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    Summary
    EudraCT Number:2017-001409-34
    Sponsor's Protocol Code Number:MO39171
    National Competent Authority:Italy - Italian Medicines Agency
    Clinical Trial Type:EEA CTA
    Trial Status:Completed
    Date on which this record was first entered in the EudraCT database:2021-06-17
    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 ConcernedItaly - Italian Medicines Agency
    A.2EudraCT number2017-001409-34
    A.3Full title of the trial
    A PHASE III/IV, SINGLE ARM, MULTICENTER STUDY OF ATEZOLIZUMAB (TECENTRIQ) TO INVESTIGATE LONG-TERM SAFETY AND EFFICACY IN PREVIOUSLY-TREATED PATIENTS WITH LOCALLY ADVANCED OR METASTATIC NON-SMALL CELL LUNG CANCER (TAIL)
    STUDIO DI FASE III/IV MULTICENTRICO, A SINGOLO BRACCIO DI TRATTAMENTO, VOLTO A VALUTARE LA SICUREZZA A LUNGO TERMINE E L¿EFFICACIA DI ATEZOLIZUMAB (TECENTRIQ) IN PAZIENTI AFFETTI DA CARCINOMA POLMONARE NON A PICCOLE CELLULE LOCALMENTE AVANZATO O METASTATICO PRECEDENTEMENTE TRATTATI (TAIL)
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    A Study of Atezolizumab to investigate long term safety and efficacy in patients with locally advanced or metastatic non small cell lung cancer (NSCLC)
    Studio volto a valutare la sicurezza a lungo termine e l¿efficacia di Atezolizumab in pazienti affetti da carcinoma polmonare non a piccole cellule localmente avanzato o metastatico (NSCLC)
    A.3.2Name or abbreviated title of the trial where available
    A Study of Atezolizumab to investigate long term safety and efficacy in patients with locally advanc
    Studio volto a valutare la sicurezza a lungo termine e l¿efficacia di Atezolizumab in pazienti affet
    A.4.1Sponsor's protocol code numberMO39171
    A.5.4Other Identifiers
    Name:NANumber:NA
    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 SponsorF. HOFFMANN - LA ROCHE LTD.
    B.1.3.4CountrySwitzerland
    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 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 organisationF.Hoffmann-La Roche Ltd.
    B.5.2Functional name of contact pointTrial Information Support Line-TISL
    B.5.3 Address:
    B.5.3.1Street AddressGrenzacherstrasse 124
    B.5.3.2Town/ cityBasel
    B.5.3.3Post code4070
    B.5.3.4CountrySwitzerland
    B.5.4Telephone number0041616881111
    B.5.5Fax number0041616919319
    B.5.6E-mailglobal.rochegenentechtrials@roche.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 nameAtezolizumab
    D.3.2Product code RO5541267/F03
    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.3.9.1CAS number 1380723-44-3
    D.3.9.2Current sponsor codeRO5541267
    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 Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    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 Tecentriq
    D.2.1.1.2Name of the Marketing Authorisation holderRoche Registration GmbH - AIC: EU/1/17/1220/001
    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 Concentrate for solution for injection
    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.3.9.1CAS number 1380723-44-3
    D.3.9.2Current sponsor codeRO5541267
    D.3.9.3Other descriptive nameMPDL3280A, Tecentriq
    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 Information not present in EudraCT
    D.3.11.3.2Gene therapy medical product Information not present in EudraCT
    D.3.11.3.3Tissue Engineered Product Information not present in EudraCT
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) Information not present in EudraCT
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product Information not present in EudraCT
    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
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    Malignant neoplasm of bronchus and lung (nsc) adv.
    Neoplasia maligna dei bronchi e dei polmoni (nsc) avanzata.
