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    Summary
    EudraCT Number:2016-002718-32
    Sponsor's Protocol Code Number:CanStem43L
    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:2021-01-20
    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 ConcernedItaly - Italian Medicines Agency
    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
    Sperimentazione clinica di fase III, randomizzata, in aperto su BBI-608 pi¿ paclitaxel settimanale rispetto a paclitaxel settimanale in monoterapia nei pazienti con carcinoma polmonare non a piccole cellule non squamoso, in stadio avanzato, precedentemente trattato
    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.
    Lo scopo dello studio ¿ vedere quanto ¿ efficace un farmaco sperimentale (chiamato BBI-608) quando ¿ somministrato in combinazione con paclitaxel, un trattamento chemioterapico, o se ¿ meglio ricevere paclitaxel in monoterapia nelle persone con tumore avanzato precedentemente trattato. Per fare questo, met¿ dei pazienti dello studio riceveranno paclitaxel pi¿ BBI-608 mentre l'altra met¿ ricever¿ paclitaxel da solo.
    A.3.2Name or abbreviated title of the trial where available
    -
    -
    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 number0016176746800
    B.5.5Fax number0016176748662
    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, hard
    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.3.9.2Current sponsor code-
    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 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 Paclitaxel Amneal 6 mg/ml, Concentrate for solution for infusion
    D.2.1.1.2Name of the Marketing Authorisation holderAmneal Pharma Europe Limited - MA n. 90953.00.00
    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.3.9.2Current sponsor code-
    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 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 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.
    Carcinoma polmonare non a piccole cellule non squamoso istologia¿camente o citologicamente confermato ricorrente, localmente avanzato o metastatico.
    E.1.1.1Medical condition in easily understood language
    Cancer of the lung.
    Tumore al polmone.
    E.1.1.2Therapeutic area Diseases [C] - Cancer [C04]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 21.1
    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.
    Confrontare la sopravvivenza globale (OS) in pazienti con carcinoma polmonare non a
    piccole cellule non squamoso (NSCLC non squamoso) metastatico precedentemente trattato
    che sono randomizzati a ricevere il trattamento con BBI-608 pi¿ paclitaxel settimanale rispetto a paclitaxel settimanale da solo.
    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.
    ¿ Confrontare la OS in pazienti con NSCLC non squamoso metastatico precedentemente
    trattato che sono positivi per il biomarcatore e sono randomizzati a ricevere il trattamento con
    BBI-608 pi¿ paclitaxel settimanale rispetto a paclitaxel settimanale da solo.
    ¿ Confrontare la sopravvivenza libera da progressione (PFS) (definita come il tempo trascorso dalla randomizzazione alla progressione della malattia secondo i criteri RECIST 1.1 o al
    decesso) in pazienti con NSCLC non squamoso che sono randomizzati a ricevere il trattamento con BBI-608 pi¿ paclitaxel settimanale rispetto a paclitaxel settimanale da solo.
    ¿ Confrontare la PFS in pazienti con NSCLC non squamoso che sono positivi per il biomarcatore e sono randomizzati a ricevere il trattamento con BBI-608 pi¿ paclitaxel settimanale rispetto a paclitaxel settimanale da solo.
    Si prega di fare riferimento al protocollo per gli ulteriori obiettivi secondari.
    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)
    CI 1 NSCLC non squamoso confermato dall’esame istologico o citologico. Nei pazienti affetti da tumori
    ad istologia mista, l’adenocarcinoma deve rappresentare la morfologia prevalente alla diagnosi patologica mediante microscopia ottica. Nei pazienti con tumori poco differenziati, le analisi
    immunoistochimiche (IHC) devono indicare una colorazione positiva per TTF-1 o Napsina A e
    negativa per p63 o p40.
    CI 2 I pazienti che presentano un’aberrazione genetica a carico di EGFR o ALK/ROS1 devono essere stati sottoposti a una terapia mirata appropriata.
    CI 3 Progressione a seguito di chemioterapia di combinazione a base di platino per malattia metastatica.
