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    Summary
    EudraCT Number:2017-001902-14
    Sponsor's Protocol Code Number:D5760C00001
    National Competent Authority:Spain - AEMPS
    Clinical Trial Type:EEA CTA
    Trial Status:Completed
    Date on which this record was first entered in the EudraCT database:2017-07-28
    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 number2017-001902-14
    A.3Full title of the trial
    A Phase 1/2 Multicenter, Open-label, Dose-escalation, and Dose-expansion Study to Evaluate the Safety, Pharmacokinetics, Immunogenicity, and Antitumor Activity of MEDI4276 in Subjects with Select HER2-expressing Advanced Solid Tumors
    Estudio fase I/II, multicéntrico, abierto, con escalado y ampliación de dosis para evaluar la seguridad, farmacocinética, inmunogenicidad y actividad antitumoral de MEDI4276 en sujetos con tumores sólidos avanzados que expresan HER2
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    A study to evaluate the drug MEDI4276 in patients with selected, advanced, solid cancers
    Estudio para evaluar el fármaco MEDI4276 en pacientes con tumores sólidos específicos avanzados
    A.4.1Sponsor's protocol code numberD5760C00001
    A.5.2US NCT (ClinicalTrials.gov registry) numberNCT02576548
    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 SponsorMedImmune LLC, a wholly owned subsidiary of AstraZeneca PLC
    B.1.3.4CountryUnited States
    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 supportMedImmune LLC, a wholly owned subsidiary of AstraZeneca PLC
    B.4.2CountryUnited States
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationMedImmune LLC
    B.5.2Functional name of contact pointClinical Trial Enquiries
    B.5.3 Address:
    B.5.3.1Street AddressOne MedImmune Way
    B.5.3.2Town/ cityGaithersburg
    B.5.3.3Post codeMD 20878
    B.5.3.4CountryUnited States
    B.5.6E-mailclinicaltrialenquiries@MedImmune.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 nameMEDI4276
    D.3.2Product code MEDI4276
    D.3.4Pharmaceutical form Lyophilisate 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 INNNot available
    D.3.9.1CAS number N/A
    D.3.9.2Current sponsor codeMEDI4276
    D.3.9.3Other descriptive nameN/A
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number10
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    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
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    HER2 expressing Advanced Solid Tumors
    Tumores sólidos avanzados que expresan HER2
    E.1.1.1Medical condition in easily understood language
    Selected advanced solid cancers
    Tumores sólidos específicos avanzados
    E.1.1.2Therapeutic area Diseases [C] - Cancer [C04]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 20.0
    E.1.2Level PT
    E.1.2Classification code 10065430
    E.1.2Term HER-2 positive breast cancer
    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 20.0
    E.1.2Level PT
    E.1.2Classification code 10066896
    E.1.2Term HER-2 positive gastric cancer
    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 20.0
    E.1.2Level PT
    E.1.2Classification code 10075566
    E.1.2Term Triple negative breast cancer
    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 20.0
    E.1.2Level LLT
    E.1.2Classification code 10066354
    E.1.2Term Adenocarcinoma of the gastroesophageal junction
    E.1.2System Organ Class 100000016800
    E.1.3Condition being studied is a rare disease No
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    1.Dose-escalation: To assess the safety, describe the dose-limiting toxicities (DLTs), and determine the maximum tolerated dose (MTD) or the maximum administered dose (MAD; in the absence of exceeding the MTD) of MEDI4276 administered as a single agent in subjects with human epidermal growth factor receptor (HER) 2-expressing advanced breast or gastric cancer refractory to standard therapy.

    2. All dose-expansion cohorts (up to 30 subjects/cohort): To assess the safety of MEDI4276 administered as a single agent.

    3. Dose-expansion Cohort 1 (T-DM1 progressors, HER2-positive breast cancer) and Cohort 2 (TNBC); (31 to 60 subjects/cohort): To evaluate the overall response rate of MEDI4276 administered as a single agent.
    1. Incremento de dosis: evaluar la seguridad, describir las toxicidades limitantes de la dosis (TLD) y determinar la dosis máxima tolerable (DMT) o la dosis máxima administrada (DMA; en ausencia de superación de la DMT) de MEDI4276 administrado en monoterapia en sujetos con cáncer de mama o gástrico avanzado con expresión del receptor 2 del factor de crecimiento epidérmico humano (HER) resistente al tratamiento estándar.

