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    Summary
    EudraCT Number:2016-002718-32
    Sponsor's Protocol Code Number:CanStem43L
    National Competent Authority:Spain - AEMPS
    Clinical Trial Type:EEA CTA
    Trial Status:Ongoing
    Date on which this record was first entered in the EudraCT database:2017-02-10
    Trial 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 number2016-002718-32
    A.3Full title of the trial
    A Phase III Randomized, Open-Label Clinical Trial of BBI-608 plus Weekly Paclitaxel versus Weekly Paclitaxel Alone in Patients with Advanced, Previously Treated, Non-Squamous Non-Small Cell Lung Cancer
    Ensayo clínico en fase III, aleatorizado y sin enmascaramiento de BBI-608 más paclitaxel semanal en comparación con paclitaxel semanal en monoterapia en pacientes con cáncer de pulmón no microcítico, no escamoso, avanzado y previamente tratado
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    The aim of this study is to see how well an investigational drug (called BBI-608) works when it is given in combination with paclitaxel, a chemotherapy treatment, or if it is better to receive paclitaxel alone for people with advanced, previously treated lung cancer. To do so, half of the patients in this study will receive paclitaxel plus BBI-608 while the other half will receive paclitaxel alone.
    El estudio pretende ver como el producto en investigación (llamado BBI-608) funciona cuándo es dado en combinación con Paclitaxel, un tratamiento quimioterápico, o si es mejor recibir Paclitaxel sólo para pacientes con con cáncer de pulmón avanzado y previamente tratado. Para ello, la mitad de los pacientes en el estudio recibirán paclitaxel más BBI-608 mientras que la otra mitad recibirán Paclitaxel solo.
    A.4.1Sponsor's protocol code numberCanStem43L
    A.5.2US NCT (ClinicalTrials.gov registry) numberNCT02826161
    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 SponsorBoston Biomedical, Inc.
    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 supportBoston Biomedical, Inc.
    B.4.2CountryUnited States
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationBoston Biomedical, Inc.
    B.5.2Functional name of contact pointClinical Division
    B.5.3 Address:
    B.5.3.1Street Address640 Memorial Drive
    B.5.3.2Town/ cityCambridge
    B.5.3.3Post codeMA 02139
    B.5.3.4CountryUnited States
    B.5.4Telephone number+16176746800
    B.5.5Fax number+16176748662
    B.5.6E-mailBBIRegulatory@bostonbiomedical.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 nameBBI-608 (napabucasin)
    D.3.2Product code BBI-608
    D.3.4Pharmaceutical form Capsule
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNNapabucasin
    D.3.9.1CAS number 83280-65-3
    D.3.9.3Other descriptive nameNAPABUCASIN, BBI-608, BBI608, BB608
    D.3.9.4EV Substance CodeSUB179666
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number80
    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: 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 Paclitaxel Amneal 6 mg/ml, Concentrate for solution for infusion
    D.2.1.1.2Name of the Marketing Authorisation holderAmneal Pharma Europe Limited
    D.2.1.2Country which granted the Marketing AuthorisationGermany
    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.3.4Pharmaceutical 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.3.9.4EV 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 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 Yes
    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
    Histologically or cytologically confirmed recurrent, locally advanced, or metastatic non-squamous non-small cell lung cancer
    Cáncer de pulmón no microcítico y no escamoso, localmente avanzado o metastásico, confirmado histológica o citológicamente.
    E.1.1.1Medical condition in easily understood language
    Cancer of the lung.
    Cáncer de pulmón
    E.1.1.2Therapeutic area Diseases [C] - Cancer [C04]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 19.1
    E.1.2Level LLT
    E.1.2Classification code 10066490
    E.1.2Term Progression of non-small cell lung 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
    To compare overall survival in patients with previously treated metastatic non-squamous non-small
    cell lung cancer (non-squamous NSCLC) who are randomized to receive treatment with BBI-608
    plus weekly paclitaxel versus weekly paclitaxel alone.