    E.1.1.1Medical condition in easily understood language
    CELL LUNG CANCER
    Carcinoma polmonare
    E.1.1.2Therapeutic area Diseases [C] - Cancer [C04]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 21.1
    E.1.2Level PT
    E.1.2Classification code 10061873
    E.1.2Term Non-small cell lung cancer
    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
    -To evaluate the long-term safety of atezolizumab in previously treated patients with advanced NSCLC
    -Valutare la sicurezza a lungo termine di atezolizumab in pazienti pretrattati affetti da NSCLC in stadio avanzato
    E.2.2Secondary objectives of the trial
    - To evaluate the efficacy of atezolizumab in previously treated patients with advanced NSCLC
    - To further evaluate the efficacy of atezolizumab in previously treated patients with advanced NSCLC
    - To further evaluate the long-term safety and efficacy of atezolizumab in previously treated patients with advanced NSCLC
    -Valutare l¿efficacia di atezolizumab in pazienti pretrattati affetti da NSCLC in stadio avanzato
    -Valutare pi¿ approfonditamente l¿efficacia di atezolizumab in pazienti pretrattati affetti da NSCLC in stadio avanzato
    -Valutare pi¿ approfonditamente la sicurezza a lungo termine e l¿efficacia di atezolizumab in pazienti pretrattati affetti da NSCLC in stadio avanzato
    E.2.3Trial contains a sub-study Yes
    E.2.3.1Full title, date and version of each sub-study and their related objectives

    Other types of substudies
    Specify title, date and version of each substudy with relative objectives: STOOL SAMPLE COLLECTION FOR THE ROCHE RESEARCH BIOSAMPLE REPOSITORY IN ASSOCIATION WITH PROTOCOL MO39171
    Version 2 dated 14. Jan 2019..
    The objective of this study is to obtain stool samples from patients who participate in Study MO39171 for the Roche RBR in order to assess the micobiome, metabolites and other biomarkers in the stool of patients.

    Altre tipologie di sottostudi
    specificare il titolo, la data e la versione di ogni sottostudio con i relativi obiettivi: RACCOLTA FACOLTATIVA DI CAMPIONI DI FECI PER IL RESEARCH BIOSAMPLE REPOSITORY DI ROCHE IN ASSOCIAZIONE AL PROTOCOLLO MO39171
    Versione 2 datata 14/01/2019..
    L'obiettivo si questo studio è quello di ottenere campioni di feci dai pazienti che partecipano allo studio MO39171 per il Roche Research Biosample Repository, al fine di studiare il microbioma, i metaboliti e altri biomarcatori nelle feci dei pazienti...
    E.3Principal inclusion criteria
    -Age >/= 18 years.
    -Able to comply with the study protocol, in the investigator's judgment
    -Histologically or cytologically documented Stage IIIb or Stage IV NSCLC that has progressed following standard systemic chemotherapy (including if given in combination with anti-PD-1 therapy after anti-PD-1 as monotherapy, or after TKI therapy). Patients with a previously detected sensitizing EGFR mutation or ALK fusion oncogene must have received targeted therapy(TKI), followed by at least one line of standard systemic chemotherapy, prior to receiving atezolizumab. Overall, patients should not have received more than two lines of standard systemic chemotherapy. Patients who have discontinued first-line or second-line therapy due to intolerance are also eligible
    –Staging must be according to the UICC/AJCC system, 7th edition (Detterbeck et al. 2009) (see Appendix 8)
    –Pathological characterization may be conducted on tumor specimens from earlier stage disease, but the tumor samples must be sufficient to distinguish squamous or non-squamous histology.
    –Chemotherapy regimens will be counted based on interval disease progression, and not on the number of agents or the number of switches in agents (e.g., a first-line or second-line therapy that consists of several cycles of a platinum doublet and subsequent maintenance therapy that introduces or switches to a new chemotherapy agent without interval disease progression will all be considered one chemotherapy regimen)
    –Patients with a previously-detected sensitizing EGFR mutation must have experienced disease progression (during or after treatment) on an EGFR TKI
    –Patients with a previously detected ALK fusion oncogene must have experienced disease progression (during or after treatment) with crizotinib, alectinib, or another ALK inhibitor.
    –Prior radiation therapy is allowed, provided that the patient has recovered from any toxic effects thereof. Combined radiation/chemotherapy treatment constitutes a single regimen
    –Combined radiation/chemotherapy treatment (chemoradiation) counts as one prior chemotherapy regimen if < 6 months have elapsed between the last dose and the date of recurrence
    –Adjuvant/neoadjuvant chemotherapy is not counted as a line of treatment
    –Debulking surgery and anticancer agents used for pleurodesis are not counted as lines of therapy
    - The last dose of prior systemic anticancer therapy or targeted therapy must have been administered >/= 21 days prior to randomization.
