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    Summary
    EudraCT Number:2017-000202-37
    Sponsor's Protocol Code Number:AGO-OVAR2.29
    National Competent Authority:Spain - AEMPS
    Clinical Trial Type:EEA CTA
    Trial Status:Ongoing
    Date on which this record was first entered in the EudraCT database:2019-10-21
    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 ConcernedSpain - AEMPS
    A.2EudraCT number2017-000202-37
    A.3Full title of the trial
    Atezolizumab in combination with Bevacizumab and Chemotherapy versus Bevacizumab and Chemotherapy in recurrent ovarian cancer – a randomized Phase III trial
    Atezolizumab en combinación con Bevacizumab y Quimioterapia versus Bevacizumab y Quimioterapia en el cáncer de ovario recurrente: un ensayo aleatorizado de Fase III
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    Evaluation of treatment combination Atezolizumab/Bevacizumab +/- Chemotherapy in patients with recurrent ovarian cancer
    Evaluación de la combinación de tratamiento Atezolizumab / Bevacizumab +/- Quimioterapia en pacientes con cáncer de ovario recurrente
    A.4.1Sponsor's protocol code numberAGO-OVAR2.29
    A.5.2US NCT (ClinicalTrials.gov registry) numberNCT03353831
    A.5.4Other Identifiers
    Name:ENGOTNumber:ov-34
    Name:EudraCT No.Number:2017-000202-37
    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 SponsorAGO Research GmbH
    B.1.3.4CountryGermany
    B.3.1 and B.3.2Status of the sponsorNon-Commercial
    B.4 Source(s) of Monetary or Material Support for the clinical trial:
    B.4.1Name of organisation providing supportF. Hoffmann-La Roche Ltd
    B.4.2CountrySwitzerland
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationAGO Research GmbH
    B.5.2Functional name of contact pointStudy Office
    B.5.3 Address:
    B.5.3.1Street AddressMoltkeplatz 63
    B.5.3.2Town/ cityEssen
    B.5.3.3Post code45138
    B.5.3.4CountryGermany
    B.5.4Telephone number00492019598120
    B.5.5Fax number004920195981221
    B.5.6E-mailncron@ago-ovar.de
    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 Yes
    D.2.1.1.1Trade name Tecentriq
    D.2.1.1.2Name of the Marketing Authorisation holderTecentriq
    D.2.1.2Country which granted the Marketing AuthorisationEuropean Union
    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 nameAtezolizumab
    D.3.2Product code RO5541267
    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 INNATEZOLIZUMAB
    D.3.9.2Current sponsor codeRO5541267
    D.3.9.3Other descriptive nameMPDL3280A
    D.3.9.4EV Substance CodeSUB178312
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number60
    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) No
    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.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 Yes
    D.2.1.1.1Trade name Avastin
    D.2.1.1.2Name of the Marketing Authorisation holderRoche Registration GmbH (RGG), Grenzach-Whylen, Germany
    D.2.1.2Country which granted the Marketing AuthorisationEuropean Union
    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 nameBevacizumab
    D.3.2Product code RO4876646
    D.3.4Pharmaceutical form Concentrate for 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 INNBEVACIZUMAB
    D.3.9.1CAS number 216974-75-3
    D.3.9.2Current sponsor codeRO4876646
    D.3.9.4EV Substance CodeSUB16402MIG
    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) No
    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
    D.8 Placebo: 1
    D.8.1Is a Placebo used in this Trial?Yes
    D.8.3Pharmaceutical form of the placeboSolution for infusion
    D.8.4Route of administration of the placeboIntravenous use
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    Efficacy of atezolizumab in combination with non-platinum based chemotherapy and bevacizumab versus the combination of a non-platinum based chemotherapy and bevacizumab in recurrent ovarian cancer
    La eficacia de atezolizumab en combinación con quimioterapia no basada en platino y bevacizumab frente a la combinación de una quimioterapia no basada en platino y bevacizumab en el cáncer de ovario recurrente
    E.1.1.1Medical condition in easily understood language
    Efficacy of atezolizumab and bevacizumab in patients with recurrent ovarian cancer
    Eficacia de atezolizumab y bevacizumab en pacientes con cáncer de ovario recurrente
    E.1.1.2Therapeutic area Diseases [C] - Cancer [C04]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 21.0
    E.1.2Level PT
    E.1.2Classification code 10016182
