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    Summary
    EudraCT Number:2016-003608-30
    Sponsor's Protocol Code Number:BGBC007/MK-3475_PN-530
    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:2017-03-31
    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 number2016-003608-30
    A.3Full title of the trial
    A Phase II, Multi Center Study of BGB324 in combination with Pembrolizumab in Patients with Previously Treated, Locally Advanced and Unresectable or Mestastic Triple Negative Breast Cancer (TNBC) or Triple Negative Inflammatory Breast Cancer (TN-IBC)
    Ensayo en fase II, multicéntrico, sobre BGB324 en combinación con pembrolizumab en pacientes tratados con anterioridad con cáncer de mama triple negativo (CMTN) o cáncer de mama inflamatorio triple negativo (CMI-TN) localmente avanzado e irresecable o metastásico
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    A Phase II, Multi Center Study of BGB324 in combination with Pembrolizumab in Patients with Previously Treated, Locally Advanced and Unresectable or Mestastic Triple Negative Breast Cancer (TNBC) or Triple Negative Inflammatory Breast Cancer (TN-IBC)
    Ensayo en fase II, multicéntrico, sobre BGB324 en combinación con pembrolizumab en pacientes tratados con anterioridad con cáncer de mama triple negativo (CMTN) o cáncer de mama inflamatorio triple negativo (CMI-TN) localmente avanzado e irresecable o metastásico
    A.4.1Sponsor's protocol code numberBGBC007/MK-3475_PN-530
    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 SponsorBerGenBio AS
    B.1.3.4CountryNorway
    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 supportBerGenBio AS
    B.4.2CountryNorway
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationBerGenBio AS
    B.5.2Functional name of contact pointClinical Project Manager
    B.5.3 Address:
    B.5.3.1Street AddressJonas Lies vei 91
    B.5.3.2Town/ cityBergen
    B.5.3.3Post code5009
    B.5.3.4CountryNorway
    B.5.4Telephone number447789922464
    B.5.6E-mailkath.lowery@bergenbio.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 nameBGB324
    D.3.2Product code BGB324
    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 INNBGB324
    D.3.9.1CAS number 1037624-75-1
    D.3.9.3Other descriptive nameBGB324
    D.3.9.4EV Substance CodeSUB168256
    D.3.10 Strength
    D.3.10.1Concentration unit g gram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number100
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product 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 RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product namepembrolizumab
    D.3.2Product code MK-3475
    D.3.4Pharmaceutical form Solution for infusion
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPIntravenous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNpembrolizumab
    D.3.9.1CAS number 1374853-91-4
    D.3.9.2Current sponsor codeMK-3475
    D.3.9.3Other descriptive nameAnti-PD-1 monoclonal antibody
    D.3.9.4EV Substance CodeSUB91641
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number25
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin No
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) Yes
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) No
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product No
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) Yes
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product Yes
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.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
    Previously Treated, Locally Advanced and Unresectable
    or Metastatic Triple Negative Breast Cancer (TNBC) or
    Triple Negative Inflammatory Breast Cancer (TN-IBC)
    pacientes tratados con anterioridad con cáncer de mama triple negativo (CMTN) o cáncer de mama inflamatorio triple negativo (CMI-TN) localmente avanzado e irresecable o metastásico
    E.1.1.1Medical condition in easily understood language
    Breast Cancer
    cáncer de mama
    E.1.1.2Therapeutic area Diseases [C] - Cancer [C04]
    MedDRA Classification
    E.1.3Condition being studied is a rare disease No
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    To assess anti-tumor activity of the combination
    of BGB324 and pembrolizumab
    •Evaluar la actividad antineoplásica de la combinación de BGB324 y pembrolizumab
    E.2.2Secondary objectives of the trial
    To assess the safety of BGB324 and pembrolizumab when given in combination
    To further assess the anti-tumor activity of the combination of BGB324 and pembrolizumab
    The number and frequency of adverse events; assessment of safety laboratory parameters,
    vital signs and ECGs
    •Evaluar la seguridad de BGB324 y de pembrolizumab cuando se administran en combinación
    •Seguir evaluando la actividad antineoplásica de la combinación de BGB324 y pembrolizumab
    •El número y la frecuencia de acontecimientos adversos; evaluación de los parámetros clínicos de seguridad, constantes vitales y ECG
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1. Provision of signed informed consent.2. Age 18 years or older at the time of provision of informed consent.3. Histopathologically or cytologically documented TNBC or TN-IBC. Tumors must have been confirmed negative for ER and PR by IHC (<1% positive tumor nuclei, as per ASCO-CAP guideline recommendations3) and negative for HER2 by IHC or fluorescent or chromogenic in situ hybridization (FISH or CISH). Patients with equivocal HER2 results by IHC should have their negativity status confirmed by FISH. 4. Locally advanced and unresectable or metastatic TNBC or triple negative inflammatory breast cancer. 5. Received one or more prior therapies for TNBC or TN-IBC, which may include adjuvant, neo-adjuvant and metastatic therapy, and must have included a prior taxane and/or anthracycline-based therapy 6. Has measurable disease as defined by RECIST 1.12 on computed tomography (CT) or magnetic resonance imaging (MRI) and as determined by the site study team. Tumor lesions situated in a previously irradiated area are considered measurable if progression
    has been demonstrated in such lesions.