    Comparar la supervivencia global en pacientes con cáncer de pulmón no microcítico (NSCLC, non-small cell lung cancer) y no escamoso, metastásico y tratado previamente, a los que se les ha aleatorizado a recibir tratamiento con BBI 608 más paclitaxel semanal frente a paclitaxel semanal en monoterapia.
    E.2.2Secondary objectives of the trial
    • To compare OS in patients with previously treated metastatic non-squamous NSCLC who are
    biomarker positive and who are randomized to receive treatment with BBI-608 plus weekly
    paclitaxel versus weekly paclitaxel alone.
    • To compare progression free survival (PFS, defined as the time from randomization until disease
    progression per RECIST 1.1 or death) in patients with non-squamous NSCLC who are randomized
    to receive treatment with BBI-608 plus weekly paclitaxel versus weekly paclitaxel alone.
    • To compare PFS in patients with non-squamous NSCLC who are biomarker positive and who are
    randomized to receive treatment with BBI-608 plus weekly paclitaxel versus weekly paclitaxel
    alone.

    Please refer to the protocol for further secondary objectives.
    -Comparar la supervivencia global (OS, overall survival) en pacientes con cáncer de pulmón no microcítico y no escamoso, metastásico y tratado previamente, con biomarcador positivo y a los que se les ha aleatorizado a recibir tratamiento con BBI 608 más paclitaxel semanal frente a paclitaxel semanal en monoterapia.
    -Comparar la supervivencia sin progresión (PFS, progression free survival; definida como el tiempo transcurrido desde la aleatorización hasta la progresión de la enfermedad según los RECIST 1.1 o la muerte) en pacientes con cáncer de pulmón no microcítico y no escamoso a los que se les ha aleatorizado a recibir tratamiento con BBI 608 más paclitaxel semanal frente a paclitaxel semanal en monoterapia.
    -Comparar la supervivencia sin progresión en pacientes con cáncer de pulmón no microcítico y no escamoso, con biomarcador positivo, a los que se les ha aleatorizado a recibir tratamiento con BBI 608 más paclitaxel semanal frente a paclitaxel semanal en monoterapia.
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    IC 1 Must have histologically or cytologically confirmed non-squamous NSCLC. Patients with mixed
    histology must have adenocarcinoma as the predominant morphology according to light microscopy
    pathologic diagnosis. Patients with poorly differentiated tumors must have immunohistochemical
    (IHC) staining positive for either TTF-1 or NapsinA and negative for p63 or p40.
    IC 2 Patients with an EGFR or ALK/ROS1 genetic aberration must have received appropriately targeted
    treatment.
    IC 3 Must have progressed following treatment with platinum-based combination chemotherapy for
    metastatic disease. (...)
    IC 4 Patients who are candidates for immunotherapy must have received either nivolumab or pembrolizumab or a different IND-approved anti-PD1 or anti-PD-L1 therapy.
    IC 5 Prior treatment with the approved agents such as pemetrexed and/or erlotinib is permitted, and candidates who have not received a prior approved regimen must be informed that enrollment onto the trial may delay or prevent treatment that has shown a survival benefit in randomized trials.
    IC 6 Weekly paclitaxel must be an acceptable treatment option
    IC 7 Must have had resolution to Grade ≤ 1 of all clinically significant adverse events from prior therapy, (grade defined according to the National Cancer Institute Common Terminology Criteria for Adverse Events [NCI-CTCAE]); or, the adverse events must be deemed irreversible, and considered not an impediment to participation in the trial according to the investigator.