    E.1.2Term Fallopian tube cancer metastatic
    E.1.2System Organ Class 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 21.1
    E.1.2Level PT
    E.1.2Classification code 10057529
    E.1.2Term Ovarian cancer metastatic
    E.1.2System Organ Class 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 21.1
    E.1.2Level PT
    E.1.2Classification code 10066697
    E.1.2Term Ovarian cancer recurrent
    E.1.2System Organ Class 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    E.1.3Condition being studied is a rare disease No
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    Overall survival (OS), defined as the time from randomi-zation to death from any cause
    Progression free survival (PFS) defined as the time from randomization to progressive disease (PD) or death, which-ever occurs earlier. PD is based on investigator assess-ment using the Response Evaluation Criteria in Solid Tu-mors (RECIST v1.1)
    Supervivencia general (SG), definida como el tiempo desde la aleatorización hasta la muerte por cualquier causa
    La supervivencia libre de progresión (SLP) se define como el tiempo desde la aleatorización hasta la enfermedad progresiva (EP) o la muerte, lo que ocurra antes. La DP se basa en la evaluación del investigador utilizando los Criterios de Evaluación de Respuesta en tumores sólidos (RECIST v1.1)
    E.2.2Secondary objectives of the trial
    •QoL/PROs including predefined subgroups (symptomatic vs asymptomatic) and subdo-mains (EORTC C-30, OV28, PRO-CTCAE) and time until definitive deterioration (TUDD) including
    • To evaluate PROs of function and HRQoL associated with atezolizumab versus placebo in combination with non-platinum based chemotherapy + bevacizumab, as meas-ured by the functional and HRQoL scales of the EORTC QLQ-C30
    • To evaluate overall response rate (ORR) and duration of response (DOR)
    • Efficacy regarding OS, PFS, ORR/DOR depending on PD-L1 status present vs absent and T eff cell signature high vs low (This might be amended as there is at the moment no clear definition feasible of the optimal PDL-1 and T eff cell signature status of a “target” population)
    • To evaluate safety and tolerability of atezolizumab versus placebo in combination with non-platinum chemotherapy + bevacizumab.
    • QoL / PRO que incluyen subgrupos predefinidos (sintomático vs asintomático) y subdominios (EORTC C-30, OV28, PRO-CTCAE) y el tiempo hasta el deterioro definitivo (TUDD)
    • Para evaluar los PRO de la función y la calidad de vida relacionada con la salud (CVRS) asociada con el uso de atezolizumab versus placebo en combinación con quimioterapia no basada en platino + bevacizumab, según las escalas funcionales y de la CVRS del EORTC QLQ-C30
    • Para evaluar la tasa de respuesta general (ORR) y la duración de la respuesta (DOR)
    • Eficacia con respecto a OS, PFS, ORR / DOR según el estado de PD-L1 presente vs ausente y la firma de la célula T eff alta vs baja (Esto podría modificarse, ya que en este momento no existe una definición clara de la óptima PDL-1 y el estado de firma de la célula T eff de una población "diana")
    • Para evaluar la seguridad y la tolerabilidad de atezolizumab versus placebo en combinación con quimioterapia sin platino + bevacizumab.
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1. Patients with histologically diagnosed ovarian, fallopian tube, or primary peritoneal cancer
    2. Relapsed disease
    3. Patients with up to three prior therapies. In patients with 1 or 2 prior treatment lines, the treatment free interval after platinum has to be less than 6 months; in addition patients with three prior lines of chemotherapy who are not considered for platinum-containing chemotherapy lines are also eligible
    4. Measurable disease, evaluable disease in combination with GCIG CA-125 criteria, or histologically proven relapse/progression
    5. Patient agrees and is able to provide a recent tumor biopsy (not older than 3 months) or agrees and has a tumor lesion amenable for taking a new tumor biopsy.
    6. Availability of a representative archival FFPE tumor sample (preferable from primary diagnosis)
    7. Patient has not progressed on the chosen/planned chemotherapy (PLD or Paclitaxel) in any prior line
    8. Patients previously treated with bevacizumab are eligible, with the exclusion of those patients that has suspended bevacizumab for more than 2 subsequent cycles or permanently discontinued bevacizumab during their previous treatment due to toxicity. A washout period of at least 20 days after last bevacizumab treatment must be adhered.