    7. Provision of suitable tumor tissue for the analysis of Axl kinase expression and PD-L1
    expression. Suitable tumor tissue must consist of a minimum of newly acquired (fresh)
    tumor tissue sample (as a FFPE block), together with either further newly acquired
    tumor tissue (i.e. further FFPE block) or an archival tumor tissue sample (as a further
    FFPE block or further 10 unstained slides). See Section 5.3.13 for further details.
    8. Eastern Cooperative Oncology Group (ECOG) performance score 0 or 1 [Appendix
    A].
    9. Life expectancy of at least 3 months.
    10. Adequate organ function confirmed at Screening and within 10 days of initiating
    treatment, as evidenced by:
    a. Platelet count ≥100,000 /mm3;
    b. Hemoglobin ≥9.0 g/dL (≥5.6 mmol/L);
    c. Absolute neutrophil count (ANC) >1,500 /mm3;
    d. Alanine aminotransferase (ALT) and Aspartate aminotransferase (AST) ≤2.5
    times the upper limit of normal (ULN), or ≤5 times the ULN for patients with
    liver metastases;
    e. Total bilirubin ≤1.5 times the ULN, or direct bilirubin <ULN for patients with
    total bilirubin levels >1.5xULN;
    f. Creatinine ≤1.5 times the ULN and calculated creatinine clearance >60 mL/min
    (by Cockcroft Gault formula; see Appendix B);
    g. International Normalized Ratio (INR) or Prothrombin Time (PT) ≤1.5 times the
    ULN and Activated Partial Thromboplastin Time (aPTT) ≤1.5 times the ULN.
    Note: If patient is receiving anticoagulant therapy, then PT or PTT must be
    within therapeutic range of intended use of anticoagulants;
    h. LDH ≤2.5 times the ULN.
    11. Female patients of childbearing potential must have a negative pregnancy test (either
    urine or serum pregnancy test) within 72 hours prior to the first dose of study treatment.
    If the urine test is positive or cannot be confirmed as negative, a serum pregnancy test
    will be required.
    12. Have resolution of toxic effect(s) of the most recent prior chemotherapy to Grade 1 or
    less (except alopecia). If the patient received major surgery or radiation therapy of >30
    Gy, they must have recovered from the toxicity and/or complications from the
    intervention.
    13. Patients of reproductive potential must be willing to practice highly effective methods
    of contraception (such as those described in Section 6.13) throughout the study and for
    120 days after the last dose of study medication. Abstinence is acceptable if this is the
    usual lifestyle of the patient. Female patients are considered NOT of childbearing
    potential if they have a history of surgical sterility or evidence of post-menopausal
    status defined as any of the following:
    a. ≥45 years of age and has not had menses for more than 1 year;
    b. Amenorrheic for >2 years without a hysterectomy and oophorectomy and a
    follicle stimulating hormone (FSH) value in the postmenopausal range upon
    Screening evaluation and oestradiol <30 pg/mL;
    c. Post hysterectomy, oophorectomy or tubal ligation.
