E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Relapsed or Refractory Diffuse Large B-Cell Lymphoma |
Linfoma difuso de células B grandes recidivante o resistente |
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E.1.1.1 | Medical condition in easily understood language |
Relapsed or Refractory Diffuse Large B-Cell Lymphoma |
Linfoma difuso de células B grandes recidivante o resistente |
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E.1.1.2 | Therapeutic area | Diseases [C] - Cancer [C04] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.0 |
E.1.2 | Level | HLT |
E.1.2 | Classification code | 10012819 |
E.1.2 | Term | Diffuse large B-cell lymphomas |
E.1.2 | System Organ Class | 100000004851 |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To assess the efficacy of TAK-659 measured by independent radiologic review committee (IRC)-assessed overall response rate (ORR) in patients with diffuse large B-cell lymphoma (DLBCL). |
Evaluar la eficacia de TAK-659 a partir de la tasa de respuesta global (TRG), según el comité de revisión independiente radiológico (CRI), en pacientes con linfoma difuso de células B grandes recidivante o resistente (LDCBG). |
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E.2.2 | Secondary objectives of the trial |
• To assess complete response (CR) rate per IRC in patients with DLBCL • To assess durable response rate (DRR) per Independent Radiologic Review Committee (IRC) (complete response/partial response (CR/PR) with duration ≥16 weeks, which is the equivalent of 4 cycles for 28-day cycles) in patients with DLBCL. • To assess duration of response (DOR) and duration of CR per IRC in patients with DLBCL. • To assess overall response rate (ORR) per IRC in the subgroup of patients with germinal center B-cell (GCB) DLBCL. • To assess ORR per IRC in the subgroup of patients with DLBCL transformed from indolent lymphoma. • To assess progression-free survival (PFS) per IRC in patients with DLBCL. • To assess overall survival (OS) in patients with DLBCL. |
• Evaluar la tasa de respuesta completa (RC) según el CRI en pacientes con LDCBG • Evaluar la TRD (RC/respuesta parcial [RP] con una duración ≥ 16 semanas, que es equivalente a cuatro ciclos de 28 días) según el CRI en pacientes con LDCBG • Evaluar la duración de respuesta (DR) y la duración de la RC según el CRI en pacientes con LDCBG • Evaluar la tasa de respuesta global (TRG) según el CRI en el subgrupo de pacientes con LDCBG con células B de centro germinal (GCB) • Evaluar la TRG según el CRI en el subgrupo de pacientes con LDCBG transformado a partir de un linfoma no Hodgkin (LNH) indolente • Evaluar la supervivencia libre de progresión (SLP) según el CRI en pacientes con LDCBG • Evaluar la supervivencia global (SG) según el CRI en pacientes con LDCBG |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Male or female patients aged 18 years or older. 2. Patients must have histologically confirmed DLBCL, including de novo disease or transformed disease from indolent NHL. High-grade B-cell lymphoma with MYC and BCL-2 and/or BCL-6 translocations (double-hit DLBCL under DLBCL, NOS, based on the 2008 WHO classification criteria) is not eligible for this study. a. Local pathology review for histological confirmation: - A formalin-fixed, paraffin-embedded (FFPE) tumor block or appropriately stained slides from a fresh biopsy is required. 3. Relapsed or refractory to ≥2 prior lines of chemotherapy based on standard of care with certain requirements for prior therapy. 4. For patients who have relapsed or progressed after achieving a response, documented, investigator-assessed relapse or progression after the last treatment is required. 5. Must have FDG-PET–avid measurable disease that meets the size criteria per IWG as assessed on cross-sectional imaging by CT/MRI. 6. ECOG performance status score of 0 or 1. 7. Life expectancy of >3 months 8. Patients must have adequate organ function, including the following: a. Bone marrow reserve: absolute neutrophil count (ANC) ≥1000/μL, platelet count ≥75,000/μL (≥50,000/μL for patients with bone marrow involvement), and hemoglobin ≥8 g/dL (red blood cell [RBC] and platelet transfusion allowed ≥14 days before assessment). b. Hepatic: total bilirubin ≤1.5 times the upper limit of the normal range (ULN); ALT and AST ≤2.5xULN. c. Renal: creatinine clearance ≥60 mL/min either as estimated by the Cockcroft-Gault equation or based on urine collection (12 or 24 hours). d. Others: •Lipase ≤1.5xULN and amylase ≤1.5xULN with no clinical symptoms suggestive of pancreatitis or cholecystitis. •Blood pressure ≤Grade 1 (hypertensive patients are permitted if their blood pressure is controlled to ≤Grade 1 by hypertensive medications and glycosylated hemoglobin is ≤6.5%). |
