E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Advanced (unresectable or metastatic) biliary tract cancer |
neoplasia avanzata (non operabile o metastatica) delle vie biliari. |
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E.1.1.1 | Medical condition in easily understood language |
Advanced (unresectable or metastatic) biliary tract cancer |
neoplasia avanzata (non operabile o metastatica) delle vie biliari. |
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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 | PT |
E.1.2 | Classification code | 10073073 |
E.1.2 | Term | Hepatobiliary cancer |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
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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 |
The primary objective of the phase I part of the study is to determine the maximum tolerated dose (MTD) of the combination gemcitabine plus oxaliplatin plus nab-paclitaxel, established in the first cycle of therapy, in order to determine the recommended phase II dose (RP2D). The primary objective of the phase II is to determine activity of GEMOX plus nab-paclitaxel.
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L’obiettivo primario della fase I dello studio è determinare la dose massima tollerata della combinazione di gemcitabina con oxaliplatino e nab-paclitaxel, stabilita nel primo ciclo di terapia, per determinare la dose raccomandata per la fase II (RP2D) L’obiettivo primario della fase II dello studio è determinare l’attivita di GemOx in associazione a nab-paclitaxel.
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E.2.2 | Secondary objectives of the trial |
The secondary objectives of the study consist in to better define the safety profile and the outcome of the study treated population. |
L’obiettivo secondario dello studio (Fase I e Fase II) consiste nel definire meglio il profilo di safety e l’outcome della popolazione di studio trattata. |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Written, signed informed consent 2. Male or female aged 18 years or older 3. Histologically or citologically-confirmed advanced (unresectable or metastatic) BTC (gallbladder cancer, cancer of the extrahepatic bile duct, intrahepatic cholangiocarcinoma and ampullary carcinoma) 4. Measurable or evaluable but non-measurable disease according to RECIST v. 1.1 5. Chemotherapy-naïve (prior chemotherapy in the adjuvant setting completed more than 6 months before the trial entry is accepted) 6. Adequate bone marrow, liver, and renal function 7. ECOG PS 0-1 8. Life expectancy of at least 12 weeks 9. Negative serum pregnancy test for women of childbearing potential; 10. Adoption of adequate contraceptive methods when applicable : Women of child-bearing potential must use the following adequate contraceptive methods during all the study and for 1 month after completion of study treatment: abstinence, tubal ligation, oral contraception or transdermal contraceptives, copper intrauterine device, vasectomy of the partner. It is unknown whether the experimental drugs interact or have effect on the hormonal contraceptives functioning: if patients are using hormonal contraceptives, must be associated a barrier method of contraception. For male patients with female partners of childbearing potential, agreement to use a barrier method of contraception from the first dose of treatment and for 6 months after completion of study treatment. 11. Male patients mustn’t donate sperm during the treatment with nab-paclitexel and for 6 months after completion of study treatment. 12. Agreement not to donate blood during the study.
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Criteri di inclusione: 1. Firma del consenso informato scritto 2. Maschi e femmine di età ≥ 18 anni 3. Neoplasia avanzata (non operabile o metastatica) delle vie biliari (tumore della colecisti, tumore del dotto biliare extraepatico,colangiocarcinoma intraepatico e carcinoma ampollare) istologicamente e citologicamente confermata 4. Malattia non misurabile o valutabile ma misurabile in accordo a RECIST v. 1.1 5. Pazienti naive alla chemioterapia (è accettata precedente chemioterapia in trattamento adiuvante completata più di 6 mesi prima dell’arruolamento nel trial) 6. Adeguata funzione del midollo osseo, renale, ed epatica 7. ECOG PS 0-1 8. Aspettativa di vita di almeno 12 settimane 9. Per donne in età fertile, è necessario un test di gravidanza su siero negativo; 10. Adozione di adeguati metodi contraccettivi, quando applicabile: Le donne in età fertile devono usare metodi contraccettivi adeguati durante lo studio e per 1 mese dopo il completamento del trattamento in studio, quali: astinenza, legatura delle tube, contraccezione orale o contraccettivi transdermici, dispositivi intrauterini in rame, vasectomia del partner. Non è noto se i farmaci sperimentali interagiscano o abbiano effetto sul funzionamento dei contraccettivi ormonali: se le pazienti stanno utilizzando contraccettivi ormonali, dovrà essere associato un metodo contraccettivo di barriera. I pazienti di sesso maschile con partner di sesso femminile in età fertile, dovranno utilizzare un metodo contraccettivo di barriera dalla prima dose di trattamento fino a 6 mesi dopo il completamento del trattamento in studio. 11. Pazienti di sesso maschile non devono donare sperma durante il trattamento con nab-paclitexel e fino a 6 mesi dopo il completamento del trattamento in studio. 12. Accordo a non donare sangue durante lo studio.
