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    Summary
    EudraCT Number:2016-002522-36
    Sponsor's Protocol Code Number:CPDR001E2201
    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:2016-12-09
    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 ConcernedSpain - AEMPS
    A.2EudraCT number2016-002522-36
    A.3Full title of the trial
    An open label phase II study to evaluate the efficacy and safety of PDR001 in patients with advanced or metastatic non-functional neuroendocrine tumors of pancreatic, gastrointestinal (GI), or thoracic origin who have progressed on prior treatment
    Estudio fase II, abierto, para evaluar la eficacia y la seguridad de PDR001 en pacientes con tumores neuroendocrinos metastásicos, no funcionales de origen pancreático, gastrointestinal (GI) o torácico, que han progresado al tratamiento previo
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    An open label phase II study to find out if the drug PDR001 is safe and has beneficial effects in patient who have advanced or metastatic non-functional neuroendocrine tumors of pancreatic, gastrointestinal, or thoracic origins and have progressed on prior treatment
    Estudio de eficacia y seguridad de PDR001 en pacientes con tumores neuroendocrinos metastásicos, no funcionales de origen pancreático, gastrointestinal (GI) o torácico
    A.4.1Sponsor's protocol code numberCPDR001E2201
    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 SponsorNovartis Farmacéutica, S.A.
    B.1.3.4CountrySpain
    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 supportNovartis Pharma Services AG
    B.4.2CountrySwitzerland
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationNovartis Farmacéutica, S.A.
    B.5.2Functional name of contact pointDepartamento Médico
    B.5.3 Address:
    B.5.3.1Street AddressGran Vía de les Corts Catalanes, 764
    B.5.3.2Town/ cityBarcelona
    B.5.3.3Post code'08013
    B.5.3.4CountrySpain
    B.5.4Telephone number+ 34 90 0353036
    B.5.5Fax number+ 34 93 2479903
    B.5.6E-maileecc.novartis@novartis.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.3.2Product code PDR001
    D.3.4Pharmaceutical form Lyophilisate 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 INNPDR001
    D.3.9.1CAS number PDR001
    D.3.9.2Current sponsor codePDR001
    D.3.9.4EV Substance CodeSUB171710
    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 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) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product Yes
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.8 Information on Placebo
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    Advanced neuroendocrine tumor (NET) of pancreatic, GI or lung origin
    Tumores neuroendocrinos metastásicos (NET) de origen pancreático, gastrointestinal (GI) o pulmonar
    E.1.1.1Medical condition in easily understood language
    Advanced neuroendocrine cancer of gastrointestinal or pancreatic or lung origin
    Cancer neuroendocrinos metastásicos de origen gastrointestinal o pancreático o pulmonar
    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 PT
    E.1.2Classification code 10052399
    E.1.2Term Neuroendocrine tumour
    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 estimate the antitumor activity of
    PDR001 as a single agent in patients
    with non-functional NET
    Calcular la actividad antitumoral de PDR001 en monoterapia, en pacientes con TNE no funcional
    E.2.2Secondary objectives of the trial
    To estimate efficacy of PDR001
    To assess the safety and tolerability
    of PDR001 in patients with non-functional
    NET
    To evaluate additional efficacy
    parameters
    To evaluate biochemical response to
    treatment (based on CgA and NSE)
    To characterize the
    pharmacokinetics of PDR001 with
    400 mg flat dose Q4W
    To characterize patient’s health related
    quality of life with PDR001
    To evaluate the prevalence and
    incidence of immunogenicity
    Calcular la eficacia de PDR001.
    Evaluar la seguridad y la tolerabilidad de PDR001 en pacientes con TNE no funcional.
    Evaluar parámetros de eficacia adicionales.
    Evaluar la respuesta bioquímica al tratamiento (basado en CgA y NSE).
    Caracterizar la farmacocinética de PDR001 con dosis fijas de 400 mg Q4S.
    Caracterizar la calidad de vida relacionada con la salud del paciente con PDR001.
    Evaluar el predominio y la frecuencia de inmunogenicidad.
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1. Written informed consent must be obtained prior to any screening procedures
    2. Adult males or females ≥ 18 years at screening.
    3. Pathologically confirmed, well-differentiated (G1 or G2) based on local pathologist report,
    advanced (unresectable or metastatic), non-functional neuroendocrine tumor of GI,
    pancreatic or thoracic (including lung and thymus) origin.