    1.Otorgue el consentimiento informado firmado.2.Sea mayor de 18 años en el momento de otorgar el consentimiento informado.3.Presente CMTN o CMI-TN, documentado mediante histopatología o citología. Se debe haber confirmado que los tumores son negativos para los receptores de estrógenos y para los receptores de progesterona mediante IHQ (<1 % de núcleos tumorales positivos, según las recomendaciones de las directrices de la ASCO-CAP)3 y negativos para HER2 mediante IHQ o hibridación fluorescente o cromógena in situ (FISH o CISH, por sus siglas en inglés). En los ptes con resultado de HER2 dudosos mediante IHQ, se deberá confirmar dicho resultado negativo mediante hibridación FISH.4.CMTN o cáncer de mama inflamatorio triple negativo localmente avanzado e irresecable o metastásico. 5.El pte se ha sometido a uno o más tratamientos previos para el CMTN o CMI-TN, entre los cuales podría figurar tratamiento adyuvante, neoadyuvante y metastásico; en el tto previo debe figurar un tratamiento con taxano y/o antraciclina.6.El pte presenta una enfermedad medible conforme a los criterios RECIST 1.12 en tomografía computarizada (TAC) o en resonancia magnética (RM) y según lo haya determinado el equipo del estudio del centro. Las lesiones neoplásicas que se encuentren en una zona irradiada con anterioridad se considerarán medibles en el caso de que se haya demostrado progresión en dichas lesiones.7.Entrega de tejido tumoral apto para el análisis de la expresión de cinasa de Axl y de la expresión de PD-L1. El tejido tumoral apto deberá constar de como mínimo una muestra de tejido tumoral recién extraído (en un bloque FFPE), junto con bien otra muestra de tejido tumoral recién extraído (es decir, otro bloque FFPE) o una muestra de tejido tumoral de archivo (otro bloque FFPE u otros 10 frotis sin teñir). Si desea más información, consulte el Apartado 5.3.13.8.9.Esperanza de vida de como mínimo 3 meses. 10.Función orgánica adecuada confirmada en la selección y en un plazo de 10 días desde el comienzo del tratamiento, lo cual se deberá demostrar mediante:a.Recuento plaquetario ≥100 000 /mm3; b.Hemoglobina ≥9,0 g/dl (≥5,6 mmol/l);c.Recuento absoluto de neutrófilos (RAN) >1500 /mm3;d.Alanina aminotransferasa (ALT) y asparatato aminotransferasa (AST) ≤2,5 veces el límite superior de la normalidad (LSN), o ≤5 veces el LSN en el caso de ptes con metástasis hepáticas;e.Bilirrubina total ≤1,5 veces el LSN, o bilirrubina directa <LSN en el caso de ptes con niveles de bilirrubina total >1,5 ×LSN;f.Creatinina ≤1,5 veces el LSN y cálculo de aclaramiento de creatinina >60 ml/min (mediante la fórmula de Cockcroft-Gault; consulte el Anexo B);g.Índice internacional normalizado (IRN) o tiempo de protrombina (TP) ≤1,5 veces el LSN tiempo de tromboplastina parcial activada (TTPa) ≤1,5 veces el LSN. Nota: en el caso de que al paciente se le esté administrando tratamiento anticoagulante, el TP o el TTP deberá estar dentro del rango terapéutico del uso deseado de los anticoagulantes;h.LDH ≤2,5 veces el LSN.11.Las pacientes en edad fértil deberán presentar una prueba de embarazo con resultado negativo (prueba de embarazo bien en orina o en suero) en un plazo de 72 horas antes de la administración de la primera dosis del tto del estudio. En el caso de que la prueba en orina arroje un resultado positivo o no se pueda confirmar un resultado negativo, se deberá efectuar una prueba de embarazo en suero.12.Se debe(n) haber resuelto el (los) efecto(s) tóxico(s) del tratamiento quimioterápico más reciente hasta situarse en el grado 1 o inferior (salvo la alopecia). En el caso de que el paciente se haya sometido a una intervención de cirugía mayor o a radioterapia de >30 Gy, debe haberse recuperado de la toxicidad o de las complicaciones derivadas de la intervención.13.Los ptes en edad fértil deben estar dispuestos a emplear métodos anticonceptivos de alta eficacia (como los que se describen en el Apartado 6.13) durante el transcurso del estudio y durante 120 días después de la admon de la última dosis de la medicación del estudio. La abstinencia sexual se aceptará siempre y cuando ese sea el estilo de vida habitual del paciente. Se considerará que las pacientes NO se encuentran en edad fértil en el caso de que tengan documentada la esterilidad quirúrgica o demuestren haber superado la menopausia según se define a continuación:a.paciente de ≥45 años de edad y sin menstruación durante un período superior a 1 año;b.pte amenorreica durante >2 años sin histerectomía ni ovariectomía y con un valor de la hormona foliculoestimulante (FSH) en el rango posmenopáusico en el momento de la evaluación de selección y estradiol <30 pg/ml;c.paciente que se haya sometido a histerectomía, ovariectomía o ligadura de trompas. Se deberá confirmar la histerectomía o de la ovariectomía mediante la documentación de la historia clínica del procedimiento concreto o mediante ecografía. La ligadura de trompas se deberá confirmar con la historia clínica de la propia intervención.