    - Measurable disease, as defined by Response Evaluation Criteria for Solid Tumors, Version 1.1 (RECIST v1.1)
    - Patients with asymptomatic CNS metastases (treated or untreated), as determined by CT or MRI evaluation during screening and prior radiographic evaluation, are eligible
    - ECOG performance status 0, 1, or 2 [Appendix 7]
    - For women of childbearing potential: agreement to remain abstinent (refrain from heterosexual intercourse) or use contraceptive methods that result in a failure rate of < 1% per year during the treatment period and for at least 5 months after the last dose of atezolizumab
    –A woman is considered to be of childbearing potential if she is postmenarchal, has not reached a postmenopausal state (>/= 12 continuous months of amenorrhea with no identified cause other than
    menopause), and has not undergone surgical sterilization (removal of ovaries and/or uterus)
    –Examples of contraceptive methods with a failure rate of < 1% per year include bilateral tubal ligation, male sterilization, established, proper use of hormonal contraceptives that inhibit ovulation, hormonereleasing intrauterine devices, and copper intrauterine devices
    –The reliability of sexual abstinence should be evaluated in relation to the duration of the clinical trial and the preferred and usual lifestyle of the patient. Periodic abstinence and withdrawal are not acceptable methods of contraception
    - HIV-positive patients are allowed, so long as they are stable on antiretroviral therapy, have a CD4 count >/= 200 cells
    -Sottoscrizione del modulo di consenso informato
    -Età >/= 18 anni...
    -Capacità di rispettare il protocollo dello studio secondo il giudizio dello sperimentatore
    -NSCLC in stadio IIIb o IV documentato dall’esame istologico o citologico andato incontro a progressione dopo chemioterapia sistemica standard. Prima di poter essere trattati con atezolizumab, i p. nei quali è stata precedentemente osservata una mutazione sensibilizzantedi EGFR o un oncogene di fusione ALK devono essere stati sottoposti ad una terapia target seguita da almeno una linea di chemioterapia sistemica standard. Nel complesso, ai p. non devono essere state somministrate più di due linee di chemioterapia sistemica standard. Sono ritenuti idonei anche i pazienti che hanno interrotto terapie di prima o seconda linea a causa di intolleranza.
    -La stadiazione dovrà seguire il sistema UICC/AJCC, 7° edizione (cfr. Append. 8)
    -La caratterizzazione patologica potrà essere effettuata su campioni tumorali afferenti alla malattia in stadio iniziale. I campioni dovranno tuttavia essere sufficienti per distinguere l’istologia squamosa da quella non squamosa
    -I regimi chemioterapici verranno conteggiati in base all’intervallo di progressione della malattia e non al numero di agenti o di switch tra agenti
    -I p. che presentano una mutazione sensibilizzante di EGFR precedentemente osservata devono aver manifestato progressione della malattia durante o dopo il trattamento con un TKI di EGFR
    -I p. che presentano un oncogene di fusione ALK precedentemente osservato devono aver manifestato progressione della malattia durante o dopo il trattamento con crizotinib, alectinib o un altro inibitore di ALK
    -Sono ammessi trattamenti pregressi con radioterapia, purché si siano risolti eventuali effetti tossici degli stessi. Il trattamento di associazione radioterapia/chemioterapia rappresenta un unico regime.
    -Se sono trascorsi < 6 mesi tra l’ultima dose somministrata e la data della recidiva, il trattamento di associazione radioterapia/chemioterapia viene considerato come un solo regime chemioterapico precedente.
    -La chemioterapia adiuvante/neoadiuvante non viene considerata una linea di trattamento
    -La citoriduzione e gli agenti antitumorali usati per la pleurodesi non sono considerati linee di terapia
    -L’ultima dose della terapia antitumorale sistemica precedente deve essere stata somministrata >/= 21 giorni prima dell’inizio del trattamento in studio
    -Malattia misurabile secondo i criteri di valutazione della risposta nei tumori solidi, versione 1.1
    -I p. con metastasi asintomatiche a carico del SNC, secondo quanto stabilito mediante TC o RM durante lo screening e prima della valutazione radiografica, sono ritenuti idonei.