    4. No history of, and no active symptoms related to carcinoid syndrome.
    5. Patients must have received prior treatment for advanced disease:
     Thoracic (lung and thymus origin) cohort:
     Thymus origin: at least one prior systemic therapy according to investigator’s
    choice
     Lung origin: at least one prior systemic therapy is required, which must include
    everolimus.
     GI cohort: at least two prior systemic regimens, which must include everolimus. Prior
    systemic therapies may include: somatostatin analogs, PRRT, and chemotherapy
     pNET cohort: at least two prior systemic regimens, which must include everolimus or
    sunitinib. Prior systemic therapies may include: somatostatin analogs, PRRT, and
    chemotherapy
    Note: Prior treatment with interferon alpha is allowed provide that it is not the last
    treatment received prior to study entry
    6. Radiological documentation of disease progression while on/or after the last treatment,
    and this progression must have been observed within 6 months prior to start of study
    treatment (i.e. maximum of 24 weeks from documentation of progression until study
    entry). Disease must show evidence of radiological disease progression based on scans
    performed not more than one year apart.
    7. At least one measurable lesion assessed by CT and/or MRI according to RECIST 1.1.
    Note: Any lesions which have been subjected to percutaneous therapies or radiotherapy
    should not be considered measurable, unless the lesion has clearly progressed since the
    procedure.
    8. Patient has an Eastern Cooperative Oncology Group (ECOG) performance status 0-2.
    9. Patients must be willing to provide biopsy material for the purpose of biomarker analysis
    that was collected following the diagnosis of metastatic disease. The tumor sample must
    be collected from a metastatic site not previously irradiated and should preferably be
    taken within 6 months but not more than 1 year prior to start of study treatment.
    10. Women of childbearing potential must have had a negative serum pregnancy test within
    72 hours prior to the start of study treatment. Highly effective contraception must be used
    while on study.
    11. Patient is deemed by the investigator to have the ability and means to be compliant with
    the protocol (treatment and follow-up).
    12. Patient must meet the following laboratory values at the screening visit:
     Absolute Neutrophil Count ≥1.5 x 109/L
     Platelets ≥75 x 109/L
     Hemoglobin (Hgb) ≥9 g/dL
     Serum creatinine <1.5 mg/dL
     Total bilirubin ≤1.5 x ULN
     Aspartate transaminase (AST) ≤ 3.0 x ULN, except for patients with liver metastasis,
    if AST ≤5.0 x ULN
     Alanine transaminase (ALT) ≤ 3.0 x ULN, except for patients with liver metastasis, if
    ALT ≤5.0 x ULN
    1.El consentimiento informado por escrito deberá obtenerse antes de cualquier procedimiento de selección.
    2.Pacientes hombres y mujeres adultos >/=18 años, en el momento de la selección.
    3.Tumor neuroendocrino no funcional, avanzado, bien diferenciado (G1 o G2), confirmado patológicamente basado en el informe del patólogo local, de origen GI, pancreático o torácico (incluyendo pulmón y timo)
    4. Sin antecedentes de, ni síntomas activos relacionados con síndrome carcinoide.
    5. A los pacientes se les deberá haber tratado previamente la enfermedad avanzada con lo siguiente:
    - Cohorte torácica (origen pulmonar y del timo)
    - Origen del timo: por lo menos una terapia sistémica previa a elección del investigador.
    - Origen pulmonar: se requiere por lo menos una terapia sistémica previa, que deberá incluir everolimus.
    - Cohorte GI: por lo menos dos regímenes sistémicos previos que deberán incluir everolimus. Las terapias sistémicas previas pueden incluir: análogos de la somatostatina, PRRT y quimioterapia
    - Cohorte pTNE: por lo menos dos regímenes sistémicos previos que deberán incluir everolimus o sunitinib. Las terapias sistémicas previas pueden incluir: análogos de la somatostatina, PRRT y quimioterapia.
    Nota: Se permite el tratamiento previo con interferón alfa siempre que no sea el último tratamiento recibido antes de entrar en el estudio.
    6. Documentación radiológica de progresión de la enfermedad durante/o después del último tratamiento; la progresión deberá haber sido observada dentro de los 6 meses antes de iniciar el tratamiento del estudio (es decir, máximo de 24 semanas desde la documentación de progresión hasta el inicio del estudio). La enfermedad deberá mostrar evidencia de progresión basado en escáneres realizados con no más de 1 año de diferencia.