    E.4Principal exclusion criteria
    1. Has disease that is suitable for local therapy administered with curative intent.
    2. More than 3 previous lines of therapy in the metastatic setting.
    3. Has received prior therapy with an immunomodulatory agent.
    4. Has a known additional malignancy that is progressing or requires active treatment.
    5. Has known active central nervous system (CNS) metastases and/or carcinomatous
    meningitis.
    6. History of the following cardiac conditions:
    a. Congestive cardiac failure of >Grade II severity according to the
    NYHA
    b. Ischemic cardiac event including myocardial infarction within 3 months prior to
    first dose;
    c. Uncontrolled cardiac disease, including unstable angina, uncontrolled
    hypertension or need to change medication due to lack of disease control within 6
    weeks prior to the provision of consent;
    d. History or presence of sustained bradycardia (≤55 BPM), left bundle branch
    block, cardiac pacemaker or ventricular arrhythmia.
    e. Family history of long QTc syndrome; personal history of long QTc syndrome
    or previous drug-induced QTc prolongation of at least Grade 3 (QTc >500 ms).
    7. Abnormal left ventricular ejection fraction on echocardiography or MUGA
    8. Current treatment with any agent known to cause Torsades de Pointes which cannot
    be discontinued at least five half-lives or two weeks prior to the first dose of study
    treatment.
    9. Screening 12-lead ECG with a measurable QTc interval according to Fridericia’s
    correction >450 ms.
    10. Is currently participating and receiving study therapy or has participated in a study of
    an investigational agent and received study therapy or used an investigational device
    within 4 weeks of the first dose of study treatment.
    11. Has had prior chemotherapy, targeted small molecule therapy, or radiation therapy
    within 2 weeks prior to study Day 1 or who has not recovered from AEs due to a previously administered agent.
    12. Received an anti-cancer monoclonal antibody (mAb) within 4 weeks prior to the first
    dose of study treatment or who has not recovered from AEs
    due to agents administered more than 4 weeks earlier.
    13. Major surgery within 28 days prior to start of study treatment and failure to have
    recovered adequately from the toxicity and/or complications from the intervention
    prior to the first dose of study treatment.
    14. Received transfusion of blood products (including platelets or red blood cells) or
    administration of colony stimulating factors (including G-CSF, GM-CSF or
    recombinant erythropoetin) within 4 weeks prior to the first dose of study treatment.

    15. Has a diagnosis of immunodeficiency or is receiving systemic steroid therapy or any
    other form of immunosuppressive therapy within 7 days prior to the first dose of study
    treatment.
    16. Active autoimmune disease that has required systemic treatment in past 2 years
    Note: Replacement therapy is not considered a
    form of systemic treatment.
    17. Known history of human immunodeficiency virus (HIV 1/2 antibodies)
    18. Has known active infection with Hepatitis B or Hepatitis C
    19. Has received a live-virus vaccination within 30 days of planned treatment start. Note:
    Seasonal flu vaccines that do not contain live virus are permitted.