    -Performance status secondo l’ECOG pari a 0, 1 o 2 (Appendice 7)
    -Nelle donne in età fertile: consenso a praticare l’astinenza dai rapporti eterosessuali o ad adottare metodi contraccettivi che garantiscano un tasso di insuccesso < 1% all’anno durante il periodo di trattamento e per almeno 5 mesi dopo la somministrazione dell’ultima dose di atezolizumab
    -Con “in età fertile” si intendono donne in cui è già comparso il menarca ma che non sono ancora in stato postmenopausale (>/= 12 mesi consecutivi di amenorrea senza identificazione di cause diverse dalla menopausa) e che non si sono sottoposte a sterilizzazione chirurgica
    -Esempi di metodi anticoncezionali con tasso di insuccesso <1% all’anno includono chiusura bilaterale delle tube, vasectomia, uso consolidato e appropriato di contraccettivi ormonali che inibiscono l’ovulazione e dispositivi intrauterini a rilascio di ormoni e in rame
    -sperimentazione clinica e allo stile di vita preferito e abituale della p. L’astinenza periodica e il coito interrotto non sono ritenuti metodi contraccettivi accettabili
    -Sono ammessi i p. positivi per il HIV, a condiz. che siano sottoposti a terapia antiretrovirale stabile e presentino una conta di CD4 >/= 200 cellule/µl e una carica virale non rilevabile al momento dello screening
    E.4Principal exclusion criteria
    - Symptomatic CNS metastases
    - Spinal cord compression not definitively treated with surgery and/or
    radiation or previously diagnosed and treated spinal cord compression
    without evidence that disease has been clinically stable for = 2 weeks
    prior to randomization
    - Leptomeningeal disease
    - Uncontrolled pericardial effusion or ascites requiring recurrent
    drainage procedures
    - Pregnant or lactating, or intending to become pregnant during the
    study
    –Women who are not postmenopausal (postmenopausal defined as = 12
    months of non-drug-induced amenorrhea) or surgically sterile must have
    a negative serum pregnancy test result within 2 weeks prior to initiation
    of study drug
    - Evidence of significant uncontrolled concomitant disease that could
    affect compliance with the protocol, including significant liver disease
    (such as cirrhosis, uncontrolled major seizure disorder, or superior vena
    cava syndrome)
    - Significant cardiovascular disease, such as New York Heart Association
    cardiac disease = Class III, myocardial infarction within 3 months,
    unstable arrhythmias, or unstable angina
    –Patients with known coronary artery disease or left ventricular ejection
    fraction < 50% must be on a stable medical regimen that is optimized in
    the opinion of the treating physician, in consultation with a cardiologist
    if appropriate
    - Major surgical procedure within 4 weeks prior to study treatment
    initiation or anticipation of need for a major surgical procedure during
    the course of the study other than for diagnosis
    - History of autoimmune disease (Appendix 5) are allowed if controlled
    and on stable treatment (i.e., same treatment, same dose) for the last
    12 weeks, with the exception of:
    - Patients taking concurrent abatacept or belatacept treatment, unless
    therapy has been withdrawn for > 8 weeks
    –Patients with a history of serious or life threatening immune-related
    events
    –No more than 1 concomitant autoimmune disease at the time of study
    entry is allowed unless one of them is:
    Autoimmune-mediated hypothyroidism on a stable dose of thyroid
    replacement hormone
    Controlled Type I diabetes mellitus on a stable dose of insulin regimen
    A medical history of such entities as atopic disease or childhood
    arthralgias, where the clinical suspicion of autoimmune disease is low.