    CI 3a È ammesso il precedente trattamento con una chemioterapia perioperatoria a base di platino o
    una chemioterapia a base di platino nell’ambito di una chemioradioterapia definitiva in caso
    di recidiva o progressione della malattia nei 6 mesi successivi alla somministrazione dell’ultima dose. Affinché il paziente risulti idoneo anche in presenza di recidiva o progressione della malattia oltre 6 mesi dopo la conclusione della chemioradioterapia o della chemioterapia perioperatoria a base di platino, occorre somministrare un successivo regime a base di platino nel contesto metastatico/avanzato.
    CI 3b I pazienti possono essere ritenuti idonei anche qualora durante il trattamento abbiano
    manifestato eventi avversi inaccettabili tali da rendere inopportuna, secondo il parere dello
    sperimentatore, la somministrazione di una nuova terapia a base di platino.
    CI 4 I pazienti candidati all’immunoterapia devono essere stati trattati con nivolumab, pembrolizumab o
    un altro trattamento anti-PD-1 o anti-PD-L1 approvato come IND.
    CI 5 È ammesso il precedente trattamento con agenti approvati come pemetrexed e/o erlotinib. I candidati non precedentemente sottoposti a un regime approvato devono essere informati che l’arruolamento nella ricerca potrebbe posticipare o impedire la somministrazione di un trattamento che negli studi randomizzati è stato associato a benefici in termini di sopravvivenza.
    CI 6 Paclitaxel settimanale deve rappresentare un’opzione terapeutica accettabile.
    CI 7 Risoluzione di tutti gli eventi avversi clinicamente significativi determinati dalla terapia precedente a un grado = 1 (grado definito in base ai criteri NCI-CTCAE [National Cancer Institute Common Terminology Criteria for Adverse Events]); in alternativa, gli eventi avversi devono essere ritenuti irreversibili e non devono rappresentare, secondo lo sperimentatore, un impedimento alla
    partecipazione allo studio.
    CI 8 Valutazione radiologica basale di torace, addome e bacino nei 21 giorni precedenti alla
    randomizzazione che documenti la presenza di malattia misurabile o non misurabile secondo i criteri RECIST 1.1.
    CI 9 Fornitura di campioni di tessuto tumorale per analisi correlative.
    CI 10 Consenso al prelievo e alla conservazione di campioni di sangue per analisi correlative.
    CI 11 Età uguale o superiore a 18 anni.
    CI 12 Performance status ECOG (Eastern Cooperative Oncology Group) pari a 0 o 1.
    CI 13 Disponibilità e capacità di assumere BBI-608 per via orale.
    CI 14 Bilirubina totale = 1,5 volte il limite superiore della norma (ULN).
    CI 15 Aspartato aminotransferasi (AST) e alanina aminotransferasi (ALT) = 2,5 x ULN o AST e ALT = 5 x ULN se l’aumento dei livelli di aminotransferasi è imputabile alla presenza di metastasi epatiche.
    CI 16 Clearance della creatinina stimata = 50 ml/min calcolata a seguito di raccolta delle urine nelle 24 ore o mediante la formula di Cockcroft-Gault (stima della clearance della creatinina secondo Cockcroft-Gault = [140-età] * [peso in kg] * [(0,85 se donna) versus (1,0 se uomo)] / [72 * Cr], ove con “Cr” si intende la creatinina sierica in mg/dl); o
    CI 16a Clearance della creatinina stimata (eCrCl) = 50 ml/min quando corretta per la superficie
    corporea (BSA, in m2 ) come segue:
    Clearance della creatinina stimata corretta (eCrClcorretta) = (eCrCl) x 1,73 / BSA del paziente.
    CI 17 Conta assoluta dei neutrofili (ANC) = 1,5 x 103 /µl (= 1,5 x 109 /L).
    CI 18 Emoglobina = 9,0 g/dl senza trasfusioni nei 7 giorni precedenti.
    CI 19 Piastrine = 100 x 103 /µl (=100 x 109 /L) senza trasfusioni nei 7 giorni precedenti.
    CI 20 Albumina sierica = 3,0 g/dl.
    CI 21 Indice di massa corporea (IMC) > 18,5 kg/m2 .
    CI 22 Aspettativa di vita = 3 mesi.