    9. Females aged ≥ 18 years at signing at time of signing informed consent form
    10. Signed written informed consent and ability to comply with the study protocol, in the investigator’s judgement
    11. Adequate hematological, renal and hepatic function within 28 days prior to first admin-istration of study treatment:
    Hemoglobin ≥ 9.0 g/dl
    - Absolute neutrophil count (ANC) ≥ 1.5 x 10E9/L
    - Platelet count ≥ 100 x 10E9/L
    - Total bilirubin ≤ 1.5 x institutional upper limit of normal (ULN)
    - Aspartate aminotransferase /Serum Glutamic Oxaloacetic Transaminase (ASAT/SGOT) and Alanine aminotransferase /Serum Glutamic Pyruvate Transam-inase (ALAT/SGPT) ≤ 2.5 x ULN, unless liver metastases are present, in case of liver metastases values must be ≤ 5 x ULN
    - Serum creatinine ≤ 1.5 x institutional ULN
    - Patient not receiving anticoagulant medication who has an International Normalized Ratio (INR) ≤ 1.5 and an Activated ProThrombin Time (aPTT) ≤ 1.5 x ULN. The use of full-dose oral or parenteral anticoagulants is permitted as long as the INR or aPTT is within therapeutic limits (according to site medical standard). If the patient is on oral anticoagulants, dose has to be stable for at least two weeks at the time of ran-domization
    - Urine dipstick for proteinuria < 2+. If urine dipstick is ≥ 2+, 24-hours urine must demonstrate ≤ 1 g of protein in 24 hours.
    12. Patients must have adequately controlled blood pressure (BP), with a systolic BP of ≤ 140 mmHg and diastolic BP of ≤ 90 mmHg for eligibility. Patients must have a BP of ≤ 140/90 mmHg taken in the clinic setting by a medical professional within 2 weeks prior to starting study.
    13. Estimated life expectancy of at least 3 months
    14. ECOG performance status 0 – 1
    15. Negative urine or serum pregnancy test within 7 days of study treatment in women of childbearing potential (WOCBP), confirmed prior to treatment on day 1
    16. For women of childbearing potential: agreement to remain abstinent (refrain from het-erosexual inter-course) or use a contraceptive method with a failure rate of < 1% per year during the treatment period and for at least 5 months after administration of the last dose of atezolizumab/placebo and 6 months after the last dose of bevacizumab, paclitaxel, or PLD, whichever is later.
    17. For countries where this will apply to: a patient will be eligible for randomization in this study only, if either affiliated to, or a beneficiary of a social security category.
    18. Willingness and ability to comply with scheduled visits, treatment plans, laboratory tests, and other study procedures, that include the completion of patient-reported out-comes questionnaires.
    1. Pacientes con cáncer de ovario, trompa de Falopio o peritoneal primario diagnosticado histológicamente
    2. Enfermedad recurrente.
    3. Pacientes con hasta tres terapias previas. En pacientes con 1 o 2 líneas de tratamiento previo, el intervalo libre de tratamiento después del platino debe ser inferior a 6 meses; además, los pacientes con tres líneas de quimioterapia anteriores que no se consideran para las líneas de quimioterapia que contienen platino también son elegibles
    4. Enfermedad medible, enfermedad evaluable en combinación con los criterios de GCIG CA-125, o recaída / progresión histológicamente demostrada
    5. El paciente está de acuerdo y puede proporcionar una biopsia de tumor reciente (no más de 3 meses) o está de acuerdo y tiene una lesión tumoral susceptible de tomar una nueva biopsia de tumor.
    6. Disponibilidad de una muestra representativa de tumor FFPE de archivo (preferible a partir del diagnóstico primario)
    7. El paciente no ha progresado con la quimioterapia elegida / planeada (PLD o Paclitaxel) en ninguna línea previa
    8. Los pacientes tratados previamente con bevacizumab son elegibles, con la exclusión de los pacientes que suspendieron el bevacizumab durante más de 2 ciclos subsiguientes o suspendieron permanentemente el bevacizumab durante su tratamiento anterior debido a su toxicidad. Se debe respetar un período de lavado de al menos 20 días después del último tratamiento con bevacizumab.