    In addition, transient autoimmune manifestations of an acute infectious
    disease that resolved upon treatment of the infectious agent are not
    excluded (e.g., acute Lyme arthritis)
    - Treatment with systemic immunostimulatory agents (including, but not
    limited to, interferons or interleukin-2) within 4 weeks or five half-lives
    of the drug, whichever is longer, prior to initiation of study treatment
    –Prior cancer vaccines and cellular immunotherapy are permitted
    - Specifically for patients without autoimmune disease: treatment with
    systemic corticosteroids or other systemic immunosuppressive
    medications (including but not limited to prednisone, dexamethasone,
    cyclophosphamide, azathioprine, methotrexate, thalidomide, and anti-
    tumor necrosis factor [TNF] agents) within 2 weeks prior to study
    treatment initiation, or anticipated requirement for systemic
    immunosuppressive medications during the trial
    –For patients with CNS metastases, use of prednisone at a stable dose
    (or dose equivalent) of = 20 mg/day is acceptable
    –The use of inhaled corticosteroids for chronic obstructive pulmonary disease, mineralocorticoids (e.g., fludrocortisone) for patients with
    orthostatic hypotension, and low-dose supplemental corticosteroids for
    adrenocortical insufficiency and topical steroids for cutaneous diseases
    are allowed
    - Metastasi sintomatiche a carico dell’SNC.
    - Compressione del midollo spinale non definitivamente trattata con chirurgia e/o radioterapia, oppure diagnosticata e trattata in precedenza senza evidenze di malattia clinicamente stabile per >/= 2 sett prima dell’inizio del trattamento in studio
    - Malattia leptomeningea.
    - Versamento pericardico o ascite non controllati, che necessitano di procedure ricorrenti di drenaggio
    - Gravidanza o allattamento, o intenzione di iniziare una gravidanza durante lo studio.
    - Le donne non in stato postmenopausale (ossia >/= 12 mesi di amenorrea non indotta da farmaci) o non sottoposte a sterilizzazione chirurgica devono ottenere un risultato negativo al test di gravidanza sul siero nelle 2 sett. precedenti all’inizio del trattamento con il farmaco in studio.
    - Evidenza di malattia concomitante significativa non controllata che potrebbe interferire con l’aderenza al protocollo, ivi inclusa epatopatia significativa (quale cirrosi, disturbo convulsivo maggiore non controllato o sindrome della vena cava superiore).
    - Cardiovasculopatia significativa, quale malattia cardiaca di classe >/= III secondo i criteri della NYHA, infarto del miocardio nei 3 mesi precedenti, aritmie instabili o angina instabile.
    - I pazienti affetti da coronaropatia arteriosa nota o con frazione di eiezione del ventricolo sinistro < 50% dovranno essere sottoposti a un regime medico stabile che risulti ottimizzato a giudizio del medico curante o, laddove appropriato, d’intesa con un cardiologo.
    - Procedura chirurgica maggiore nelle 4 settimane precedenti all’inizio del trattamento in studio o necessità prevista di una procedura chirurgica maggiore nel corso dello studio per ragioni diverse dalla diagnosi.
    - È ammessa un’anamnesi positiva per malattia autoimmune (Appendice 5) purché controllata e in trattamento stabile (medesima terapia e stessa dose) nelle ultime 12 sett., fatte salve le seguenti eccezioni:
    - Pazienti sottoposti a trattamento concomitante con abatacept o belatacept, a meno che la terapia non sia stata interrotta per > 8 settimane.
    - Pazienti con anamnesi positiva per eventi immunocorrelati gravi o potenzialmente letali.
    - Al momento dell’ingresso nello studio è ammessa non più di 1 malattia autoimmune concomitante, a meno che una di esse non risponda ai seguenti requisiti:
    Ipotiroidismo autoimmune trattato mediante terapia sostitutiva con ormoni tiroidei a dose stabile.
    Diabete mellito di tipo I controllato trattato con regime insulinico a dose stabile.
    Anamnesi positiva per patologie quali malattia atopica o artralgie infantili, ove sussista un basso sospetto clinico di malattia autoimmune. Inoltre, le manifestazioni autoimmuni transitorie di malattie infettive acute risoltesi con il trattamento dell’agente infettivo non sono oggetto di esclusione
    - Trattamento con immunostimolanti sistemici nelle 4 settimane o nelle cinque emivite del farmaco precedenti all’inizio del trattamento in studio.