    IC 8 Must have had baseline radiologic imaging evaluation of the chest, abdomen, and pelvis in the 21 days prior to randomization that documents the presence of measurable or non-measurable disease as defined by RECIST 1.1
    IC 9 Must submit tumor tissue for correlative analyses
    IC 10 Must allow collection and storage of blood samples for correlative analyses
    IC 11 Must be at least 18 years of age
    IC 12 Must have an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1
    IC 13 Must be willing and able to take BBI-608 orally
    IC 14 Must have total bilirubin ≤ 1.5 x upper limit of normal (ULN)
    IC 15 Must have aspartate aminotransferase (AST) and alanine aminotransferase (ALT) ≤ 2.5 x ULN; or must have AST and ALT ≤ 5 x ULN if the aminotransferase elevation is due to liver metastases
    IC 16 Must have estimated creatinine clearance ≥ 50 mL/min as calculated following a 24 hour urine collection or by using the Cockcroft-Gault formula (Cockcroft-Gault estimation of creatinine clearance = [140-age] * [Wt in kg] * [(0.85 if female) vs (1.0 if male)] / [72 * Cr] where “Cr” is serum creatinine in mg/dl); or,
    IC 16a Must have estimated creatinine clearance (eCrCl) ≥ 50 mL/min when corrected for body surface area (in m2) as follows:
    Corrected estimated creatinine clearance (eCrClcorrected) = (eCrCl) x 1.73 / patient BSA
    IC 17 Must have absolute neutrophil count (ANC) ≥ 1.5 x 103/μL (≥ 1.5 x 109/L)
    IC 18 Must have hemoglobin ≥ 9.0 g/dL without transfusion in the prior 7 days
    IC 19 Must have platelets ≥100 x 103/μL (≥100 x 109/L) without transfusion in the prior 7 days
    IC 20 Must have serum albumin ≥ 3.0 g/dL
    IC 21 Must have Body Mass Index (BMI) > 18.5 kg/m2
    IC 22 Must have a life expectancy of ≥ 3 months
    IC 23 Must be able (i.e. sufficiently fluent) and willing to complete the Quality of Life questionnaires in one of the validated languages for the questionnaires; (...)
    IC 24 Patients must be accessible for treatment and follow-up. (...)
    IC 25 Must agree to begin protocol therapy within 72 hours of randomization.
    IC 26 Male and female patients of child-bearing potential must use adequate methods of contraception during the study (outlined in Section 7.4) and
    IC 26a Male patients must use contraception or take measures to avoid pregnancy for 90 days after the last dose of BBI-608 and for 6 months after the last dose of paclitaxel, whichever is longest based on when the agents were permanently discontinued for that patient.
    IC 26b Female patients must use contraception or take measures to avoid pregnancy for 30 days after the last dose of BBI-608 and for 6 months after the last dose of paclitaxel, whichever is longest based on when the agents were permanently discontinued for that patient.
    IC 27 Female patients of reproductive potential (see Section 7.4) must have a negative serum or urine pregnancy test within 72 hours prior to randomization. The minimum sensitivity of the pregnancy test must be 25 IU/L (or equivalent units) HCG.

    (Please refer to protocol for more detailed information)
    IC 1 Pacientes con NSCLC, confirmado. En caso de histología mixta, la morfología predominante por microscopía óptica deberá ser adenocarcinomatosa según el diagnóstico anatomopatológico. Los pacientes con tumores poco diferenciados deberán dar un resultado positivo en los análisis de tinción inmunohistoquímica de TTF-1 o napsina A, y un negativo en los de p63 o p40.
    IC 2Los pacientes con anomalías de EGFR o ALK/ROS1 deberán haber recibido el tto. dirigido.
    IC 3 Progresión de la enfermedad tras de quimioterapia de combinación con platino(pt) por metástasis. (...)
    IC 4 Los pacientes en los que esté indicada la inmunoterapia deberán haber recibido tto. con nivolumab o pembrolizumab u otro tto. anti-PD1 o anti-PD-L1 diferente.
    IC 5 Se permite el tratamiento previo con otros agentes autorizados como pemetrexed o erlotinib, y los pacientes que no hayan recibido un régimen aprobado previo deberán ser informados de que la inclusión en el ensayo podría retrasar o impedir un tratamiento que ha demostrado prolongar la supervivencia en los ensayos aleatorizados.
    IC 6 El paclitaxel semanal debe ser una opción de tto adecuada.
    IC 7 Todos los AA clínicamente importantes del tratamiento previo deben haber remitido hasta grado ≤1 ; o bien, el investigador considera que los AA son irreversibles y no constituyen un impedimento para la participación en el EC.
    IC 8 Evaluación de diagnóstico por imagen basal de tórax, abdomen y pelvis en los 21 días anteriores a la aleatorización, en la que se documente la presencia de enfermedad medible o no medible por los RECIST 1.1. IC 9 Envío de tejido tumoral para análisis relacionados.