    7. Por lo menos una lesión medible evaluada con TC y/o RM según los RECIST 1.1. Nota: Cualquier lesión que haya sido sometida a terapias percutáneas o a radioterapia no debería ser considerada medible, a menos que la lesión haya progresado claramente desde el procedimiento.
    8. Paciente con un estado funcional del Grupo de oncología cooperativo del este (ECOG) 0-2
    9. Los pacientes deberán estar dispuestos a proporcionar material de biopsia para el propósito del análisis de biomarcadores que haya sido recogido después del diagnóstico de enfermedad metastásica. La muestra de tumor deberá recogerse de una zona metastásica que no haya sido irradiada previamente y preferiblemente debería haberse recogido dentro de los 6 meses pero no más 1 año antes de iniciar el tratamiento del estudio.
    10. Las mujeres en edad fértil deberán presentar una prueba de embarazo en suero con resultados negativos, 72 horas antes de iniciar el tratamiento del estudio. Deberán utilizarse métodos anticonceptivos altamente eficaces durante todo el estudio.
    11. Pacientes que sean considerados por el investigador con capacidad y medios para cumplir con el protocolo (tratamiento y seguimiento).
    12.Los pacientes deberán cumplir los siguientes valores de laboratorio en la visita de selección:
    - Recuento absoluto de neutrófilos >/= 1.5 x 109/L
    - Plaquetas >/= 75 x 109/L
    - Hemoglobina (Hb) >/= 9 g/dL
    - Creatinina sérica < 1.5 mg/dL
    - Bilirrubina total </=1.5 x LSN
    - Aspartato transaminasa (AST) </= 3.0 x LSN, excepto para pacientes con metástasis hepáticas, si AST </= 5.0 x LSN
    - Alanina transaminasa (ALT) </= 3.0 x LSN, excepto para pacientes con metástasis hepáticas, si AST </= 5.0 x LSN
    E.4Principal exclusion criteria
    1. Poorly differentiated neuroendocrine carcinoma, high-grade neuroendocrine carcinoma,
    adenocarcinoid, goblet cell carcinoid, large cell neuroendocrine carcinoma and small cell
    carcinoma.
    2. Pretreatwith interferon as last treatment prior to start of study treatment
    3. Prior treatment for study indication
    4. Systemic chronic steroid therapy (≥ 10mg/day prednisone or equivalent) or any
    immunosuppressive therapy 7 days prior to planned date for first dose of study treatment.
    5. Any untreated central nervous system (CNS) lesion.
    6. Use of hematopoietic colony-stimulating growth factors (e.g. G-CSF, GM-CSF, M-CSF),
    thrombopoietin mimetics or erythroid stimulating agents ≤ 2 weeks prior to the first dose
    of study treatment.
    7. Malignant disease, other than that being treated in this study.
    8. Major surgery, open biopsy, or significant traumatic injury within 2 weeks prior to start of
    study treatment.
    9. Anticipation of the need for major surgical procedure during the course of the study
    10. Radiation therapy within 4 weeks prior to start of study treatment
    11. Hepatic intra-arterial embolization within the last 6 months.
    12. History of severe hypersensitivity reactions to other monoclonal antibodies
    13. Impaired cardiac function or clinically significant cardiac disease, including any of the
    following:
    14. Active, known or suspected autoimmune disease or a documented history of autoimmune
    disease, including ulcerative colitis and Crohn’s disease
    15. Active infection requiring systemic antibiotic therapy.
    16. Known history of testing positive for Human Immunodeficiency Virus (HIV) infection.
    17. Patients with active Hepatitis B infection (HBsAg positive) will be excluded.
    18. Patients with positive test for hepatitis C ribonucleic acid (HCV RNA)..
    19. Any medical condition that would, in the investigator’s judgment, prevent the patient’s
    participation in the clinical study due to safety concerns, compliance with clinical study
    procedures or interpretation of study results.
    20. Use of any live vaccines against infectious diseases within 4 weeks of initiation of study
    treatment.
    21. Presence of ≥ CTCAE grade 2 toxicity (except alopecia, peripheral neuropathy, and
    ototoxicity, which are exclusion criteria if ≥ CTCAE grade 3) due to prior cancer therapy.
    22. Not able to understand and to comply with study instructions and requirements.
    23. Pregnant or nursing (lactating) women confirmed by a positive hCG laboratory test within
    72 hours prior to initiating study treatment. Note: Low levels of hCG may also be
    considered a tumor marker, therefore if low hCG levels are detected, another blood sample
    at least 4 days later must be taken to assess the kinetics of the increase and transvaginal
    ultrasound must be performed to rule out pregnancy.