    2. Todas las cohortes de expansión de la dosis (hasta 30 sujetos por cohorte): evaluar la seguridad de MEDI4276 administrado como en monoterapia.

    3. Cohorte 1 de expansión de la dosis (sujetos con cáncer de mama positivo para HER-2, que experimentan progresión de la enfermedad con T-DM1) y cohorte 2 (CMTN); (de 31 a 60 sujetos por cohorte): evaluar la tasa de respuesta global de MEDI4276 administrado en monoterapia.
    E.2.2Secondary objectives of the trial
    1. To evaluate the preliminary antitumor activity of MEDI4276 administered as a single agent in subjects with unresectable, locally advanced or metastatic breast or gastric cancer based on HER2 status

    2. To determine the pharmacokinetics (PK) of MEDI4276 administered as a single agent in subjects with unresectable, locally advanced or metastatic breast or gastric cancer

    3. To determine the immunogenicity of MEDI4276 administered as a single agent in subjects with unresectable, locally advanced or metastatic breast or gastric cancer
    1. Evaluar la actividad antitumoral preliminar de MEDI4276 administrado en monoterapia en sujetos con cáncer de mama o gástrico irresecable, metastásico o localmente avanzado basado en el estado del gen HER2

    2. Determinar la farmacocinética (FC) de MEDI4276 administrado en monoterapia en sujetos con cáncer de mama o gástrico irresecable, metastásico o localmente avanzado

    3. Determinar la inmunogenicidad de MEDI4276 administrado en monoterapia en sujetos con cáncer de mama o gástrico irresecable, metastásico o localmente avanzado
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1.Age ≥ 18 years at the time of screening.

    2.Written informed consent and any locally required authorization obtained from the subject prior to performing any protocol related procedures, including screening evaluations.

    3.In the dose-escalation phase:
    a.Histologically or cytologically documented unresectable, locally advanced or metastatic breast or gastric cancer refractory to standard therapy.
    b.HER2-positive disease documented as FISH-positive and/or 3+ by IHC on previously collected tumor tissue.
    c.At least one lesion measurable by RECIST Version 1.1

