, deve essere stato somministrato almeno 1 regime chemioterapico citotossico precedente per l’indicazione della malattia metastatica. Per la malattia ormone-recettore-positiva (HER2-positiva) devono essere stati somministrati almeno 2 regimi chemioterapici citotossici per l’indicazione della malattia metastatica, oltre ad almeno 1 terapia ormonale. Per la malattia HER2-positiva devono essere stati somministrati almeno 2 regimi chemioterapici citotossici per l’indicazione della malattia metastatica, oltre ad almeno 1 terapia mirata a HER2 (ado-trastuzumab emtansine è considerato un regime chemioterapico citotossico).
    -Hanno ricevuto una terapia precedente (somministrata in setting neoadiuvante, adiuvante e/o metastatico) con un’antraciclina, un taxano e capecitabina (l’antraciclina precedente può essere omessa se clinicamente non appropriata o controindicata per il paziente).
    -L’ultima dose di terapia antitumorale deve essere stata somministrata entro 6 mesi dalla data di randomizzazione nel presente studio.
    -Tutte le tossicità correlate alla terapia antitumorale e alla radioterapia devono essersi risolte completamente o diminuite
    -Stato ECOG di 0 o 1
    -adeguata funzionalità organica raggiunta entro 14 giorni prima della randomizzazione, analizzata dal laboratorio centrale
    -usare metodi contraccettivi altamente efficaci per tutta la durata dello studio e fino a 6 mesi dopo l’ultima dose del farmaco in studio
    E.4Principal exclusion criteria
    - Last dose of anticancer therapy (including HER2-targeted therapy) within 14 days prior to randomization.
    - High-dose chemotherapy followed by stem cell transplantation (autologous or allogeneic).
    - Major surgery within 28 days prior to randomization.
    - Concomitant use of any anticancer therapy or use of any investigational agent(s).
    - Received prior treatment for cancer with a camptothecin-derived agent.
    - Brain metastases amenable to local therapy but without completion of such therapy
    - Lesions on imaging, by cerebrospinal fluid or with neurological findings that are consistent with leptomeningeal disease or meningeal carcinomatosis.
    - Chronic or acute GI disorders resulting in diarrhea of any severity grade.
    - Patients who are pregnant or lactating, plan to get pregnant, or have a positive serum pregnancy test prior to randomization.
    - Enzyme-inducing anti-epileptic drugs (EIAEDs) within 14 days of randomization.
    - Hepatitis B or C, tuberculosis, or HIV.
    - Cirrhosis.
    - Prior malignancy (other than breast cancer) unless diagnosed and definitively treated more than 5 years prior to randomization.
    - Severe/uncontrolled illness within the previous 28 days prior to randomization.
    - Daily use of oxygen supplementation
    - Significant known cardiovascular impairment
    - Prior treatment with NKTR-102.
    - Psychiatric illness, social situation, or geographical situation that
    precludes informed consent or limit compliance.
    - Known hypersensitivity to any of the products used in this study, or their excipients.
    - For patients selecting vinorelbine or gemcitabine as the TPC agent, patients may not receive yellow fever vaccine in the 28 days prior to randomization.
    -Ultima dose di terapia antitumorale (compresa la terapia mirata a HER2) entro 14 giorni prima della randomizzazione.
    -chemioterapia ad alto dosaggio seguita da trapianto di cellule staminali (autologo o allogenico).
    -intervento importante entro 28 giorni prima della randomizzazione.
    -Uso concomitante di qualsiasi terapia antitumorale o uso di qualsiasi agente sperimentale.
    -trattamento precedente con un derivato della camptotecina
    -metastasi cerebrali ricettive alla terapia locale ma senza completamento di tale terapia
    -lesioni all’imaging, nel liquido cefalorachidiano o con risultati neurologici che lo sperimentatore ritiene coerenti con la patologia leptomeningea o carcinomatosi leptomeningea.
    -disturbi gastrointestinali acuti o cronici che provocano diarrea di qualsiasi grado di gravità;
    -Pazienti in gravidanza o allattamento, che pianificano una gravidanza o che hanno un test di gravidanza sierologico positivo prima della randomizzazione
    -Farmaci EIAED entro 14 giorni dalla randomizzazione
    -Terapia per epatite B o C, tubercolosi o l’HIV.
    -Malignità precedente (diversa dal cancro al seno), tranne nei casi in cui sia stata diagnostica e trattata definitivamente più di 5 anni prima della randomizzazione.
    -Malattia grave/incontrollata entro i 28 giorni precedenti alla randomizzazione.
    -uso quotidiano di ossigeno supplementare nei 28 giorni precedenti alla randomizzazione.
    -Disturbo cardiovascolare significativo noto
    -Trattamento precedente con NKTR-102.
    -malattia psichiatrica, situazione sociale o situazione geografica che impedirebbero il consenso informato o limiterebbero il rispetto dei requisiti dello studio.
    -Ipersensibilità nota nei confronti di qualsiasi dei prodotti utilizzati in questo studio o ai relativi eccipienti.
    -Per i pazienti selezionati per la vinorelbina o la gemcitabina come agente TPC, i pazienti non possono ricevere il vaccino contro la febbre gialla nei 28 giorni antecedenti la randomizzazione.