    24. Women of child-bearing potential, defined as all women physiologically capable of
    becoming pregnant, unless they are using highly effective methods of contraception
    during dosing and for 150 days after stopping treatment with PDR001. Highly effective
    contraception methods include:
    a. Total abstinence (when this is in line with the preferred and usual lifestyle of the
    patient). Periodic abstinence (e.g., calendar, ovulation, symptothermal, post-ovulation
    methods) and withdrawal are not acceptable methods of contraception
    b. Female sterilization (have had surgical bilateral oophorectomy with or without
    hysterectomy), total hysterectomy, or tubal ligation at least six weeks before taking
    study treatment. In case of oophorectomy alone, only when the reproductive status of
    the woman has been confirmed by follow up hormone level assessment
    c. Male sterilization (at least 6 months prior to screening). The vasectomized male
    partner should be the sole partner for that patient
    d. Use of oral, injected or implanted hormonal methods of contraception or placement of
    an intrauterine device (IUD) or intrauterine system (IUS), or other forms of hormonal
    contraception that have comparable efficacy (failure rate <1%), for example hormone
    vaginal ring or transdermal hormone contraception
    Note: In case of use of oral contraception women should have been stable on the same
    pill for a minimum of 3 months before taking study treatment.
    25. Sexually active males unless they use a condom during intercourse while on treatment and
    for 150 days after stopping treatment with PDR001 and should not father a child in this
    period. A condom is required to be used by vasectomized men as well during intercourse
    in order to prevent delivery of the drug via semen.
    1. Carcinoma neuroendocrino pobremente diferenciado, carcinoma neuroendocrino de alto grado, adenocarcinoide, carcinoide de células globet, carcinoma neuroendocrino de células grandes y carcinoma de células pequeñas
    2. Pretratamiento con interferón como último tratamiento previo al inicio del tratamiento del estudio.
    3. Tratamiento previo para la indicación del estudio
    4. Tratamiento sistémico crónico con esteroides (>/= 10 mg/día de prednisona o equivalente) o cualquier terapia inmunosupresora 7 días antes de la fecha prevista para la primera dosis del tratamiento del estudio.
    5. Cualquier lesión del SNC no tratada.
    6. Uso de factores de crecimiento hematopoyético estimulantes de colonias, de miméticos de trombopoyetina o agentes estimulantes de eritroides </=2 semanas antes de la primera dosis del tratamiento del estudio.
    7. Otra enfermedad maligna que no sea la que se está tratando en este estudio.
    8. Procedimiento quirúrgico mayor, biopsia abierta o lesión traumática significativa dentro de las 2 semanas antes de iniciar el tratamiento del estudio.
    9. Previsión de necesidad de procedimiento quirúrgico mayor durante el transcurso del estudio.
    10. Radioterapia dentro de las 4 semanas antes de iniciar el tratamiento.
    11.Embolización hepática intraarterial dentro de los últimos 6 meses.
    12.Antecedentes de reacciones de hipersensibilidad severa a otros anticuerpos monoclonales.
    13.Deterioro de la función cardíaca o cardiopatía clínicamente significativa
    14.Enfermedad autoinmune sospechada, conocida o activa o antecedentes documentados de enfermedad autoinmune que incluya colitis ulcerativa y enfermedad de Crohn.
    15. Infección activa que precise tratamiento sistémico con antibióticos.
    16.Antecedentes de prueba de infección por VIH con resultados positivos.
    17.Pacientes con infección activa por hepatitis B serán excluidos.
    18.Pacientes con resultados positivos en la prueba de ácido ribonucléico de hepatitis C.
    19.Cualquier condición médica que, a criterio del investigador, pudiese impedir la participación del paciente en el estudio clínico debido a problemas de seguridad, de cumplimiento con los procedimientos del estudio clínico o con la interpretación de los resultados del estudio.
    20.Uso de vacunas vivas contra enfermedades infecciosas dentro de las 4 semanas del inicio del tratamiento del estudio.
    21.Presencia de toxicidad >/= grado 2 de los CTCAE (excepto alopecia, neuropatía periférica y ototoxicidad, que son criterios de exclusión si son >/= grado 3 de los CTCAE) debida a la terapia antineoplásica previa.
    22.Pacientes que no puedan comprender o cumplir con las instrucciones y requisitos del estudio.