    4.In the dose-expansion phase:
    a.Cohort 1 (T-DM1 progressors, HER2-positive breast cancer) must meet all of the following:
    i.Histologically or cytologically documented unresectable, locally advanced or metastatic breast cancer (locally advanced disease must not be amenable to surgical resection or radiation with curative intent).
    ii.At least one lesion measurable by RECIST Version 1.1. NOTE: A previously irradiated lesion can be considered a target lesion if the lesion is well defined, measurable per RECIST v1.1, there is objective evidence for interval increase in size, and the subject consents to providing the prior computed tomography (CT) scan before enrolling in the study.
    iii.HER2-positive disease documented as FISH-positive and/or 3+ by IHC based on previously collected tumor tissue.
    iv.Subjects with a primary tumor that is hormone (estrogen, progesterone, or both) receptor positive or receptor-negative are eligible
    v.Prior treatment with trastuzumab + pertuzumab-based regimen
    vi.Prior treatment with T-DM1 in the metastatic setting with documented radiographic disease progression while receiving or after completing T-DM1.
    vii.Prior hormone therapy is allowed, but last dose must be at least 14 days prior to first dose of MEDI4276
    viii.Documented radiographic disease progression during or after the most recent treatment is also required if not T-DM1.
    b.Cohort 2 (TNBC) must meet all of the following:
    i.Histologically or cytologically documented unresectable, locally advanced or metastatic breast cancer (locally advanced disease must not be amenable to either surgical resection or radiation with curative intent).
    ii.At least one lesion measurable by RECIST Version 1.1. NOTE: A previously irradiated lesion can be considered a target lesion if the lesion is well defined, measurable per RECIST v1.1, there is objective evidence for interval increase in size, and the subject consents to providing the prior CT scan before enrolling in the study.
    iii.HER2-negative disease documented according to 2013 ASCO/College of American Pathologists (CAP) HER2 Testing Clinical Practice Guidelines (Wolff et al, 2013) as HER2 0, 1+ by IHC or HER2 2+ by IHC on previously collected tumor tissue. If HER2 2+ by IHC is documented, FISH must also be performed and the ratio of HER2 to chromosome enumeration probe 17 (CEP17) must be < 2.0 or average HER2 gene copy number must be < 4 signals per nucleus.
    iv.ER/PR-negative documented disease according to 2010 ASCO/CAP Guideline Recommendations for Immunohistochemical Testing of Estrogen and Progesterone Receptors in Breast Cancer (Hammond et al, 2010), defined as < 1% of tumor cell nuclei are immunoreactive by IHC.
    v.If futility criteria are met in the TNBC all-comers population after an initial 15 subjects are enrolled and evaluated, then further enrollment will be limited to the TNBC HER2Low population defined as the subset of TNBC subjects with tumor HER2 expression as determined by the more sensitive AZ/Dako HER2Low IHC assay.
    vi.Prior treatment with at least 1 line of chemotherapy in the unresectable, locally advanced or metastatic setting.
    c.Cohort 3 (trastuzumab progressors, HER2-positive gastric or GEJ cancer) must meet all of the following:
    i.Histologically or cytologically documented unresectable, locally advanced or metastatic gastric or GEJ adenocarcinoma (locally advanced disease must not be amenable to either surgical resection or radiation with curative intent).
    ii.At least one lesion measurable by RECIST Version 1.1. NOTE: A previously irradiated lesion can be considered a target lesion if the lesion is well defined, measurable per RECIST v1.1, there is objective evidence for interval increase in size, and the subject consents to providing the prior CT scan before enrolling in the study.
    iii.HER2-positive disease documented as IHC 3+ or IHC 2+ and FISH-positive based on previously collected tumor tissue.
    iv.Prior treatment with a trastuzumab-based regimen in the metastatic setting.
    v.Documented radiographic disease progression during or after trastuzumab treatment.
    5.LVEF ≥ 50% by either echocardiogram (ECHO) or multi-gated acquisition (MUGA) scan.
    6.Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.
    7.In the opinion of the investigator, likely to complete ≥ 56 days of treatment.
    See protocol section 4.1.2 for full inclusion criteria
    1. Edad ≥18 años en el momento de la selección.
    2. Obtención del consentimiento informado por escrito del sujeto y de cualquier autorización que sea requerida en el ámbito local del sujeto antes de llevar a cabo ningún procedimiento relacionado con el protocolo, incluidas las evaluaciones de selección.
    3. En la fase de incremento de dosis:
    a. Documentación histológica o citológica de cáncer de mama o gástrico irresecable, metastásico o localmente avanzado, resistente al tratamiento estándar.
    b. Enfermedad positiva para HER2 documentada como positiva para FISH y/o 3+ mediante IHQ en tejido tumoral obtenido previamente.
    c. Al menos una lesión medible según la versión 1.1 de los criterios RECIST.
    4. En la fase de expansión de la dosis:
    a. La cohorte 1 (sujetos con cáncer de mama positivo para HER2 que experimentan progresión con T-DM1) debe cumplir todo lo siguiente
    i. Cáncer de mama irresecable, metastásico o localmente avanzado, documentado histológicamente o citológicamente (la enfermedad localmente avanzada no debe ser susceptible de resección quirúrgica o radiación con intenciones curativas).
    ii. Al menos una lesión medible mediante la versión 1.1 de los criterios RECIST. NOTA: Una lesión previamente irradiada se puede considerar una lesión diana si la lesión está bien definida, es medible según la versión 1.1 de los criterios RECIST, hay signos objetivos de aumento en el tamaño, y el sujeto da su consentimiento a proporcionar una tomografía axial computarizada (TAC) previa antes de inscribirse en el estudio.