    CI 23 Capacità (ossia padronanza sufficiente della lingua) e volontà di rispondere ai questionari sulla qualità della vita in una delle lingue validate dei questionari; (...)
    CI 24 I pazienti devono avere accesso al trattamento e al follow-up. (...)
    CI 25 Essere d'accordo ad iniziare la terapia del protocollo entro 72 ore dalla randomizzazione.
    CI 26 I pazienti di sesso maschile e femminile potenzialmente fertili devono usare adeguati metodi di contraccezione durante lo studio (evidenziato nella Sezione 7.4) e
    CI 26a I pazienti di sesso maschile devono usare un metodo contraccettivo o prendere misure adeguate per evitare la gravidanza per (...)
    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.
    CE 1 NSCLC di sottotipo squamoso secondo la morfologia istologica mediante microscopia ottica; o
    CE 1a NSCLC a morfologia istologica mista indicante la prevalenza di caratteristiche squamose; o
    CE 1b NSCLC a morfologia istologica poco differenziata che non soddisfa il CI 1.
    CE 2 Precedente trattamento sistemico con un taxano per malattia avanzata/metastatica. I pazienti sono esclusi anche in presenza di progressione o recidiva della malattia nei 6 mesi successivi alla
    somministrazione di una terapia adiuvante, neoadiuvante o chemioradioterapia contenente un taxano.
    CE 3 Terapia antitumorale sistemica nei 14 giorni precedenti alla randomizzazione.
    CE 4 Radioterapia nei 28 giorni precedenti alla randomizzazione, ad eccezione della radioterapia palliativa diretta contro lesioni focali per il controllo del dolore o di altri sintomi fino a 8 gy (800 rad).
    CE 5 Metastasi cerebrali con sintomi neurologici in fase di progressione o necessità di steroidi. I pazienti con metastasi cerebrali clinicamente stabili che non richiedono l’uso di steroidi possono essere
    ritenuti idonei. Sono esclusi i pazienti con metastasi leptomeningee note, anche se trattate o
    asintomatiche.
    CE 6 Intervento di chirurgia maggiore richiedente anestesia generale e/o ventilazione artificiale nei
    28 giorni precedenti alla randomizzazione, o intenzione di sottoporsi a una procedura chirurgica
    elettiva durante la partecipazione pianificata allo studio che determini altri rischi oltre ad un minimo
    fastidio. Le biopsie non sono considerate interventi di chirurgia maggiore.
    CE 7 Ipersensibilità a paclitaxel nonostante procedure di risensibilizzazione o anamnesi positiva per ipersensibilità grave a uno qualsiasi degli eccipienti di paclitaxel, ivi incluso macrogolglicerolo ricinoleato.
    CE 8 Neoplasia maligna concomitante, ad eccezione di carcinoma cutaneo baso- o squamocellullare e/o carcinoma in situ della cervice, o altri tumori solidi trattati con intento curativo e senza evidenze di recidiva per almeno 3 anni prima della randomizzazione.
    CE 9 Resezione estesa del colon o dell’intestino tenue tale da compromettere l’assorbimento di medicinali somministrati per via orale.
    CE 10 Epatite B nota associata a complicanze cliniche (possono considerarsi idonei i pazienti affetti da epatite B cronica controllata con o senza terapia antivirale e sorvegliati ai sensi delle linee guida ASCO del 2015 relative al monitoraggio dell’epatite B).
    CE 11 Trattamento in corso con interferone per epatite C nota, o presenza di epatite C clinicamente non controllata o epatite C associata a complicanze significative che probabilmente interferirebbero con
    l’aderenza al protocollo.
    CE 12 Infezione nota sostenuta dal virus dell’immunodeficienza umana (HIV), sindrome da
    immunodeficienza acquisita (AIDS) o malattia correlata a/diagnostica per AIDS.
    CE 13 Infarto del miocardio, angina instabile, ictus, attacco ischemico transitorio o altra complicanza
    vascolare importante nei 6 mesi precedenti alla randomizzazione.
    CE 14 Insufficienza cardiaca congestizia (CHF) clinicamente rilevante (di classe NYHA II-IV).