    9. Mujeres de edad ≥ 18 años al momento de firmar al momento de firmar el formulario de consentimiento informado
    10. Firmado consentimiento informado por escrito y capacidad de cumplir con el protocolo del estudio, a juicio del investigador
    11. Función hematológica, renal y hepática adecuada dentro de los 28 días anteriores a la primera administración del tratamiento del estudio:
    Hemoglobina ≥ 9.0 g / dl
    - Recuento absoluto de neutrófilos (ANC) ≥ 1.5 x 10E9 / L
    - Recuento de plaquetas ≥ 100 x 10E9 / L
    - Bilirrubina total ≤ 1.5 x límite superior institucional normal (ULN)
    - Aspartato aminotransferasa / Transutasa glutámica oxaloacética en suero (ASAT / SGOT) y Alanina aminotransferasa / Piruvato piramato en suero (ALAT / SGPT) ≤ 2,5 x ULN, a menos que haya metástasis en el hígado, en caso de metástasis hepáticas, los valores deben ser ≤ 5 x x ULN
    - Creatinina sérica ≤ 1.5 x ULN institucional
    - Paciente que no está recibiendo medicación anticoagulante que tiene un índice normalizado internacional (INR) ≤ 1.5 y un tiempo de pro-trombina activada (aPTT) ≤ 1.5 x ULN. Se permite el uso de anticoagulantes orales o parenterales de dosis completa siempre y cuando el INR o aPTT se encuentre dentro de los límites terapéuticos (según el estándar médico del sitio). Si el paciente está tomando anticoagulantes orales, la dosis debe ser estable durante al menos dos semanas en el momento de la administración.
    - Varilla de orina para proteinuria <2+. Si la varilla medidora de orina es ≥ 2+, la orina de 24 horas debe demostrar ≤ 1 g de proteína en 24 horas.
    12. Los pacientes deben tener una presión arterial (PA) adecuadamente controlada, con un PA sistólico de ≤ 140 mmHg y un PA diastólico de ≤ 90 mmHg para la elegibilidad. Los pacientes deben tener un BP de ≤ 140/90 mmHg tomado en el entorno clínico por un profesional médico dentro de las 2 semanas antes de comenzar el estudio.
    13. Estimación de la esperanza de vida de al menos 3 meses.
    14. Estado de rendimiento ECOG 0 - 1
    15. Prueba de embarazo negativa en orina o suero dentro de los 7 días del tratamiento del estudio en mujeres en edad fértil (WOCBP), confirmada antes del tratamiento el día 1
    16. Para las mujeres en edad fértil: acuerdo para permanecer abstinente (abstenerse de inter-curso heterosexual) o utilizar un método anticonceptivo con una tasa de fracaso de <1% por año durante el período de tratamiento y durante al menos 5 meses después de la administración de la última dosis de atezolizumab / placebo y 6 meses después de la última dosis de bevacizumab, paclitaxel o PLD, la que sea posterior.
    17. Para países donde esto se aplicará a: un paciente será elegible para la aleatorización en este estudio solo, si está afiliado a, o un beneficiario de una categoría de seguridad social.
    18. Disposición y capacidad para cumplir con las visitas programadas, los planes de tratamiento, las pruebas de laboratorio y otros procedimientos del estudio, que incluyen la finalización de cuestionarios de resultados informados por los pacientes.
    E.4Principal exclusion criteria
    1. Non-epithelial tumor origin of the ovary, the fallopian tube or the peritoneum
    2. Ovarian tumors of low malignant potential
    3. Malignancies other than ovarian cancer within 5 years prior to randomisation.
    4. More than three prior systemic anticancer regimens; maintenance therapies are not calculated as separate line.
    5. Prior systemic anticancer therapy within 28 days before randomization.
    6. Prior radiotherapy to the pelvis or the abdomen.
    7. Administration of other simultaneous chemotherapy drugs, any other anticancer ther-apy or anti-neoplastic hormonal therapy, or simultaneous radiotherapy during the trial treatment period.