    iii. Enfermedad positiva para HER2 documentada como positiva para FISH y/o 3+ mediante IHQ basándose en tejido tumoral obtenido previamente.
    iv. Son aptos los sujetos con un tumor primario positivo para el receptor de hormonas (estrógenos, progesterona o ambos) o negativo para el receptor.
    v. Tratamiento previo con una pauta a base de trastuzumab + pertuzumab.
    vi. Tratamiento previo con T-DM1 en el escenario metastásico con progresión radiográfica documentada de la enfermedad mientras se recibe T-DM1 o después de completar el tratamiento con T-DM1.
    vii. Se permite el tratamiento hormonal previo, pero la última dosis debe tener lugar al menos 14 días antes de la primera dosis de MEDI4276.
    b. La cohorte 2 (CMTN) debe cumplir todo lo siguiente:
    i. Cáncer de mama irresecable, metastásico o localmente avanzado, documentado histológicamente o citológicamente (la enfermedad localmente avanzada no debe ser susceptible de resección quirúrgica o radiación con intenciones curativas).
    ii. Al menos una lesión medible mediante la versión 1.1 de los criterios RECIST. NOTA: Una lesión previamente irradiada se puede considerar una lesión diana si la lesión está bien definida, es medible según la versión 1.1 de los criterios RECIST, hay signos objetivos de aumento en el tamaño, y el sujeto da su consentimiento a proporcionar una TAC previa antes de inscribirse en el estudio.
    iii. Enfermedad negativa para HER2 documentada de acuerdo con las directrices de la práctica clínica para la prueba de HER2 de 2013 de la ASCO/Colegio de Patólogos Americanos como HER2 0, 1+ mediante IHQ o HER2 2+ mediante IHQ en tejido tumoral obtenido previamente. Si se documenta HER2 2+ mediante IHQ, también se debe hacer la FISH, y la relación de HER2 y la sonda de determinación del número de cromosomas 17 (CEP17) debe ser <2,0, o el promedio del número de copias del gen HER2 debe ser <4 señales por núcleo.
    iv. Enfermedad negativa para RE/PR documentada de acuerdo con las recomendaciones de la directriz de 2010 de la ASCO/CAP para pruebas inmunohistoquímicas de receptores de estrógenos y progesterona en el cáncer de mama, definido como <1 % de núcleos de células tumorales inmunorreactivas mediante IHQ.
    v. Si se cumplen los criterios de futilidad en la población de todos los sujetos que lleguen con CMTN después de que se haya inscrito y evaluado a los 15 sujetos iniciales, las inscripciones posteriores se limitarán a la población de CMTN HER2Low definida como el subgrupo de sujetos de CMTN con expresión tumoral de HER2 determinada por el análisis de IHQ AZ/Dako HER2Low más sensible.
    c. La cohorte 3 (sujetos de cáncer gástrico o de la UGE positivos para HER2 que hayan experimentado progresión de la enfermedad con trastuzumab) deben cumplir todo lo siguiente:
    i. Adenocarcinoma gástrico o de la UGE irresecable, metastásico o localmente avanzado, documentado histológicamente o citológicamente (la enfermedad localmente avanzada no debe ser susceptible de resección quirúrgica o radiación con intenciones curativas).
    ii. Al menos una lesión medible mediante la versión 1.1 de los criterios RECIST. NOTA: Una lesión previamente irradiada se puede considerar una lesión diana si la lesión está bien definida, es medible según la versión 1.1 de los criterios RECIST, hay signos objetivos de aumento en el tamaño, y el sujeto da su consentimiento a proporcionar una TAC previa antes de inscribirse en el estudio.
    E.4Principal exclusion criteria
    1.Receipt of any conventional or investigational anticancer treatment within 28 days prior to the first dose of MEDI4276.
    2.History of exposure to the following cumulative doses of anthracyclines:
    a.Doxorubicin or liposomal doxorubicin > 350 mg/m2.
    b.Epirubicin > 530 mg/m2.
    c.Mitoxantrone > 90 mg/m2 and idarubicin > 70 mg/m2.
    d.If another anthracycline or more than 1 anthracycline has been used, then the cumulative dose must not exceed the equivalent of 350 mg/m2 of doxorubicin.
    3.Unresolved toxicities from prior anticancer therapy, defined as having not resolved to NCI CTCAE v4.03 Grade 0 or 1 with the exception of Grade 2 peripheral neuropathy that is clinically stable for at least 28 days prior to the first dose of MEDI4276, alopecia, and laboratory values listed per the inclusion criteria. NOTE: Subjects with irreversible toxicity that is not reasonably expected to be exacerbated by the investigational product may be included (eg, hearing loss) after consultation with the medical monitor.
    4.Concurrent enrollment in another clinical study, unless it is an observational (non interventional) clinical study or the follow-up period of an interventional study.
    5.History of or currently with symptomatic congestive heart failure (New York Heart Association classes II-IV) or serious cardiac arrhythmia requiring treatment.
    6.Cardiac troponin I ≥ 0.2 ng/mL within 28 days prior to the first dose of MEDI4276.
    7.History of myocardial infarction or unstable angina within 6 months of the first dose of MEDI4276.
    8.History of intolerance (such as Grade 3 or Grade 4 infusion-related reaction) to trastuzumab or T-DM1.
    9.Known hypersensitivity to any component of MEDI4276, including the excipients.
    10.Any of the following within 6 months before the first dose of MEDI4276: active peptic ulcer disease, active inflammatory bowel disease (including ulcerative colitis and Crohn’s disease).
    11.Diarrhea of any grade within 14 days prior to the first dose of MEDI4276.
    12.Previous radiotherapy is not allowed if:
    a.More than 25% of marrow-bearing bone has been irradiated.
    b.The last fraction of radiotherapy has been administered within approximately 3 weeks prior to the first dose of MEDI4276.