    - È ammesso l’uso pregresso di vaccini antitumorali e immunoterapia cellulare.
    - Specificatamente nei pazienti senza malattia autoimmune: trattamento con corticosteroidi sistemici o altri immunosoppressori sistemici nelle 2 settimane precedenti all’inizio del trattamento in studio o necessità prevista di immunosoppressori sistemici durante la sperimentazione.
    - L’uso di prednisone a una dose stabile (o dose equivalente) </= 20 mg/giorno nei pazienti con metastasi a carico dell’SNC è ritenuto accettabile.
    - L’utilizzo cronico di prednisone o equivalente deve essere discusso con il Medical Monitor.
    - È ammesso l’uso di corticosteroidi per via inalatoria per broncopneumopatia cronica ostruttiva, di mineralcorticoidi nei pazienti con ipotensione ortostatica, di corticosteroidi supplementari a basse dosi per insufficienza surrenale e di steroidi topici per malattie cutanee.
    E.5 End points
    E.5.1Primary end point(s)
    •Incidence of serious adverse events (SAEs) related to atezolizumab treatment
    •Incidence of immune-related adverse events (irAEs) related to atezolizumab treatment.
    •Incidenza di eventi avversi gravi (SAE) connessi al trattamento con atezolizumab
    •Incidenza di eventi avversi immunocorrelati (irAE) connessi al trattamento con atezolizumab
    E.5.1.1Timepoint(s) of evaluation of this end point
    At the end of the study. The end of study and final analysis will occur when all enrolled patients have either died, withdrawn consent, are lost to follow up, or have been followed for 30 months since the last study patient is enrolled, whichever occurs first.
    Alla fine dello studio. La fine dello studio e l’analisi finale avranno luogo quando tutti i pazienti arruolati saranno deceduti, avranno revocato il consenso, saranno stati persi al follow-up o saranno stati seguiti per 30 mesi dall’arruolamento dell’ultimo paziente della ricerca, a seconda di quale evento si verifichi per primo.
    E.5.2Secondary end point(s)
    ¿Overall survival (OS) rate at 2 years, defined as the proportion of patients remaining alive 2 years after initiation of study treatment ¿OS, defined as the time from initiation of study treatment to death from any cause ¿Progression-free survival (PFS), defined as the time from initiation of study treatment to the first occurrence of disease progression or death from any cause, whichever occurs first. PFS will be calculated based on disease status evaluated by the investigator according to Response Evaluation Criteria in Solid Tumors, Version 1.1 (RECIST v1.1) and also by disease status evaluated by the investigator according to modified RECIST ¿OS rate at 3 years, defined as the proportion of patients remaining alive 3 years after initiation of study treatment ¿Objective response rate (ORR), defined as the percentage of patients who attain complete response (CR) or partial response (PR) according to RECIST v1.1 and also by disease status evaluated by the investigator according to modified RECIST ¿Duration of response (DOR), defined as the time from initial response to disease progression or death among patients who have experienced a CR or PR (unconfirmed) during the study. Duration of response will be calculated based on disease status evaluated by the investigator according to RECIST v1.1 and also by disease status evaluated by the investigator according to modified RECIST
    ¿Tasso di sopravvivenza globale (OS) a 2 anni, inteso come la percentuale di pazienti in vita 2 anni dopo l¿inizio del trattamento in studio ¿OS, intesa come il tempo intercorso tra l¿inizio del trattamento in studio e il decesso per qualsiasi causa ¿Sopravvivenza libera da progressione (PFS), intesa come il tempo intercorso tra l¿inizio del trattamento in studio e la prima comparsa di progressione della malattia o il decesso per qualsiasi causa, a seconda di quale evento si verifichi per primo. La PFS verr¿ calcolata in base allo stato della malattia valutato dallo sperimentatore secondo i criteri di valutazione della risposta nei tumori solidi, versione 1.1 (RECIST v1.1), nonch¿ secondo i criteri RECIST modificati ¿Tasso di OS a 3 anni, inteso come la percentuale di pazienti in vita 3 anni dopo l¿inizio del trattamento in studio ¿Tasso di risposta obiettiva (ORR), inteso come la percentuale di pazienti che ottengono una risposta completa (CR) o parziale (PR) in base ai criteri RECIST v1.1, nonch¿ in funzione dello stato della malattia valutato dallo sperimentatore secondo i criteri RECIST modificati ¿Durata della risposta (DOR), intesa come il tempo intercorso tra la risposta iniziale e la progressione della malattia o il decesso nei pazienti che ottengono una CR o una PR (non confermata) durante lo studio. La durata della risposta verr¿ calcolata in base allo stato della malattia valutato dallo sperimentatore secondo i criteri RECIST v1.1, nonch¿ secondo i criteri RECIST modificati
    E.5.2.1Timepoint(s) of evaluation of this end point
    At the end of the study. The end of study and final analysis will occur when all enrolled patients have either died, withdrawn consent, are lost to follow up, or have been followed for 30 months since the last study patient is enrolled, whichever occurs first.