    8. Prior treatment with anti-CD137 or immune checkpoint blockade therapies, anti-PD1, or anti-PD-L1 therapeutic antibodies or anti-CTLA 4
    9. Prior randomization in AGO-OVAR 2.29.
    10. Treatment with systemic immunostimulatory agents (including but not limited to inter-feron-alpha and interleukin-2 within 4 weeks or five half-lives of the drug (whichever is longer) prior to Cycle 1, Day 1
    11. Treatment with systemic corticosteroids or other systemic immunosuppressive medi-cations within 2 weeks prior to Cycle 1, Day 1, or anticipated requirement for systemic immu-nosuppressive medications during the trial
    12. the use of inhaled corticosteroids for chronic obstructive pulmonary disease, mineral-ocorticoids.
    13. Prophylactic antiemetic corticosteroids shall be avoided if possible in patients treated with pegylated liposomal doxorubicin regimen.
    14. Patients with a history of allergic reaction to IV contrast requiring steroid pre-treatment should have screening and subsequent tumor assessments performed using magnetic resonance imaging (MRI)
    15. Administration of a live, attenuated vaccine within 4 weeks prior to Cycle 1, Day 1 or anticipation that such a live attenuated vaccine will be required during the study or within 5 months after the last dose of atezolizumab/placebo.
    16. Major surgery within 4 weeks of starting study treatment or patient who has not com-pletely recovered from the effects of any major surgery.
    17. Previous allogeneic bone marrow transplant or previous solid organ transplantation
    18. Current treatment with anti-viral therapy for HBV.
    19. History of idiopathic pulmonary fibrosis, organizing pneumonia, or evidence of active pneumonitis on screening chest CT scan.
    20. Previous Cerebro-Vascular Accident, Transient Ischemic Attack or Sub-Arachnoids Hemorrhage within 6 months prior to randomization
    21. History or evidence of thrombotic or hemorrhagic disorders within 6 months prior to randomization
    22. History or clinical suspicion of brain metastases or spinal cord compression.
    23. History of autoimmune disease.
    24. Any prior history of hypertensive crisis (CTCAE grade 4) or hypertensive encephalopathy
    25. Immunocompromised patients, e.g., patients who are known to be serologically posi-tive for human immunodeficiency virus (HIV). Patients with active hepatitis B or hepatitis C
    26. Persistent toxicities (≥ CTCAE grade 2) with the exception of alopecia, caused by previous cancer treatment.
    27. Severe infection requiring oral or IV antibiotics within 4 weeks prior to randomization.
    28. Current or recent (within 10 days prior randomization) chronic use of aspirin > 325 mg/day
    29. Clinically significant cardiovascular disease.
    30. Left ventricular ejection fraction defined by ECHO below the institutional lower limit of normal
    31. Evidence of bleeding diathesis or significant coagulopathy (in the absence of anticoagulation)
    32. Non-healing wound, active ulcer or bone fracture
    33. History of bowel obstruction related to underlying disease, a history of abdominal fistula, GI perforation, or intraabdominal abscess, or evidence deep infiltration of the bowel by pelvic examination or on computed tomography, or clinical symptoms of bowel obstruction
    34. Patients with evidence of abdominal free air
    35. Evidence of any other disease, metabolic dysfunction, physical examination finding or laboratory finding giving reasonable suspicion of disease or condition that contraindicates the use of an investigational drug or puts the patient at high risk for treatment re-lated complications
    36. Known hypersensitivity or allergy to drugs containing Chinese hamster (CHO) ovary cells or history of severe allergic, anaphylactic, or other hypersensitivity reactions to chimeric or humanized antibodies or fusion proteins
    37. Known hypersensitivity reaction or allergy to drugs chemically related to bevaci-zumab, paclitaxel, pegylated liposomal doxorubicin, or their excipients that contraindicates the subject’s participation
    38. Patients considered a poor medical risk due to a serious, uncontrolled medical disorder, non-malignant systemic disease or active, uncontrolled infection. This includes al-so any psychiatric disorder that prohibits obtaining informed consent
    1.Origen tumoral no epitelial del ovario, trompa de Falopio o peritoneo
    2.Tumores ováricos de bajo potencial maligno
    3.Enfermedades malignas distintas del cáncer de ovario dentro de los 5a anteriores a la aleatorización
    4.Más de tres regímenes sistémicos anticancerosos previos
    5.Terapia sistémica previa contra el cáncer dentro de los 28d anteriores a la aleatorización
    6.Radioterapia previa a la pelvis o al abdomen
    7.Administración de otros medicamentos de quimioterapia simultáneos,cualquier otra terapia anticancerosa o terapia hormonal antineoplásica, o radioterapia simultánea durante el período de tratamiento de prueba