1. Varones o mujeres con 18 años o mayors. 2. Los pacientes deben presentar LDCBG confirmado histológicamente, incluida la enfermedad de novo o la enfermedad transformada a partir de un LNH indolente.El linfoma de células B de alto grado con translocaciones de MYC y BCL-2 y/o BCL-6 (LDCBG doble hit en LDCBG sin especificar, según los criterios de clasificación de la OMS de 2008) no será apto para este estudio
a. Revisión de la patología local para confirmación histológica: - Se requiere un bloque de tumor fijado en formalina y contenido en parafina o portaobjetos de una biopsia fresca con una tinción adecuada. 3. Recidivante o resistente a ≥ 2 líneas previas de quimioterapia conforme al tratamiento estándar con cierto requisites para la terapia previa. 4. Para pacientes que hayan presentado recidiva o progresión tras presentar respuesta (definida como RC o RP), se requerirá recidiva o progresión tras el último tratamiento, evaluada por el investigador y documentada. 5. Deben presentar enfermedad ávida de FDG-PET que cumpla los criterios de tamaño según el GIT mediante evaluación con imágenes transversales por TAC/RM |
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E.4 | Principal exclusion criteria |
1. CNS lymphoma; active brain or leptomeningeal metastases. 2. Known human immunodeficiency virus (HIV)–related malignancy. 3. Systemic anticancer treatment (including investigational agents) less than 3 weeks before the first dose of study treatment. 4. Radiotherapy less than 3 weeks before the first dose of study treatment. 5. Known HIV positive (testing not required). 6. Known hepatitis B surface antigen positive or known or suspected active hepatitis C infection. 7. Prior ASCT within 6 months or prior ASCT at any time without full hematopoietic recovery before Cycle 1 Day 1, or allogeneic stem cell transplant any time. 8. Participants with certain cardiovascular conditions are excluded. 9. Major surgery within 14 days before the first dose of study drug or incomplete recovery from any complications from surgery. 10. Systemic infection requiring parenteral antibiotic therapy or other serious infection (bacterial, fungal, or viral) within 21 days before the first dose of study drug. 11. Treatment with high-dose corticosteroids for anticancer purposes within 7 days before the first dose of TAK-659. 12. Patients with another malignancy within 2 years of study start. Patients with nonmelanoma skin cancer or carcinoma in situ of any type are not excluded if they have undergone complete resection and are considered disease-free at the time of study entry. 13. Known gastrointestinal (GI) disease or GI procedure that could interfere with the oral absorption or tolerance of TAK-659. 14. Certain wash-out restrictions before the first dose of study drug on inhibitors of P-gp and/or strong reversible inhibitors of CYP3A, strong CYP3A mechanism-based inhibitors or strong CYP3A inducers and/or Pgp inducers, grapefruit containing food or beverages. |
1. Linfoma del sistema nervioso central; metástasis activas en el cerebro o leptomeníngeas. 2. Neoplasia maligna conocida asociada al virus de la inmunodeficiencia humana. 3. Tratamiento anticanceroso sistémico (incluidos productos en investigación) en las tres semanas anteriores a la primera dosis de tratamiento del studio. 4. Radioterapia en las tres semanas anteriores a la primera dosis del tratamiento del estudio. 5. Positivo conocido para VIH (prueba no necesaria). 6. Positivo conocido para antígeno de superficie de la hepatitis B o infección conocida o sospechada por hepatitis C activa. 7. TACM en los seis meses anteriores o TACM previo en cualquier momento sin recuperación hematopoyética completa antes del día 1 del ciclo 1, o trasplante alogénico de células madre en cualquier momento. 8. Participantes con determinadas enfermedades cardiovasculares. 9. Cirugía mayor en los 14 días anteriores a la primera dosis del fármaco del estudio o recuperación incompleta de cualquier complicación derivada de una intervención quirúrgica. 10. Infección sistémica que precise tratamiento antibiótico por vía parenteral u otra infección grave (bacteriana, fúngica o vírica) en los 21 días anteriores a la primera dosis del fármaco del estudio. 11. Tratamiento anticanceroso con dosis altas de corticosteroides en los 7 días anteriores a la primera dosis de TAK-659. 12. Pacientes que padeciesen otra neoplasia maligna en los 2 años anteriores al inicio del estudio. No se excluirá a los pacientes que padeciesen cáncer de piel no melanómico o carcinoma localizado de cualquier tipo solo si se han sometido a una extirpación completa y se considera que están curados en el momento de incorporarse al estudio. 13. Enfermedad gastrointestinal (GI) conocida o procedimiento GI que pudiese interferir en la absorción oral o en la tolerancia de TAK-659. 14. Ciertas restricciones en cuanto al uso o consumo de ciertas sustancias antes de la primera dosis del fármaco del estudio: inhibidores de la gp-P y/o potentes inhibidores reversibles del CYP3A, potentes inhibidores del mecanismo del CYP3A o potentes inductores del CYP3A y/o de la gp-P, así como alimentos o bebidas que contengan pomelo. |