    20. Has a history of (non-infectious) pneumonitis that required steroids or current
    pneumonitis.
    21. Has a history of interstitial lung disease.
    22. Inability to swallow or tolerate oral medication.
    23. Existing gastrointestinal disease affecting drug absorption such as celiac disease or
    Crohn’s disease, or previous bowel resection which is considered to be clinically
    significant or could interfere with absorption.
    24. Known lactose intolerance.
    25. Requires vitamin K antagonists. Note: Patients receiving low doses prescribed to
    maintain the patency of venous access devices may be included. Factor Xa antagonists
    are permitted.
    26. Treatment with any of the following: histamine receptor 2 inhibitors, proton pump
    inhibitors or antacids within 7 days of start of study treatment.
    27. Treatment with any medication which is predominantly metabolized by CYP3A4 and
    has a narrow therapeutic index.
    28. Known hypersensitivity to BGB324, pembrolizumab, or any of their excipients.
    29. Has an active infection requiring systemic therapy (apart from cutaneous infections).
    30. Has a history or current evidence of any condition, therapy, or laboratory abnormality
    that, in the opinion of the Investigator, might confound the results of the trial, interfere
    with the patient’s participation and compliance in the trial, or means it is not in the best
    interests of the patient to participate.
    31. Is pregnant or breastfeeding, or expecting to conceive or father children within the
    projected duration of the trial, starting from Screening through to 120 days after the
    last dose of study treatment.
    32. Has known psychiatric or substance abuse disorders that would interfere with
    cooperation with the requirements of the trial.
    1.Padezca una enfermedad que sea apta para someterse a tratamiento local administrado con una intención curativa.2.Más de 3 líneas de tratamiento previas en el contexto metastásico.3.Ha recibido tratamento previo con un medicamento inmunomodulador.4. Se tenga conocimiento de otra neoplasia maligna que esté en progresión o que precise un tratamiento activo. Nota: entre las excepciones permitidas figura el carcinoma basocelular de piel, carcinoma espinocelular de piel que se haya sometido a tratamiento potencialmente curativo o el cáncer de cuello uterino localizado.5.Se tenga conocimiento de metástasis activas en el sistema nervioso central (SNC) o meningitis carcinomatosa. Nota: los pacientes con metástasis cerebrales que se hayan tratado con anterioridad podrán participar en el ensayo siempre y cuando se encuentren estables (sin signos de progresión mediante prueba diagnóstica por imagen [mediante una modalidad idéntica de prueba diagnóstica por imagen en cada evaluación, ya sea RM o TAC] durante como mínimo 4 semanas previas a la administración de la primera dosis del tratamiento del ensayo y siempre que cualquier síntoma neurológico haya vuelto al estado inicial), no presenten signos de nuevas metástasis cerebrales ni de aumento del tamaño de las mismas y no se estén empleando corticosteroides durante como mínimo 7 días previos al tratamiento del ensayo.6.Antecedentes de la siguientes cardiopatías:a.insuficiencia cardíaca congestiva de intensidad grado >II de la NYHA (Anexo : se define como sintomático con niveles de actividad inferiores a los normales);b.acontecimiento cardíaco isquémico, incluido el infarto de miocardio en un período de 3 meses previos a la administración de la primera dosis;c.cardiopatía no controlada, incluida la angina inestable, la hipertensión no controlada (es decir, TA sistólica sostenida >160 mm Hg o TA diastólica sostenida >90 mm Hg) o la necesidad de cambiar la medicación debido a la falta de control de la enfermedad en un plazo de 6 semanas previas al otorgamiento del consentimiento;d.antecedentes o presencia de bradicardia sostenida (≤55 lpm), bloqueo de la rama izquierda del haz de His, marcapasos o arritmia ventricular. Nota: los pacientes con arritmia ventricular que precisen tratamiento médico pero con una frecuencia ventricular normal sí son aptos para participar en el ensayo; e. antecedentes familiares del síndrome de QT largo; antecedentes personales de síndrome de QT largo o episodio previo de prolongación de QTc de como mínimo