    23. Pacientes embarazadas o en periodo de lactancia, confirmado con una prueba de laboratorio hCG positiva dentro de las 72 horas antes de iniciar el tratamiento del estudio. Nota: Los niveles bajos de hCG también pueden ser considerados un marcador tumoral, si se detectan niveles bajos de hCG, deberá extraerse otra muestra de sangre por lo menos 4 días después para evaluar la cinética del aumento y realizarse una ecografía transvaginal para descartar el embarazo.
    24.Mujeres en edad fértil, definidas como mujeres fisiológicamente capaces de quedarse embarazadas, a no ser que utilicen métodos anticonceptivos altamente eficaces durante la dosis y durante 150 días después de suspender el tratamiento con PDR001.
    Métodos anticonceptivos altamente eficaces incluyen: a) abstinencia total: cuando esté en consonancia con el estilo de vida habitual y preferida del paciente. La abstinencia periódica y el coitus interruptus no son métodos anticonceptivos aceptables. b) Esterilización femenina (ooforectomía bilateral quirúrgica (con o sin histerectomía), histerectomía total o ligadura de trompas al menos 6 semanas antes de tomar el tratamiento del estudio. En caso de ooforectomía solo, cuando el estado reproductor de la mujer haya sido confirmado con evaluación de seguimiento del nivel hormonal. c) Esterilización masculina (al menos 6 meses antes de la selección). El varón vasectomizado debería ser la única pareja de dicha paciente. d) Uso de métodos anticonceptivos hormonales orales, inyectados o implantados o colocación de un dispositivo intrauterino o sistema intrauterino o de otros métodos anticonceptivos hormonales con una eficacia comparable (tasa de fallo <1%), por ej., anillo vaginal hormonal o anticonceptivo hormonal transdérmico. Nota: En el caso de uso de anticoncepción oral, las mujeres deberían haber mantenido dosis estables de la misma píldora durante un mínimo de 3 meses antes de tomar el tratamiento del estudio.
    25.Varones sexualmente activos, a menos que utilicen un preservativo durante el coito mientras reciban tratamiento y 150 días después de suspender el tratamiento con PDR001 y no deberían engendrar hijos durante este periodo. Los varones vasectomizados también deberán utilizar un preservativo durante el coito para evitar la liberación del fármaco vía fluido seminal.
    E.5 End points
    E.5.1Primary end point(s)
    ORR (confirmed PR and CR)
    according to blinded independent
    review committee (BIRC) radiological
    assessment by RECIST 1.1
    Tasa de Respuesta Global (confirmada Respuesta Parcial y Respuesta Completa) según la evaluación radiológica por RECIST 1.1 del Comité de Revisión Independiente enmascarado (BIRC)
    E.5.1.1Timepoint(s) of evaluation of this end point
    Imaging:
    Treatment Period: Every 8 weeks counting from Cycle 1 Day 1 for the first 13 cycles and then every 12 weeks from Cycle 13 Day1 thereafter
    EOT: If a scan was not conducted within 30 days prior to end of study treatment
    Efficacy follow-up: Continue same schedule as during treatment period until BIRC confirmed irRECIST progression
    Evaluaciones radiológicas:
    Período de tratamiento: Cada 8 semanas desde el día 1 del ciclo 1 durante los primeros 13 ciclos y cada 12 semanas después a partir del día 1 del ciclo 13.
    Fin de tratamiento: Si no se realizó un escáner dentro de los 30 días antes del final del tratamiento del estudio.
    Seguimiento de eficacia: Continuar con el mismo calendario que durante el periodo de tratamiento hasta confirmación por el BIRC de la progresión según los irRECIST.