    13.Known brain metastases that are untreated, symptomatic, or require therapy to control symptoms; or any radiation, surgery, or other therapy to control symptoms from brain metastases within 2 months prior to first dose of MEDI4276.
    ◦CT or magnetic resonance imaging (MRI) scan of the brain is mandatory (within approximately 28 days prior to first dose of MEDI4276) in cases of clinical suspicion of brain metastases or in a patient with any prior history of brain metastases.
    14.Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, uncontrolled hypertension, or psychiatric illness/social situations that would limit compliance with study requirements, substantially increase risk of incurring AEs from MEDI4276, or compromise the ability of the subject to give written informed consent.
    15.Current severe, uncontrolled systemic disease (eg, clinically significant cardiovascular, pulmonary, or metabolic disease; wound healing disorders; ulcers; or bone fractures).
    16.Major surgical procedure or significant traumatic injury (as defined by the investigator) within approximately 28 days prior to first dose of MEDI4276 or anticipation of the need for major surgery during the course of study treatment.
    17.Current pregnancy or lactation.
    18.Current known infection with human immunodeficiency virus (HIV), active hepatitis B and/or hepatitis C virus.
    1. Recepción de cualquier tratamiento antineoplásico convencional o en investigación dentro de los 28 días previos a la primera dosis de MEDI4276.
    2. Antecedente de exposición a las siguientes dosis acumuladas de antraciclinas:
    a. Doxorrubicina o doxorrubicina liposomal >350 mg/m2.
    b. Epirrubicina >530 mg/m2.
    c. Mitoxantrona >90 mg/m2 e idarrubicina >70 mg/m2.
    d. Si se ha utilizado otra antraciclina o más de 1 antraciclina, la dosis acumulada no debe exceder el equivalente a 350 mg/m2 de doxorrubicina.
    3. Toxicidades no resueltas de un tratamiento antineoplásico previo, definido como no haberse resuelto a NCI CTCAE v4.03 de grado 0 o 1, con la excepción de neuropatía periférica de grado 2 que sea clínicamente estable durante al menos los 28 días previos a la primera dosis de MEDI4276, alopecia y valores analíticos recogidos según los criterios de inclusión. NOTA: Se podrá incluir a los sujetos con toxicidad irreversible que no se espere razonablemente que pueda exacerbarse con el producto en investigación (p. ej., pérdida auditiva) tras consultar con el supervisor médico.
    4. Inscripción simultánea en otro estudio clínico, a menos que se trate de un estudio clínico observacional (no intervencionista) o el periodo de seguimiento de un estudio intervencionista.
    5. Antecedente de haber sufrido o sufrir actualmente insuficiencia cardíaca congestiva sintomática (clases II-IV según la Asociación del Corazón de Nueva York [New York Heart Association]) o arritmia cardiaca grave que precise tratamiento.
    6. Troponina I cardíaca ≥0,2 ng/ml dentro de los 28 días previos a la primera dosis de MEDI4276.
    7. Antecedentes de infarto de miocardio o angina inestable dentro de los 6 meses previos a la primera dosis de MEDI4276.
    8. Antecedente de intolerancia (como reacción relacionada con la infusión de grado 3 o 4) a trastuzumab o T-DM1.
    9. Hipersensibilidad conocida a cualquier componente de MEDI4276, incluidos los excipientes.
    10. Cualquiera de los siguientes dentro de los 6 meses previos a la primera dosis de MEDI4276: enfermedad por úlceras pépticas activa, enfermedad inflamatoria intestinal activa (incluidas colitis ulcerosa y enfermedad de Crohn).
    11. Diarrea de cualquier grado dentro de los 14 días previos a la primera dosis de MEDI4276.
    12. No se permite la radioterapia previa si:
    a. Se ha irradiado más del 25 % del hueso que alberga la médula ósea.
    b. La última fracción de radioterapia se ha administrado dentro de aproximadamente 3 semanas antes de la primera dosis de MEDI4276.
    13. Metástasis cerebral conocida que esté sin tratar, sea sintomática o requiera tratamiento para controlar los síntomas; o cualquier radiación, cirugía u otro tratamiento para controlar los síntomas de la metástasis cerebral dentro de los 2 meses previos a la primera dosis de MEDI4276.
    ◦Es obligatoria una TAC o resonancia magnética (RM) del cerebro (dentro de aproximadamente los 28 días previos a la primera dosis de MEDI4276) en casos de sospecha clínica de metástasis cerebral o en un paciente con antecedentes previos de metástasis cerebral.
    14. Enfermedad intercurrente no controlada, incluida, entre otras, infección activa o en curso, hipertensión no controlada o enfermedad psiquiátrica/situaciones sociales que limitarían el cumplimiento de los requisitos del estudio, lo que aumentaría de forma sustancial el riesgo de incurrir en AA de MEDI4276 o comprometer la capacidad del sujeto para dar el consentimiento informado por escrito.
    15. Enfermedad sistémica actual, grave y no controlada (p. ej., enfermedad cardiovascular, pulmonar o metabólica clínicamente significativa; trastornos en la cicatrización de heridas; úlceras; o fracturas óseas).
    16. Intervención quirúrgica mayor o lesión traumática significativa (definida por el investigador) dentro de aproximadamente 28 días previos a la primera dosis de MEDI4276 o anticipación de la necesidad de intervención quirúrgica mayor durante el curso del tratamiento del estudio.
    17. Embarazo o lactancia actuales.
    18. Infección actual conocida por el virus de la inmunodeficiencia humana (VIH), virus activo de la hepatitis B y/o la hepatitis C.
    E.5 End points
    E.5.1Primary end point(s)
    1. Dose-escalation and dose-expansion: The primary endpoint is safety as assessed by the occurrence of adverse events (AEs), serious adverse events (SAEs), DLTs (dose-escalation only), and changes from baseline in laboratory parameters, vital signs, and electrocardiogram results.