de grado 3 (QTc >500 ms) de origen farmacógeno.7. Fracción de eyección del ventrículo izquierdo anormal con ecocardiografía o MUGA (inferior al limite inferior de la normalidad para un paciente de esa edad en la institución en que se trata al paciente o <45 %, la que sea inferior).8.Tratamiento actual con cualquier fármaco que se conozca como causante de Tosades de Pointes (taquicardia ventricular en entorchado) y cuya administración no se pueda suspender como mínimo cinco semividas o dos semanas antes de la administración de la primera dosis del tratamiento del estudio.9.ECG de 12 derivaciones en la selección con un intervalo de QTc medible según la fórmula corregida de Fridericia de >450 ms.10.El paciente esté participando y esté recibiendo tratamiento del estudio o haya participado en un estudio de un fármaco experimental y haya recibido tratamiento del estudio o empleado un dispositivo experimental en un plazo de 4 semanas desde la administración de la primera dosis del tratamiento del estudio.11.El paciente haya recibido quimioterapia con anterioridad, un tratamiento dirigido de moléculas pequeñas, o radioterapia en un plazo de 2 semanas previas al día 1 del estudio o no se haya recuperado (es decir, grado ≤1 o estado inicial) del AA debido al fármaco que se le haya administrado con anterioridad. Nota: los pacientes con alopecia de grado ≤2 constituyen una excepción a este criterio y podrían ser aptos para participar en el estudio.12. Se le haya administrado un anticuerpo monoclonal (mAb, por sus siglas en inglés) antineoplásico en un plazo de 4 semanas previas a la administración de la primera dosis del tratamiento del estudio o no se haya recuperado (es decir, grado ≤1 o estado inicial) del AA debido a fármacos que se hayan administrado más de 4 semanas antes.13.El paciente se haya sometido a cirugía mayor en un plazo de 28 días previos al comienzo del tratamiento del estudio y no se haya recuperado suficientemente de la toxicidad o de las complicaciones de la intervención antes de la administración de la primera dosis del tratamiento del estudio. Nota: en cirugía mayor no se contemplan los procedimientos que se lleven a cabo para la inserción de catéteres venosos ni las biopsias.
    E.5 End points
    E.5.1Primary end point(s)
    Objective Response Rate
    Tasa de respuesta objetiva
    E.5.1.1Timepoint(s) of evaluation of this end point
    The study will utilize a 2-stage, single arm, extension of Simon’s 2-stage design1 with one
    (efficacy) interim and a final analysis. The interim analysis will be conducted when 28 patients
    are evaluable for Objective Response Rate (ORR).
    Recruitment to the study will be halted once 28 evaluable patients have been entered and whilst
    the Stage 1 interim analysis is conducted. Recruitment will recommence if the decision is made
    to continue to the maximum of 56 evaluable patients.
    se empleará un diseño de ampliación del diseño de Simon1 de dos etapas, y se emplearán dos etapas y un único grupo de estudio; durante el estudio se realizará un análisis provisional y uno final (de la eficacia). El análisis provisional se efectuará cuando haya 28 pacientes evaluables para la determinación de la tasa de TRO. En el caso de que se observen 5 o menos respuestas en un máx de 28 pacientes, el ensayo se dará por finalizado a favor de la hipótesis nula por futilidad. En el caso de que se observen 11 o más respuestas, se detendrá el ensayo a favor de la hipótesis alternativa por demostración de la actividad. En el caso de que, en el análisis provisional, se observe respuesta entre 6 y 10 pacientes, se podrá evaluar a otros 28 hasta alcanzar un total de 56
    E.5.2Secondary end point(s)
    Duration of Response
    Disease Control Rate
    Time to progression
    Survival at 12 months
    Response by Biomarker expression
    Safety
    Duracion de respuesta
    Ratio de Control de la enfermedad
    Tiempo de progression
    Supervivencia a lso 12 meses
    respuesta por la expression de biomarcadores
    Seguridad
    E.5.2.1Timepoint(s) of evaluation of this end point
    The study will utilize a 2-stage, single arm, extension of Simon’s 2-stage design1 with one
    (efficacy) interim and a final analysis. The interim analysis will be conducted when 28 patients
    are evaluable for Objective Response Rate (ORR).