    E.5 End points
    E.5.1Primary end point(s)
    Overall survival
    Sopravvivenza Globale
    E.5.1.1Timepoint(s) of evaluation of this end point
    Monitored throughout the study
    Controllata durante tutta la durata dello studio
    E.5.2Secondary end point(s)
    -Progression-free survival (outside the CNS)

    -Progression-free survival in brain metastases

    -Objective response rate

    -Clinical benefit rate

    -Duration of response

    -HRQoL

    -Magnitude of Clinical Benefit; -Sopravvivenza libera da progressione (al di fuori del sistema nervoso centrale)

    -La sopravvivenza libera da progressione a metastasi cerebrali

    - tasso di risposta obiettiva

    -tasso di beneficio clinico

    -La durata della risposta

    -Qualit¿ della vita coorelata alla salute (HRQoL)

    -Entit¿ del beneficio clinico
    E.5.2.1Timepoint(s) of evaluation of this end point
    PFS outside the CNS, PFS in brain metastases, CBR and DoR - monitored throughout the study,


    ORR - Screening, every 8 weeks through Week 24, then every 12 weeks thereafter


    HRQoL - Day 1 of each treatment Cycle prior to infusion and at End of Treatment visit
    Sopravvivenza libera da progressione (al di fuori del sistema nervoso centrale), la sopravvivenza libera da progressione a metastasi cerebrali, il tasso di beneficio clinico e la durata della risposta: saranno monitorati durante tutta la duranta dello studio,

    Il tasso di risposta obiettiva: allo screening, ogni 8 settimanefino alla settimana 24, e da allora in poi ogni 12 settimane;

    -Qualit¿ della vita coorelata alla salute (HRQoL) : al giorno 1 di ogni ciclo di trattamento prima dell'infusione e alla visita di fine trattamento

    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 Yes
    E.6.7Pharmacodynamic Yes
    E.6.8Bioequivalence No
    E.6.9Dose response No
    E.6.10Pharmacogenetic No
    E.6.11Pharmacogenomic No
    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 Yes
    E.8.1.3Single blind No
    E.8.1.4Double blind No
    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) Yes
    E.8.2.2Placebo No
    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 concerned15
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA116
    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
    Canada
    Israel
    New Zealand
    United States
    Austria
    Belgium
    France
    Germany
    Ireland
    Italy
    Netherlands
    Poland
    Spain
    Switzerland
    United Kingdom
    Czechia
    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 end of study is defined as the date of database lock for all patients.
    La fine dello studio ¿ definita come la data di chiusura del database per tutti i pazienti
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years2
    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 years2
    E.8.9.2In all countries concerned by the trial months11
    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: 280
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 70
    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 state30
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 200
    F.4.2.2In the whole clinical trial 350
    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
    Nessuno
    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 Decision2017-08-01
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2017-03-15
    P. End of Trial
    P.End of Trial StatusPrematurely Ended
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