    8.Tratamiento previo con antiCD137 o terapias de bloqueo del punto de control inmunitario, antiPD1, o anticuerpos terapéuticos antiPDL1 o antiCTLA4
    9.Aleatorización previa en AGO-OVAR2.29
    10.Tratamiento con agentes inmunoestimuladores sistémicos antes del Ciclo 1, Día 1
    11.Tratamiento con corticosteroides sistémicos u otros medicamentos inmunosupresores sistémicos dentro de las 2s anteriores al Ciclo1, d1, o el requerimiento anticipado de medicamentos inmunosupresores sistémicos durante el ensayo
    12.El uso de corticosteroides inhalados para la enfermedad pulmonar obstructiva crónica, mineralocorticoides
    13.Los corticosteroides antieméticos profilácticos deben evitarse en pacientes tratados con régimen de doxorrubicina liposomal pegilado
    14.Los pacientes con antecedentes de reacción alérgica al contraste intravenoso que requieren un tratamiento previo con esteroides deben someterse a exámenes de detección y realizar una evaluación tumoral posterior mediante imágenes de resonancia magnética
    15.Administración de una vacuna viva y atenuada dentro de las 4s anteriores al Ciclo 1, d1 o la anticipación de que se requerirá dicha vacuna viva atenuada durante el estudio o dentro de los 5m posteriores a la última dosis de atezolizumab/placebo
    16.Cirugía mayor dentro de las 4s posteriores al inicio del tratamiento del estudio o paciente que no se haya recuperado completamente de los efectos de cualquier cirugía mayor
    17.Trasplante alogénico previo de médula ósea o trasplante previo de órgano sólido
    18.Tratamiento actual con terapia antiviral para eVHB
    19.Antecedentes de fibrosis pulmonar idiopática, neumonía organizada o evidencia de neumonitis activa en la exploración por TAC de tórax
    20.Accidente cerebrovascular vascular anterior, ataque isquémico transitorio o hemorragia subaracnoidea en los 6m anteriores a la aleatorización
    21.Historia o evidencia de trastornos trombóticos o hemorrágicos dentro de los 6m anteriores a la aleatorización
    22.Historia o sospecha clínica de metástasis cerebrales o compresión de la médula espinal
    23.Historia de la enfermedad autoinmune
    24.Cualquier historia previa de crisis hipertensiva (grado 4) o encefalopatía hipertensiva
    25.Pacientes inmunocomprometidos.Pacientes con hepatitis B activa o hepatitis C
    26.Toxicidades persistentes (≥grado 2) con la excepción de la alopecia, causada por un tratamiento previo contra el cáncer
    27.Infección grave que requiere antibióticos orales o intravenosos dentro de las 4s previas a la aleatorización
    28.Uso crónico actual o reciente (dentro de los 10 días anteriores a la aleatorización) de aspirina>325 mg/d
    29.Enfermedad cardiovascular clínicamente significativa
    30.Fracción de eyección del ventrículo izquierdo definida por ECHO por debajo del límite inferior institucional del normal
    31.Evidencia de diátesis hemorrágica o coagulopatía significativa (en ausencia de anticoagulación)
    32.Herida no curativa, úlcera activa o fractura ósea
    33.Antecedentes de obstrucción intestinal relacionada con enfermedad subyacente, antecedentes de fístula abdominal, perforación GI o absceso intraabdominal, o evidencia de infiltración profunda del intestino mediante examen pélvico o tomografía computarizada, o síntomas clínicos de obstrucción intestinal
    34.Pacientes con evidencia de aire libre abdominal
    35.Evidencia de cualquier otra enfermedad, disfunción metabólica, hallazgo de un examen físico o de laboratorio que proporcione una sospecha razonable de una enfermedad o afección que contraindique el uso de un fármaco en investigación o ponga al paciente en alto riesgo de complicaciones relacionadas con el tratamiento
    36.Hipersensibilidad conocida o alergia a medicamentos que contienen células de ovario de hámster chino o antecedentes de reacciones alérgicas, anafilácticas u otras reacciones de hipersensibilidad severas a anticuerpos quiméricos o humanizados o proteínas de fusión
    37.Reacción de hipersensibilidad conocida o alergia a medicamentos químicamente relacionados con bevacizumab, paclitaxel, doxorubicina liposomal pegilada o sus excipientes
    38.Los pacientes se consideran de bajo riesgo médico debido a un trastorno médico grave e incontrolado, una enfermedad sistémica no maligna o una infección activa e incontrolada. Esto incluye también cualquier trastorno psiquiátrico que prohíba obtener el consentimiento informado
    E.5 End points
    E.5.1Primary end point(s)
    Overall Survival (OS)
    Progression-free Survival (PFS)
    Supervivencia global (OS)
    Supervivencia libre de progresión (SLP)
    E.5.1.1Timepoint(s) of evaluation of this end point
    at least 391 OS events have been observed
    at least 547 PFS events should be observed in the same time
    Se han observado al menos 391 eventos de SO.