    Recruitment to the study will be halted once 28 evaluable patients have been entered and whilst
    the Stage 1 interim analysis is conducted. Recruitment will recommence if the decision is made
    to continue to the maximum of 56 evaluable patients.
    se empleará un diseño de ampliación del diseño de Simon1 de dos etapas, y se emplearán dos etapas y un único grupo de estudio; durante el estudio se realizará un análisis provisional y un análisis final (de la eficacia). El análisis provisional se efectuará cuando haya 28 pacientes evaluables para la determinación de la TRO. En el caso de que se observen 5 o menos respuestas en un máximo de 28 pacientes, el ensayo se dará por finalizado a favor de la hipótesis nula por futilidad. En el caso de que se observen 11 o más respuestas, se detendrá el ensayo a favor de la hipótesis alternativa por demostración de la actividad. En el caso de que, en el análisis provisional, se observe respuesta entre 6 y 10 pacientes, se podrá evaluar a otros 28 pacientes hasta alcanzar un total de 56 pacientes
    E.6 and E.7 Scope of the trial
    E.6Scope of the trial
    E.6.1Diagnosis No
    E.6.2Prophylaxis No
    E.6.3Therapy Yes
    E.6.4Safety Yes
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic No
    E.6.7Pharmacodynamic No
    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.8.2.4Number of treatment arms in the trial1
    E.8.3 The trial involves single site in the Member State concerned No
    E.8.4 The trial involves multiple sites in the Member State concerned Yes
    E.8.4.1Number of sites anticipated in Member State concerned7
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA20
    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
    Norway
    Spain
    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
    The study will be completed when either:
    • The study is terminated at the interim analysis following the DRC review of the ORR
    and risk/benefit for all patients included in the interim analysis. The interim analysis
    will occur once 28 evaluable patients have had the potential to be followed for at least
    24 weeks.
    OR
    • The study will complete and the final analysis will occur once all patients (planned 56
    evaluable patients) have had the potential to be followed for at least 24 weeks.
    El estudio se termina con el análisis intermedio después de la revision del CRD de la TRO y Riesgo/ beneficio para todos los pacientes incluidos en el análisis intermedio. El análisis intermedio ocurrirá una vez que 28 pacientes evaluables tengan el potencial de ser seguidos por al menos 24 semanas ó
    El estudio se completará y el analisis final se realizara una vez que todos los pacientes (56 pacientes evaluables planeados) hayan tenido el potencial de ser seguidos durante al menos 24 semanas
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years4
    E.8.9.1In the Member State concerned months11
    E.8.9.1In the Member State concerned days
    E.8.9.2In all countries concerned by the trial years4
    E.8.9.2In all countries concerned by the trial months11
    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: 56
    F.1.3Elderly (>=65 years) No
    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 No
    F.3.3.1Women of childbearing potential not using contraception No
    F.3.3.2Women of child-bearing potential using contraception No
    F.3.3.3Pregnant women No
    F.3.3.4Nursing women No
    F.3.3.5Emergency situation No
    F.3.3.6Subjects incapable of giving consent personally No
    F.3.3.7Others No
    F.4 Planned number of subjects to be included
    F.4.1In the member state25
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 41
    F.4.2.2In the whole clinical trial 56
    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)
    Patients will continue to receive the study treatment(s) until 106 weeks (35 cycles) equivalent to 24 calender months or until they are no longer receiving clinical benefit (which ever is shorter). Therefore, duration of treatment will continue even after the end of the trial for those patients who are still deriving clinical benefit and who continue to receive the treatment(s) for 24 calender months.
    Los pacientes continuaran recibiendo el tratamiento del studio hasta 106 semanas (35ciclos) equivalente a 24 meses o hasta que dejen de recibir beneficio clinic. En cualquier caso la duración del tratamiento continuará incluso después del final del setudio para aquellos pacientes que todavía reciban beneficio clinic continuaran recibiendo tratamiento for 24 meses.
    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 Decision2017-06-08
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2017-05-08
    P. End of Trial
    P.End of Trial StatusCompleted
    P.Date of the global end of the trial2018-08-20
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