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E.4 | Principal exclusion criteria |
1. Peripheral neuropathy of grade 2 or greater by Common Terminology Criteria for Adverse Events (CTCAE) 4.0. In CTCAE version 4.0 grade 2 sensory neuropathy is defined as "moderate symptoms; limiting instrumental activities of daily living (ADLs)" 2. Previous systemic treatment for advanced disease 3. Known symptomatic brain metastases or carcinomatous meningitis 4. Severe or uncontrolled systemic disease and/or active or uncontrolled infection 5. Women who are currently pregnant or breast feeding 6. Previous or current malignancies of other histologies within the last 3 years, with the exception of cervical carcinoma in situ and adequately treated basal cell or squamous cell carcinoma of the skin 7. Known hypersensitivity to nab-paclitaxel, gemcitabine, oxaliplatin or any of the excipients
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1. Neuropatia periferica di grado 2 o superiore secondo CTCAE (Common Terminology Criteria for Adverse Events) 4.0. Nel CTCAE versione 4.0 il grado 2 di neuropatia periferica è definita come “sintomi moderati; limitanti le attività strumentali della vita quotidiana (ADLs)” 2. Precedente trattamento sistemico per malattia avanzata 3. Note metastasi cerebrali sintomatiche o meningite carcinomatosa 4. Malattie sistemiche severe o non controllate e/o attive o infezioni non controllate 5. Gravidanza o allattamento 6. Precedenti o attuali neoplasie di altre istologie entro gli ultimi 3 anni, ad eccezione del carcinoma cervicale in situ e carcinoma basocellulare o carcinoma delle cellule squamose della pelle adeguatamente trattati 7. Ipersensibilità nota a nab-paclitexel, gemcitabina, oxaliplatino o ad uno qualsiasi degli eccipienti.
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E.5 End points |
E.5.1 | Primary end point(s) |
Phase I : MTD established in the first cycle of therapy Phase II: PFS at 6 months |
Fase I: MTD stabilita durante il primo ciclo di terapia Fase II: PFS a 6 mesi |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
Phase I: first cycle Phase II: 6 months |
Fase I: primo ciclo Fase II: 6 mesi |
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E.5.2 | Secondary end point(s) |
Safety and Tolerability; PFS; OS; Objective response rate (ORR); Duration of response |
Sicurezza e tollerabilità; PFS; OS; Risposta (ORR); Durata della risposta |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
at each visit |
a ciascuna visita |
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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 | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | Yes |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | Yes |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | Yes |
E.7.1.3.1 | Other trial type description |
maximum tolerated dose of the combination gemcitabine plus oxaliplatin plus nab-paclitaxel |
massima dose tollerata della nuova combinazione di gemcitabina, oxaliplatino e nab-paclitaxel |
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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 | Information not present in EudraCT |
E.8.1.6 | Cross over | Information not present in EudraCT |
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 | 4 |
E.8.3 |
The trial involves single site in the Member State concerned
| Yes |
E.8.4 | The trial involves multiple sites in the Member State concerned | No |
E.8.4.1 | Number of sites anticipated in Member State concerned | 1 |
E.8.5 | The trial involves multiple Member States | No |
E.8.5.1 | Number of sites anticipated in the EEA | 1 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | No |
E.8.6.2 | Trial being conducted completely outside of the EEA | Information not present in EudraCT |
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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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 0 |
E.8.9.1 | In the Member State concerned months | 36 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 0 |
E.8.9.2 | In all countries concerned by the trial months | 36 |
E.8.9.2 | In all countries concerned by the trial days | 0 |