    2. Dose-expansion Cohort 1 (T-DM1 progressors, HER2-positive breast cancer) and Cohort 2 (TNBC); (31 to 60 subjects/cohort): The primary endpoint is objective response.
    1. Incremento de dosis y expansión de dosis: el criterio de valoración principal es la seguridad valuada por la aparición de acontecimientos adversos (AA), acontecimientos adversos graves (AAG), TLD (solo incremento de dosis), y cambios desde el inicio en parámetros analíticos, constantes vitales y resultados del electrocardiograma.

    2. Cohorte 1 de expansión de dosis (pacientes de cáncer de mama positivo para HER2, con progresión de la enfermedad tratados con T-DM1) y cohorte 2 (CMTN); (de 31 a 60 sujetos por cohorte): el criterio de valoración principal es la respuesta objetiva.
    E.5.1.1Timepoint(s) of evaluation of this end point
    Throughout the study
    A lo largo del estudio
    E.5.2Secondary end point(s)
    1. The endpoints for assessment of antitumor activity include best overall response, objective response (dose escalation and dose-expansion [up to 30 subjects/cohort] only), disease control, time to response, duration of response, progression-free survival (PFS), overall survival (OS), and change from baseline in tumor size. Response Evaluation Criteria in Solid Tumors (RECIST) Version 1.1 will be used to assess tumor response.