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E.5 End points |
E.5.1 | Primary end point(s) |
The primary endpoint is ORR as assessed by IRC according to the modified 2007 International Working Group (IWG) criteria for malignant lymphoma |
La variable principal es la TSG evaluada por el CRI conforme a los criterios modificados del Grupo Internacional de Trabajo (GIT) de 2007 para el linfoma maligno |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
Primary analysis - after all patients enrolled in the study have had the opportunity to complete 6 cycles of treatment with study drug. Conclusion of the study - when OS events have occurred in 70% of patients, or 24 months after last patient in, whichever occurs earlier. |
Análisis primario- Después de que todos los pacientes reclutados en el studio hayan tenido la oportunidad de completer 6 ciclos de tratamiento con el medicamento en investigación. Fin del ensayo - Cuando los eventos de SG hayan ocurrido en 70% de los pacientes, o 24 meses despúes de la inclusion del ultimo paciente, lo que ocurra primero. |
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E.5.2 | Secondary end point(s) |
• CR rate as assessed by IRC according to the modified 2007 IWG criteria • ORR per IRC according to the 2014 IWG (Lugano) criteria. • CR rate per IRC according to the 2014 IWG (Lugano) criteria. • DRR (rate of CR/PR with duration ≥16 weeks, which is equivalent to 4 cycles for 28-day cycles) per IRC. • DOR and duration of CR per IRC. • ORR per IRC in patients with GCB DLBCL. • ORR per IRC in patients with DLBCL transformed from indolent NHL. • PFS per IRC. • OS. |
• TSG evaluada por el CRI conforme a los criterios del GIT de 2014 (Lugano)[2]. • RC evaluada por el CRI conforme a los criterios del GIT de 2014 (Lugano)[2]. • TRD (tasa de RC/RP con una duración ≥ 16 semanas, que es equivalente a cuatro ciclos para ciclos de 28 días) evaluada por el CRI. • DRG y duración de la RC según el CRI. • TRG Según el CRI en pacientes con LDCBG GCB. • TRG Según el CRI en pacientes con LDCBG transformado a partir de un LNH indolente. • SSP según el CRI. • SG. |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
Primary analysis - after all patients enrolled in the study have had the opportunity to complete 6 cycles of treatment with study drug. Conclusion of the study - when OS events have occurred in 70% of patients, or 24 months after last patient in, whichever occurs earlier. |
Análisis primario- Después de que todos los pacientes reclutados en el studio hayan tenido la oportunidad de completer 6 ciclos de tratamiento con el medicamento en investigación. Fin del ensayo - Cuando los eventos de SG hayan ocurrido en 70% de los pacientes, o 24 meses despúes de la inclusion del ultimo paciente, lo que ocurra primero. |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | No |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | Yes |
E.6.7 | Pharmacodynamic | Yes |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | Yes |
E.6.11 | Pharmacogenomic | Yes |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | No |
E.8.1.1 | Randomised | No |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | No |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 1 |
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.8.4.1 | Number of sites anticipated in Member State concerned | 7 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 25 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
France |
Italy |
Spain |
United Kingdom |
United States |
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E.8.7 | Trial 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
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Conclusion of the study will be considered when OS events have occurred in 70% of patients, or 24 months after last patient in, whichever occurs earlier. |
El fin del ensayo sera considerado cuando los eventos de SG hayan ocurrido en 70% de los pacientes, o 24 meses después de la inclusion del ultimo paciente, lo que ocurra primero. |
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 3 |
E.8.9.1 | In the Member State concerned months | 3 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 3 |
E.8.9.2 | In all countries concerned by the trial months | 3 |
E.8.9.2 | In all countries concerned by the trial days | 0 |