    E.5.2Secondary end point(s)
    DoR by RECIST 1.1 and as per BIRC
    Frequency and severity of adverse
    events
    Other safety data as considered
    appropriate
    Disease Control Rate (DCR),
    Time to Response (TTR),
    PFS by RECIST 1.1 and as per BIRC
    Immune Response Criteria by
    irRECIST and as per BIRC (irORR,irDoR, irTTR, irDCR, irPFS)
    1-year and 2-year overall survival
    (OS) rate
    Changes from baseline in CgA and
    NSE
    PK parameters (e.g. Ctrough)
    Global health status/QOL score of
    the EORTC QLQ-C30 and the index
    score of the EQ-5D-5L
    Antidrug antibodies (ADA)
    prevalence at baseline and ADA
    incidence on-treatment
    DR según los RECIST 1.1 y según el BIRC
    Frecuencia y severidad de acontecimientos adversos
    Otros datos de seguridad que se consideren apropiados
    Tasa de control de la enfermedad (TCE)
    Tiempo hasta la respuesta (TR)
    SLP según los RECIST 1.1 y según el BIRC
    Criterios de inmunorespuesta del BIRC con los irRECIST y según el BIRC (irTRG, irDR, irTR, irTCE, irSLP)
    Tasa de supervivencia global (SG) al año y a los 2 años
    Cambios en la CgA y NSE, respecto a la visita basal
    Parámetros pK (por ejemplo, Ctrough)
    Estado de salud global/puntuación del QOL del QLQ-C30 de la EORTC y la puntuación del índice del EQ-5D-5L
    Frecuencia de anticuerpos antifármaco (ADA) en la visita basal e incidencia de ADA durante el tratamiento
    E.5.2.1Timepoint(s) of evaluation of this end point
    Imaging:
    Treatment Period: Every 8 weeks counting from C1 D1 for the first 13 cycles and then every 12 weeks from C13 D1 thereafter
    EOT: If a scan was not conducted within 30 days prior to end of study treatment
    Efficacy f/u: until BIRC confirmed irRECIST progression
    PK/IG:
    Treatment period:
    At D1 of all cycles until C13 and D1 of every 6 cycles thereafter
    EOT
    30-Day safety f/u
    Unscheduled:
    At the time of PD based on RECIST 1.1
    At the time of PD based on irRECIST
    PRO:
    Screening
    Treatment: Every 8 weeks from C3 D1 for the first 13 cycles and every 12 weeks from C13 D1 thereafter EOT 30-day safety follow-up
    Efficacy follow-up: Continue same schedule as during treatment period until BIRC confirmed irRECIST progression
    CgA/NSE:
    Screening
    Treatment: D1 of each cycle
    Evaluaciones radiológicas:
    Periodo de tratamiento:Cada 8 semanas desde el día 1 del ciclo 1 durante los primeros 13 ciclos y cada 12 semanas después a partir del día 1 del ciclo 13
    Fin de tratamiento: Si no se realizó un escáner dentro de los 30 días antes del final del tratamiento del estudio.
    Seguimiento de eficacia: hasta confirmación por el Comité de Revisión Independiente enmascarado (BIRC) de la progresión según los irRECIST
    Farmacocinética/Inmunogenicidad:
    Periodo de tratamiento: El D1 de todos los ciclos hasta el C13 y después el D1 de cada 6 ciclos
    EOT
    Seguimiento de seguridad a los 30 días
    No programado:
    En el momento de PE basado en los RECIST 1.1
    En el momento de PE basado en los irRECIST

    Por favor vean el protocolo del estudio para más información
    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) 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.8.3 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 concerned3
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA29
    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 No
    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
    Austria
    Belgium
    Canada
    France
    Germany
    Israel
    Italy
    Japan
    Netherlands
    Norway
    Spain
    Sweden
    Switzerland
    United Kingdom
    United States
    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
    LVLS: ‘end of study’ will be declared after all patients have discontinued study treatment and completed the safety follow-up period regardless of the efficacy follow-up.
    Utima Visita Ultimo Paciente: el "fin de estudio" será declarado después de que todos los pacientes hayan discontinuado el tratamiento del estudio y completado el periodo de seguimiento de seguridad independientemente del seguimiento de eficacia
    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 months10
    E.8.9.1In the Member State concerned days
    E.8.9.2In all countries concerned by the trial years3
    E.8.9.2In all countries concerned by the trial months8
    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: 60
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 30
    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 Information not present in EudraCT
    F.3.3.5Emergency situation Information not present in EudraCT
    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 state7
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 55
    F.4.2.2In the whole clinical trial 90
    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)
    ICF: After trial completion you will continue to be monitored as per standard clinical practice; if a new treatment is required your doctor will discuss with you the therapeutic options considered adequate to treat the disease.
    Hoja de Información al Paciente y Consentimiento Informado: Después de la finalización del estudio continuará siendo controlado según la práctica clínica habitual, si precisa un nuevo tratamiento, su médico le comentará las opciones terapéuticas consideradas adecuadas para tratar la enfermedad
    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 Decision2017-01-20
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2016-12-28
    P. End of Trial
    P.End of Trial StatusCompleted
    P.Date of the global end of the trial2020-05-13
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