| E.1 Medical condition or disease under investigation |
| E.1.1 | Medical condition(s) being investigated |
| Primary central nervous system (CNS) malignancies. |
|
| E.1.1.1 | Medical condition in easily understood language |
| Primary central nervous system (CNS) malignancies. |
|
| 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 | LLT |
| E.1.2 | Classification code | 10006153 |
| E.1.2 | Term | Brain tumor |
| E.1.2 | System Organ Class | 100000004864 |
|
| 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 estimate anti-tumor activity of study treatments, based on duration of disease control and survival, of children and adolescents with CNS malignancies. |
|
| E.2.2 | Secondary objectives of the trial |
| To describe the safety and tolerability of study treatments in children and adolescents with CNS malignancies. |
|
| E.2.3 | Trial contains a sub-study | No |
| E.3 | Principal inclusion criteria |
1-Children and adolescents diagnosed with either:
_Diffuse Intrinsic Pontine Glioma (DIPG),
_High Grade Glioma (HGG),
_Medulloblastoma,
_Ependymoma, or
_Other high-grade tumors of the central nervous system.
2-Lansky play score (LPS) for =< 16 years of age or Karnofsky performance scale (KPS) for > 16 years of age assessed within two weeks of enrollment must be >= 60.
3-A tumor sample must be available for submission to central laboratory [not required for DIPG]. |
|
| E.4 | Principal exclusion criteria |
1-Participants with active, known or suspected autoimmune disease.
2-Participants unable to taper steroids due to ongoing mass effect.
3-Participants with low-grade gliomas or tumors of unknown malignant potential.
4-Prior treatment with any drug that targets T cell co-stimulation pathways (such as checkpoint inhibitors). |
|
| E.5 End points |
| E.5.1 | Primary end point(s) |
1- Safety Lead In: Safety and tolerability: DLTs, SAEs, AEs leading to discontinuation;
2- Diffuse Intrinsic Pontine Glioma (DIPG): Overall Survival (OS);
3- All other tumor types: Progression Free Survival (PFS). |
|
| E.5.1.1 | Timepoint(s) of evaluation of this end point |
| Approximately 6 weeks for (1); Approximately 3 years (from first patient treated) for (2); Approximately 2 years for (3) |
|
| E.5.2 | Secondary end point(s) |
1- Safety: AEs, SAEs, drug-related AEs, AEs leading to discontinuation, and death. Incidence of laboratory abnormalities;
2- Diffuse Intrinsic Pontine Glioma (DIPG): Progression Free Survival (PFS);
3- Diffuse Intrinsic Pontine Glioma (DIPG): Overall Survival at 12 month point (OS(12));
4- High Grade Glioma (HGG), Medulloblastoma, Ependymoma, and other high-grade CNS tumors: Progression Free Survival at 6 months (PFS(6));
5- High Grade Glioma (HGG), Medulloblastoma, Ependymoma, and other high-grade CNS tumors: Overall Survival (OS);
6- High Grade Glioma (HGG), Medulloblastoma, Ependymoma: Overall Survival at 12 month point (OS(12)). |
|
| E.5.2.1 | Timepoint(s) of evaluation of this end point |
| Approximately 3 years for (1) and (5); Approximately 18 months to 2 years from first patient treated for (2) and (4); Approximately 24 months to 3 years for (3) and (6). |
|
| 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 | 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 |
| PD activity and PK parameters in paediatric participants |
|
| 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 | Yes |
| E.8.1.7.1 | Other trial design description |
|
| 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 | 2 |
| E.8.3 |
Will this trial be conducted at a single site globally?
| No |
| E.8.4 | Will this trial be conducted at multiple sites globally? | Yes |
| E.8.6 Trial involving sites outside the EEA |
| E.8.6.2 | Trial being conducted completely outside of the EEA | No |
| E.8.6.3 | Specify the countries outside of the EEA in which trial sites are planned |
| Australia |
| Brazil |
| Canada |
| Denmark |
| France |
| Germany |
| Hong Kong |
| Israel |
| Netherlands |
| Norway |
| Poland |
| Russian Federation |
| Spain |
| Sweden |
| United Kingdom |
|
| E.8.7 | Trial 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
|
|
| E.8.9 Initial estimate of the duration of the trial |
| E.8.9.2 | In all countries concerned by the trial years | 5 |
| E.8.9.2 | In all countries concerned by the trial months | 0 |
| E.8.9.2 | In all countries concerned by the trial days | 0 |