    IC 10 Consentimiento para la recogida y la conservación de muestras de sangre para análisis relacionados.
    IC 11 Edad ≥18 años.
    IC 12Estado funcional del ECOG de 0 o 1.
    IC 13 Disposición y capacidad de tomar el BBI 608 por vía oral.
    IC 14 Bilirrubina total ≤1,5 × límite superior de la normalidad. (LSN)
    IC 15 AST y ALT ≤2,5 × LSN; o bien, AST y ALT ≤5 × LSN si la elevación se debe a metástasis hepáticas.
    IC 16 eCrCl ≥50 ml/min, calculado tras la recogida de orina de 24 hrs o mediante la ecuación de Cockcroft-Gault / [72 × Cr], o bien, IC 16a eCrCl ≥50 ml/min tras aplicar la siguiente corrección en función de la superficie corporal (en m2): eCrCl × 1,73 / S corporal
    IC 17 Recuento absoluto de neutrófilos ≥1,5 × 103/µl (≥1,5 × 109/l) IC 18 Hb ≥9,0 g/dl sin transfusiones en los 7 días anteriores.
    IC 19 Plaquetas ≥100 × 103/µl (≥100 × 109/l) sin transfusiones en los 7 días anteriores.
    IC 20 Albúmina sérica ≥3,0 g/dl.
    IC 21 IMC >18,5 kg/m2.
    IC 22 Esperanza de vida ≥3 meses.
    IC 23 Capacidad y disposición para cumplimentar los cuestionarios de calidad de vida en uno de los idiomas validados de los cuestionarios; o bien,
    IC 23a Los pacientes con Capacidad pero que hayan perdido la vista, no sean capaces de leer o se encuentren en otra situación equivalente deberán aceptar la asistencia del personal del estudio para la cumplimentación de los cuestionarios ;o bien,
    IC 23b En el caso de los pacientes incapaces de cumplimentar el cuestionario (s) a pesar de dicha asistencia, el centro deberá recibir la autorización del promotor o su delegado para proceder a la selección y aleatorización . Se dará la autorización si el centro explica la limitación que impide al paciente cumplimentar el cuestionario incluso tras de haber tomado las medidas oportunas.
    IC 24El paciente deberá estar accesible para su tto. y sgto.(...)
    IC 25El paciente deberá aceptar que el tratamiento del protocolo comience en el plazo de las 72 hrs tras la aleatorización.
    IC 26Los pacientes potencialmente fértiles, varones o mujeres, deberán utilizar métodos anticonceptivos adecuados durante el estudio y,
    IC 26a Los varones deberán utilizar métodos anticonceptivos o adoptar medidas para evitar el embarazo hasta 90 días tras la última dosis de BBI 608 y hasta 6 meses tras la última dosis de paclitaxel, eligiéndose el más prolongado de estos periodos según el momento en que el paciente en cuestión suspenda definitivamente estos fármacos.IC 26b Las mujeres deberán utilizar métodos anticonceptivos o adoptar medidas para evitar el embarazo hasta 30 días tras la última dosis de BBI 608 y hasta 6 meses después de la última dosis de paclitaxel, eligiéndose el más prolongado de estos periodos según el momento en que la se suspendan definitivamente estos ttos.
    IC 27 Las mujeres potencialmente fértiles deberán presentar un resultado negativo en una prueba de embarazo en suero u orina en el plazo de las 72 hrs anteriores a la aleatorización. La sensibilidad mínima de la prueba debe ser de 25 UI/L de HCG.
    (Refiérase al protocolo para más detalles)
    E.4Principal exclusion criteria
    EC 1 Have squamous sub-type NSCLC as identified by histologic morphology using light microscopy; or,
    EC 1a NSCLC with a mixed histologic morphology suggesting a predominance of squamous features; or,
    EC 1b NSCLC with poorly differentiated histologic morphology not meeting IC 1
    EC 2 Has received systemic treatment with a taxane for advanced/metastatic disease. Patients are also excluded if there was disease progression or recurrence less than 6 months after adjuvant, neo-adjuvant or chemo-radiation therapy that contained a taxane.