    CE 15 Intervallo QT corretto (QTc) > 470 ms o nuova anomalia clinicamente significativa
    all’elettrocardiogramma (ECG). I pazienti con aritmia cardiaca nota adeguatamente controllata che non influisce sul performance status, quale fibrillazione atriale, possono essere ritenuti idonei.
    Possono considerarsi idonei anche i pazienti con pacemaker che non presentano complicanze
    importanti (ricovero in ospedale, infezione) nei 6 mesi precedenti alla randomizzazione.
    CE 16 Enteropatia infiammatoria attiva, malattia di Crohn, colite ulcerativa o altra malattia diarroica cronica non adeguatamente controllata.
    CE 17 Neuropatia periferica di grado = 2 (NCI-CTCAE).
    CE 18 Rifiuto di rispondere ai questionari sulla qualità della vita sia in autonomia sia con l’aiuto del
    personale dello studio, nonostante un’adeguata padronanza della lingua.
    CE 19 Malattia cronica intercorrente (non maligna) che necessita di > 10 mg di prednisone al giorno (o
    equivalente), oppure altra o altre condizioni mediche o psichiatriche intercorrenti (non maligne) non perfettamente controllate e che secondo lo sperimentatore determinano un rischio medio-alto di interferenza con la somministrazione della terapia prevista dal protocollo o con l’aderenza alle
    procedure richieste.
    Si prega di fare riferimento al protocollo per ulteriori informazioni.
    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
    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 dropout rate of up to 5% for the entire study.
    L'analisi finale avverrà quando si saranno osservati almeno 694 eventi randomizzando 870 pazienti in 24 mesi, con 12 mesi minimo di follow-up per ogni paziente. Il calcolo della dimensione del campione assume un rapporto di drop out fino al 5% per l'intero studio.
    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 subpopulation¿
    ¿ 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, ParaffinEmbedded
    (FFPE) tumor tissue.
    ¿ Sopravvivenza globale nella sottopopolazione positiva per il biomarcatore predefinita¿
    ¿ Sopravvivenza libera da progressione nella popolazione ITT dello studio
    ¿ Sopravvivenza libera da progressione nella sottopopolazione positiva per il biomarcatore predefinita¿
    ¿ Tasso di controllo della malattia e tasso di risposta obiettiva nella popolazione ITT dello studio
    ¿ Tasso di controllo della malattia e tasso di risposta obiettiva nella sottopopolazione positiva per il
    biomarcatore predefinita¿
    ¿ Qualit¿ della vita
    ¿ Profilo di sicurezza
    ¿ La sottopopolazione positiva per il biomarcatore ¿ definita come l¿insieme dei pazienti positivi per STAT3 fosforilato (p-STAT3) in base alla colorazione immunoistochimica (IHC) del tessuto tumorale fissato in formalina e incluso in paraffina (FFPE).
    E.5.2.1Timepoint(s) of evaluation of this end point
    Please refer to protocol for further information.
    Si prega di fare riferimento al protocollo per ulteriori informazioni.
    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
    Efficacia della qualit¿ della vita
    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 concerned22
    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 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
    China
    Israel
    Japan
    Korea, Republic of
    United States
    Belgium
    Czechia
    France
    Germany
    Hungary
    Italy
    Netherlands
    Poland
    Spain
    United Kingdom
    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.
    L¿endpoint primario ¿ la sopravvivenza globale (OS). L'analisi finale avverr¿ quando saranno osservati almeno 694 eventi randomizzando 870 pazienti in 24 mesi, con 12 mesi minimo di follow-up per ogni paziente. Il follow-up per la sopravvivenza globale pu¿ essere interrotto trascorsi 2 anni dall'ultima visita di follow-up.
    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 months7
    E.8.9.1In the Member State concerned days15
    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 state100
    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.
    Nessuno - Dopo l'interruzione definitiva della terapia in studio, i pazienti riceveranno successiva terapia e trattamento anti-tumorale a discrezione dello sperimentatore.
    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 Decision2017-04-21
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2017-02-17
    P. End of Trial
    P.End of Trial StatusPrematurely Ended
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    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

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