    Al menos 547 eventos PFS deben ser observados al mismo tiempo.
    E.5.2Secondary end point(s)
    Quality of Life (QoL) and Patient Reported Outcome (PRO)
    Evaluation of Overall Response Rate (ORR) and Duration of Response (DOR)
    Evaluation of Safety and Tolerability of Atezolizumab
    Calidad de vida (QoL) y resultado informado por el paciente (PRO)
    Evaluación de la tasa de respuesta global (ORR) y la duración de la respuesta (DOR)
    Evaluación de seguridad y tolerabilidad de Atezolizumab
    E.5.2.1Timepoint(s) of evaluation of this end point
    Quality of Life (QoL) and Patient Reported Outcome (PRO) every 4 weeks during the first 3 months, then every 12 weeks
    Evaluation of Overall Response Rate (ORR) and Duration of Response (DOR) every 12 weeks until disease progression
    Evaluation of Safety and Tolerability of Atezolizumab at every visit
    Calidad de vida (QoL) y resultado informado por el paciente (PRO) cada 4 semanas durante los primeros 3 meses, luego cada 12 semanas
    Evaluación de la tasa de respuesta global (ORR) y la duración de la respuesta (DOR) cada 12 semanas hasta la progresión de la enfermedad
    Evaluación de la seguridad y la tolerabilidad de Atezolizumab en cada visita
    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 No
    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) 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 No
    E.8.1.3Single blind No
    E.8.1.4Double blind Yes
    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) Yes
    E.8.2.2Placebo Yes
    E.8.2.3Other Yes
    E.8.2.3.1Comparator description
    Paclitaxel, Docorubicina Liposomal Pegilada
    Paclitaxel, Pegylated Liposomal Docorubicin
    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 concerned15
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA200
    E.8.6 Trial involving sites outside the EEA
    E.8.6.1Trial being conducted both within and outside the EEA No
    E.8.6.2Trial being conducted completely outside of the EEA No
    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
    LVLS
    UVUS
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years3
    E.8.9.1In the Member State concerned months3
    E.8.9.1In the Member State concerned days
    E.8.9.2In all countries concerned by the trial years3
    E.8.9.2In all countries concerned by the trial months3
    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: 442
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 222
    F.2 Gender
    F.2.1Female Yes
    F.2.2Male No
    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 For clinical trials recorded in the database before the 10th March 2011 this question read: "Women of childbearing potential" and did not include the words "not using contraception". An answer of yes could have included women of child bearing potential whether or not they would be using contraception. The answer should therefore be understood in that context. This trial was recorded in the database on 2019-10-21. Yes
    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 state64
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 664
    F.4.2.2In the whole clinical trial 664
    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)
    According local standard for each institution.
    Según norma local para cada institución.
    G. Investigator Networks to be involved in the Trial
    G.4 Investigator Network to be involved in the Trial: 1
    N. Review by the Competent Authority or Ethics Committee in the country concerned
    N.Competent Authority Decision Authorised
    N.Date of Competent Authority Decision2019-12-11
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2019-12-05
    P. End of Trial
    P.End of Trial StatusOngoing
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