    EC 3 Has received any systemic anti-cancer therapy within the 14 days prior to randomization
    EC 4 Has received radiotherapy within the 28 days prior to randomization, with the exception of palliative radiotherapy to focal lesions for pain or other symptom control up to 8 gy (800 rad)
    EC 5 Has brain metastases with evolving neurologic symptoms or a steroid requirement. Patients with brain metastases who are clinically stable and who do not require steroids may be eligible. Patients with known leptomeningeal metastases are excluded, even if treated or asymptomatic
    EC 6 Has had major surgery requiring general anesthesia and/or mechanical ventilation within the 28 days prior to randomization; or, intends to have an elective surgical procedure during the course of planned study participation that carries risk other than minimal discomfort. A biopsy is not considered major surgery.
    EC 7 Has hypersensitivity to paclitaxel despite re-sensitization procedures or has history of severe hypersensitivity to any paclitaxel excipient, including macrogolglycerol ricinoleate.
    EC 8 Has a concurrent malignancy except for basal or squamous cell skin cancer and/or in situ carcinoma of the cervix, or other solid tumors treated curatively and without evidence of recurrence for at least 3 years prior to randomization
    EC 9 Has had extensive colonic or small bowel resection such that absorption of oral medications is considered impaired
    EC 10 Has known hepatitis B with clinical complications (patients with chronic, controlled, hepatitis B with or without anti-viral therapy and monitored according to 2015 ASCO guideline for hepatitis B monitoring may be eligible)
    EC 11 Is currently receiving interferon for known hepatitis C; or has clinically uncontrolled hepatitis C or hepatitis C with significant complications likely to interfere with protocol compliance.
    EC 12 Has known human immunodeficiency virus (HIV) infection, acquired immunodeficiency syndrome (AIDS), or an AIDS-related/AIDS-defining illness
    EC 13 Has had a myocardial infarction, unstable angina, stroke, transient ischemic attack, or other major vascular complication in the 6 months prior to randomization
    EC 14 Has clinically relevant congestive heart failure (CHF; NYHA II-IV)
    EC 15 Has a corrected QT interval (QTc) > 470 ms or has an electrocardiogram (ECG) with a new abnormal finding that is clinically significant. Patients with a known cardiac arrhythmia that is adequately controlled and not affecting performance status, such as atrial fibrillation, may be eligible. Patients with a pacemaker and no major complications (hospitalization, infection) in the 6 months prior to randomization may be eligible
    EC 16 Has active inflammatory enteropathy, Crohn's disease, ulcerative colitis, or other chronic diarrheal illness that is not adequately controlled
    EC 17 Has peripheral neuropathy ≥ Grade 2 (NCI-CTCAE).
    EC 18 Refuses to complete quality of life questionnaires either alone or with assistance from study staff despite adequate fluency
    EC 19 Has an intercurrent (non-malignant) chronic illness requiring >10 mg prednisone daily (or equivalent); or has another intercurrent (non-malignant) medical or psychiatric condition(s) not optimally controlled and carrying a moderate to high risk of interfering with protocol therapy administration or compliance with required procedures, in the judgment of the investigator

    Please refer to protocol for further information.
    EC 1 Presentar cáncer de pulmón no microcítico de subtipo escamoso según su morfología histológica por microscopía óptica; o bien,
    EC 1a Cáncer de pulmón no microcítico con morfología histológica mixta que sugiera predominio de características escamosas; o bien,
    EC 1b Cáncer de pulmón no microcítico con morfología histológica poco diferenciada que no cumpla el criterio
    EC 2Haber recibido tratamiento sistémico con un taxano por enfermedad metastásica o avanzada. También se excluirá a los pacientes que hayan presentado progresión o recidiva de la enfermedad menos de 6 meses después de un tratamiento adyuvante o neoadyuvante o de quimiorradioterapia con un taxano.
    EC 3 Haber recibido cualquier tratamiento sistémico antineoplásico en el plazo de los 14 días anteriores a la aleatorización.