    2. The endpoints for assessment of PK of MEDI4276 include individual subject MEDI4276 concentrations in plasma at different time points after MEDI4276 administration. PK parameters that may be modeled on these data include, but are not limited to, maximum observed concentration, area under the concentration time curve, clearance, and terminal half-life.

    3. The endpoints for assessment of immunogenicity of MEDI4276 include the number and percentage of subjects who develop detectable anti-drug antibodies.
    1. Los criterios de valoración para la evaluación de la actividad antitumoral incluyen la mejor respuesta global, la respuesta objetiva (incremento de dosis y expansión de dosis [hasta 30 sujetos por cohorte] solamente), control de la enfermedad, tiempo hasta la respuesta, duración de la respuesta, supervivencia sin progresión (SSP), supervivencia general (SG) y cambio desde el inicio en el tamaño del tumor. Para evaluar la respuesta tumoral se utilizará la versión 1.1 de los Criterios de Evaluación de la Respuesta en Tumores Sólidos (Response Evaluation Criteria in Solid Tumors, RECIST).

    2. Los criterios de valoración para la evaluación de la FC de MEDI4276 incluyen las concentraciones en plasma de MEDI4276 individuales de cada sujeto en distintos puntos temporales tras la administración de MEDI4276. Los parámetros FC que se pueden modelar de acuerdo con estos datos incluyen, entre otros, concentración máxima observada, área bajo la curva de concentración-tiempo, aclaramiento y semivida terminal.

    3. Estos criterios de valoración para la evaluación de la inmunogenicidad de MEDI4276 incluyen el número y el porcentaje de sujetos que desarrollan anticuerpos antifármaco detectables.
    E.5.2.1Timepoint(s) of evaluation of this end point
    - From time of informed consent to end of study - ORR, DoR, PFS, and OS

    - PK and IM will be evaluated after MEDI4276 administration through 30 days post end of treatment.
    - Desde el momento del consentimiento informado hasta el final del estudio - ORR, DoR, PFS y OS

    - El PK e IM se evaluarán después de la administración de MEDI4276 hasta 30 días después del final del tratamiento.
    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 Yes
    E.6.6Pharmacokinetic Yes
    E.6.7Pharmacodynamic Yes
    E.6.8Bioequivalence No
    E.6.9Dose response Yes
    E.6.10Pharmacogenetic No
    E.6.11Pharmacogenomic Yes
    E.6.12Pharmacoeconomic No
    E.6.13Others No
    E.7Trial type and phase
    E.7.1Human pharmacology (Phase I) Yes
    E.7.1.1First administration to humans Yes
    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) Yes
    E.7.3Therapeutic confirmatory (Phase III) No
    E.7.4Therapeutic use (Phase IV) No
    E.8 Design of the trial
    E.8.1Controlled No
    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 No
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) No
    E.8.2.2Placebo No
    E.8.2.3Other No
    E.8.2.4Number of treatment arms in the trial3
    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 concerned4
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA13
    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 No
    E.8.6.3If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned
    Belgium
    France
    Korea, Republic of
    Spain
    United States
    E.8.7Trial 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
    The end of the study (“study completion”) is defined as the date of the last protocol-specified visit/assessment (including telephone contact) for the last subject in the study. This date will be 3 years after the final subject is entered into the study or when the sponsor stops the study, whichever occurs earlier.
    El final del estudio ("finalización del estudio") se define como la fecha de la última visita especificada por el protocolo/evaluación (incluyendo el contacto telefónico) para el último sujeto del estudio. Esta fecha será de 3 años después de que el último sujeto sea enrolado en el estudio o cuando el promotor deje de realizar el estudio, lo que ocurra antes.
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years1
    E.8.9.1In the Member State concerned months10
    E.8.9.1In the Member State concerned days
    E.8.9.2In all countries concerned by the trial years4
    E.8.9.2In all countries concerned by the trial months0
    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: 162
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 54
    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 state25
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 80
    F.4.2.2In the whole clinical trial 216
    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)
    Standard of care
    Estándar de tratamiento
    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 Decision2017-11-06
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2017-10-30
    P. End of Trial
    P.End of Trial StatusCompleted
    P.Date of the global end of the trial2018-05-23
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