    Alla fine dello studio. La fine dello studio e l¿analisi finale avranno luogo quando tutti i pazienti arruolati saranno deceduti, avranno revocato il consenso, saranno stati persi al follow-up o saranno stati seguiti per 30 mesi dall¿arruolamento dell¿ultimo paziente della ricerca, a seconda di quale evento si verifichi per primo.
    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 No
    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) No
    E.7.3Therapeutic confirmatory (Phase III) Yes
    E.7.4Therapeutic use (Phase IV) Yes
    E.8 Design of the trial
    E.8.1Controlled Yes
    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 Yes
    E.8.1.7.1Other trial design description
    long-term safety & efficacy study of atezolizumab treatment in patients with Stage IIIb or IV NSCLC
    studio sulla sicurezza a lungo termine ed efficacia di atezo in paz. con NSCLC in stadio IIIb o IV
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) Yes
    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 concerned17
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA80
    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 Information not present in EudraCT
    E.8.6.3If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned
    Brazil
    China
    Colombia
    Costa Rica
    Guatemala
    Lebanon
    Malaysia
    Mexico
    Morocco
    Panama
    Peru
    Philippines
    United Arab Emirates
    Denmark
    Greece
    Italy
    Latvia
    Netherlands
    Poland
    Slovenia
    Spain
    Sweden
    United Kingdom
    Argentina
    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
    The end of study and final analysis will occur when all enrolled patients
    have either died, withdrawn consent, are lost to follow up, or have
    been followed for 30 months since the last study patient is enrolled,
    whichever occurs first.
    The primary analysis will occur approximately 6 months after the last
    patient has been enrolled.
    La fine dello studio e l¿analisi finale avranno luogo quando tutti i pazienti arruolati saranno deceduti, avranno revocato il consenso, saranno stati persi al follow-up o saranno stati seguiti per 30 mesi dall¿arruolamento dell¿ultimo paziente della ricerca, a seconda di quale evento si verifichi per primo.
    L¿analisi primaria avr¿ luogo circa 6 mesi dopo l¿arruolamento dell¿ultimo paziente.
    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 months10
    E.8.9.1In the Member State concerned days0
    E.8.9.2In all countries concerned by the trial years3
    E.8.9.2In all countries concerned by the trial months10
    E.8.9.2In all countries concerned by the trial days0
    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: 256
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 363
    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 Yes
    F.3.3.1Women of childbearing potential not using contraception No
    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 state80
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 166
    F.4.2.2In the whole clinical trial 619
    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)
    When appropriate, the Sponsor will offer access to atezolizumab to patients still benefiting from the treatment at the end of the study in
    accordance with the Roche Global Policy on Continued Access to Investigational Medicinal Product.
    http://www.roche.com/policy_continued_access_to_investigational_medicines.pd
    Se del caso, lo Sponsor offrir¿ l'accesso ad atezolizumab ai pazienti che stanno ancora beneficiando del trattamento alla conclusione dello studio in accordo alla linea generale di condotta di Rocherelativamente all'accesso ai medicinali sperimentali.
    http://www.roche.com/policy_continued_access_to_investigational_medicines.pd
    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 Decision2017-10-06
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2017-10-10
    P. End of Trial
    P.End of Trial StatusCompleted
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