    EC 4Haber recibido radioterapia en el plazo de los 28 días anteriores a la aleatorización, a excepción de radioterapia paliativa en lesiones focales para analgesia o control de otros síntomas en una dosis máxima de 8 gy (800 rad).
    EC 5 Presentar metástasis cerebrales con síntomas neurológicos en evolución o necesidad de corticosteroides. Sí podrán participar los pacientes con metástasis cerebrales que mantengan un cuadro clínico estable y no precisen corticosteroides. Quedan excluidos los pacientes con diagnóstico de metástasis leptomeníngeas, incluso aunque reciban tratamiento o estén asintomáticos.
    EC 6 Haber sido intervenido de cirugía mayor con anestesia general o que precisara ventilación mecánica en el plazo de los 28 días anteriores a la aleatorización; o bien, tener programada una intervención quirúrgica durante el tiempo previsto de participación en el estudio que suponga riesgos mayores que una mínima molestia. La biopsia no se considera cirugía mayor.
    EC 7 Presentar hipersensibilidad al paclitaxel a pesar de procedimientos de resensibilización o antecedentes de hipersensibilidad severa a cualquier excipiente del paclitaxel, incluido el ricinoleato de macrogolglicerol.
    EC 8 Presentar una neoplasia maligna concomitante, excepto el cáncer cutáneo basocelular o espinocelular y el carcinoma in situ de cuello uterino, y otros tumores sólidos tratados curativamente y sin signos de recidiva desde al menos 3 años antes de la aleatorización.
    EC 9 Haber sido sometido a una resección extensa del colon o del intestino delgado, a consecuencia de la cual se considere alterada la absorción de medicamentos orales.
    EC 10 Presentar diagnóstico de hepatitis B con complicaciones clínicas (sí pueden participar los pacientes con hepatitis B crónica controlada, con o sin tratamiento antivírico y vigilados con arreglo a las directrices de la ASCO 2015 para la vigilancia de la hepatitis B).
    EC 11 Estar recibiendo interferón por diagnóstico de hepatitis C; o presentar hepatitis C no controlada clínicamente o con complicaciones importantes que es probable que vayan a dificultar el cumplimiento del protocolo.
    EC 12 Presentar infección confirmada por el virus de la inmunodeficiencia humana (VIH), síndrome de inmunodeficiencia adquirida (sida) o enfermedad relacionada con el sida o definitoria de sida.
    EC 13 Haber presentado infarto de miocardio, angina inestable, ictus, accidente isquémico transitorio u otras complicaciones vasculares importantes en el plazo de los 6 meses anteriores a la aleatorización.
    EC 14 Presentar insuficiencia cardiaca congestiva de importancia clínica (clase II-IV de la NYHA).
    EC 15 Presentar un intervalo QT corregido (QTc) >470 ms o una anomalía nueva en el electrocardiograma (ECG) de importancia clínica. Sí podrán participar los pacientes con una arritmia cardiaca diagnosticada, adecuadamente controlada y que no afecte al estado funcional, como fibrilación auricular. También podrán participar los pacientes portadores de marcapasos sin complicaciones importantes (hospitalización, infección) en los 6 meses anteriores a la aleatorización.
    EC 16 Presentar enfermedad intestinal inflamatoria activa, enfermedad de Crohn, colitis ulcerosa u otra enfermedad diarreica crónica no controlada adecuadamente.
    EC 17 Presentar neuropatía periférica de grado ≥2 (NCI-CTCAE).
    EC 18 Negarse a cumplimentar los cuestionarios de calidad de vida, por sí mismo o con la asistencia del personal del estudio, a pesar de suficiente dominio la lengua.
    EC 19 Presentar una enfermedad crónica (no maligna) intercurrente que precise >10 mg diarios de prednisona (o equivalente); o presentar otra enfermedad médica (no maligna) o psiquiátrica intercurrente que no esté bien controlada y que comporte un riesgo moderado o elevado de alterar la administración del tratamiento del protocolo o el cumplimiento de los procedimientos exigidos, a juicio del investigador.


    (Refiérase al protocolo para más detalles).
    E.5 End points
    E.5.1Primary end point(s)
    Overall Survival
    Supervivencia Global
    E.5.1.1Timepoint(s) of evaluation of this end point
    The final analysis will occur when at least 694 events are observed by randomizing 870 patients over 24 months, with 12 months minimum follow-up for each patient.The sample size calculation assumes a drop-out rate of up to 5% for the entire study.
    El análisis final tendrá lugar cuando se haya observado un mínimo de 694 acontecimientos., que se observarían mediante la aleatorización de 870 pacientes a lo largo de 24 meses, con un seguimiento mínimo de cada paciente de 12 meses. El cálculo del tamaño de la muestra presupone una tasa de abandonos de hasta el 5% en la totalidad del estudio
    E.5.2Secondary end point(s)
    • Overall Survival in the predefined biomarker-positive sub-population¥
    • Progression Free Survival in the ITT study population
    • Progression Free Survival in the predefined biomarker-positive sub-population¥
    • Disease Control Rate & Objective Response Rate in the ITT study population
    • Disease Control Rate & Objective Response Rate in the predefined biomarker-positive sub-population¥
    • Quality of Life
    • Safety Profile
    ¥The biomarker-positive sub-population is defined as those patients positive for phosphorylated STAT3 (p-STAT3) based on immunohistochemical (IHC) staining of Formalin-Fixed, Paraffin-Embedded (FFPE) tumor tissue.
    - Comparar la supervivencia global en la subpoblación con biomarcador positivo¥ .
    - Comparar la supervivencia sin progresión en la ITT población del estudio.
    - Comparar la supervivencia sin progresiÓn en la subpoblación con biomarcador positivo¥ .
    -Comparar la tasa de control de la enfermedad y la tasa de respuestas objetivas en la ITT población de estudio.
    -Comparar la tasa de control de la enfermedad y la tasa de respuestas objetivas en la subpoblación con biomarcador positivo¥
    -Calidad de vida
    -Perfil de seguridad
    ¥ La subpoblación con biomarcador positivo se define como la formada por los pacientes con resultado positivo de STAT3 fosforilado (p-STAT3) en la tinción inmunohistoquímica del tejido tumoral fijado con formol e incluido en parafina.
    E.5.2.1Timepoint(s) of evaluation of this end point
    Please refer to protocol for further information.
    Refiérase al Protocolo para más detalles.
    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 Yes
    E.6.11Pharmacogenomic Yes
    E.6.12Pharmacoeconomic No
    E.6.13Others Yes
    E.6.13.1Other scope of the trial description
    Efficacy Quality of Life
    Eficacia Calidad de vida
    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 concerned20
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA90
    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
    Belgium
    Canada
    China
    France
    Germany
    Hungary
    Israel
    Italy
    Japan
    Korea, Republic of
    Netherlands
    Poland
    Spain
    Turkey
    United Kingdom
    United States
    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 primary endpoint is Overall Survival (OS). The final analysis will occur when at least 694 events are observed by randomizing 870 patients over 24 months, with 12 months minimum follow-up for each patient. Follow-up for overall survival may be discontinued once 2 years have elapsed since the initial follow-up visit.
    El objetivo principal es la Supervivencia Global. El análisis final tendrá lugar cuando se hayan observado un mínimo de 694 acontecimientos en 870 pacientes aleatorizados en 24 meses, con un mínimo de 12 meses de seguimiento a cada paciente. El seguimiento de la Supervivencia global podrá discontinuarse tras haber transcurrido 2 años desde la primera visita de seguimiento.
    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 months1
    E.8.9.1In the Member State concerned days0
    E.8.9.2In all countries concerned by the trial years3
    E.8.9.2In all countries concerned by the trial months1
    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: 566
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 304
    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 state92
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 550
    F.4.2.2In the whole clinical trial 870
    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 - After permanent discontinuation of protocol therapy, patients will receive subsequent anti-cancer treatment and care at the Investigator's discretion.
    Ninguno- Tras la discontinuación de la terapia del protocolo, los pacientes recibirán sus correspondientes tratamientos y cuidados para el cancer a criterio del investigador.
    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 Decision2017-04-04
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2017-03-17
    P. End of Trial
    P.End of Trial StatusOngoing
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