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    Summary
    EudraCT Number:2017-001980-19
    Sponsor's Protocol Code Number:42756493BLC2002
    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:2018-02-15
    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 number2017-001980-19
    A.3Full title of the trial
    A Phase 1b-2 Study to Evaluate Safety, Efficacy, Pharmacokinetics, and Pharmacodynamics of Erdafitinib plus JNJ-63723283, an Anti-PD-1 Monoclonal Antibody, in Subjects with Metastatic or Surgically Unresectable Urothelial Cancer with Selected FGFR Gene Alterations
    Estudio de Fase 1b-2 para evaluar la seguridad, eficacia, farmacocinética y farmacodinamia de erdafitinib más JNJ-63723283, un anticuerpo monoclonal anti-PD-1, en sujetos con cáncer urotelial metastásico o no resecable con determinadas alteraciones del gen del FGFR
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    A study to evaluate the safety, the distribution and elimination of the compound in the body, and the effectiveness of Erdafitinib in combination with JNJ-63723283 in patients with metastatic or surgically not resectable urothelial cancer.
    Un estudio para evaluar la seguridad, la districución y eliminación del compuesto en el cuerpo y la eficacia de erdafitinib más JNJ-63723283, en pacientes con cáncer urotelial metastásico o no resecable.
    A.3.2Name or abbreviated title of the trial where available
    NORSE
    A.4.1Sponsor's protocol code number42756493BLC2002
    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 SponsorJanssen-Cilag International NV
    B.1.3.4CountryBelgium
    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 supportJanssen Research & Development
    B.4.2CountryUnited States
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationPAREXEL International LLC
    B.5.2Functional name of contact point-
    B.5.3 Address:
    B.5.3.1Street Address-
    B.5.3.2Town/ city-
    B.5.3.3Post code-
    B.5.3.4CountrySpain
    B.5.4Telephone number0034913913443
    B.5.5Fax number----
    B.5.6E-mailclinicaltrial.enquiries@parexel.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 nameErdafitinib
    D.3.2Product code JNJ-42756493
    D.3.4Pharmaceutical form Film-coated tablet
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNErdafitinib
    D.3.9.1CAS number 1346242-81-6
    D.3.9.2Current sponsor codeJNJ-42756493
    D.3.9.3Other descriptive nameERDAFITINIB
    D.3.9.4EV Substance CodeSUB167731
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number3
    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) No
    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 No
    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 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 nameErdafitinib
    D.3.2Product code JNJ-42756493
    D.3.4Pharmaceutical form Film-coated tablet
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNErdafitinib
    D.3.9.1CAS number 1346242-81-6
    D.3.9.2Current sponsor codeJNJ-42756493
    D.3.9.3Other descriptive nameERDAFITINIB
    D.3.9.4EV Substance CodeSUB167731
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number4
    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) No
    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 No
    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: 3
    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 nameErdafitinib
    D.3.2Product code JNJ-42756493
    D.3.4Pharmaceutical form Film-coated tablet
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOral use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNErdafitinib
    D.3.9.1CAS number 1346242-81-6
    D.3.9.2Current sponsor codeJNJ-42756493
    D.3.9.3Other descriptive nameERDAFITINIB
    D.3.9.4EV Substance CodeSUB167731
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number5
    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) No
    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 No
    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: 4
    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.3.2Product code JNJ-63723283
    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 INNNot Assigned
    D.3.9.1CAS number Not Assigned
    D.3.9.2Current sponsor codeJNJ-63723283
    D.3.9.3Other descriptive nameJNJ-63723283-AAA
    D.3.9.4EV Substance CodeSUB183887
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    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 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 No
    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
    Metastatic or Surgically Unresectable Urothelial Cancer
    Cáncer urotelial metastásico o no resecable
    E.1.1.1Medical condition in easily understood language
    Metastatic or Surgically Unresectable Urothelial Cancer
    Cáncer urotelial metastásico o no resecable
    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 10005003
    E.1.2Term Bladder 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
    Phase 1b (Dose Escalation)
    - To identify the RP2D and schedule of erdafitinib in combination with JNJ-63723283

    Phase 2
    - To evaluate the safety and clinical activity of erdafitinib alone and in combination with JNJ-63723283
    Fase 1b (Escalamiento de dosis)
    - Identificar la dosis recomendada para la Fase 2 (recommended Phase 2 dose, RP2D) y la pauta de tratamiento de erdafitinib en combinación con JNJ-63723283

    Fase 2
    - Evaluar la seguridad y la actividad clínica de erdafitinib, solo y en combinación con JNJ-63723283
    E.2.2Secondary objectives of the trial
    Phase 1b and 2
    - To characterize the PK of erdafitinib and JNJ-63723283
    - To assess the immunogenicity of JNJ-63723283

    Phase 2
    - To further assess safety at the R2PD of erdafitinib alone and in combination with JNJ-63723283
    - To further characterize the clinical activity of erdafitinib alone and in combination with JNJ-63723283
    Fase 1b y 2
    - Caracterizar la farmacocinética (PK) de erdafitinib y JNJ-63723283
    - Evaluar la inmunogenicidad de JNJ-63723283

    Fase 2
    - Seguir evaluando la seguridad de la dosis recomendada para la Fase 2 (R2PD) de erdafitinib solo y en combinación con JNJ-63723283
    - Seguir caracterizando la actividad clínica de erdafitinib solo y en combinación con JNJ-63723283
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1. >/= 18 years of age.
    2. Histologic demonstration of transitional cell carcinoma of the urothelium. Minor components (<50% overall) of variant histology such as glandular or squamous differentiation, or evolution to more aggressive phenotypes such as sarcomatoid or micropapillary change are acceptable.
    3. Stage IV disease (metastatic or surgically unresectable, cT4b, N+, or M+ cancer).
    4. Meet appropriate molecular eligibility criteria (as determined by central laboratory screening). Tumors must have at least 1 of the following translocations: FGFR2- BICC1, FGFR2-CASP7, FGFR3-TACC3, FGFR3-BAIAP2L1; or 1 of the following FGFR3 gene mutations: R248C, S249C, G370C, Y373C.
    Subjects must have available tumor tissue for molecular eligibility determination, and PD-L1 testing.
    5. Documented progression of disease per RECIST 1.1, defined as any progression that requires a change in treatment, prior to randomization.
    6. Prior systemic therapy:
    Phase 1b: Any number of lines of prior therapy.
    Phase 2: Progressed after 1 or 2 lines of prior chemotherapy
    7. ECOG performance status (PS) grade of : 0 or 1.
    8. Clinical laboratory values at screening for Hematology, Chemistry and Cardiovascular: Please refer to the study protocol
    9. Before the first dose of study drug:
    Women of childbearing potential and fertile men who are sexually active must agree to use a highly effective method of contraception (<1%/year failure rate) during the study and for 5 months after the last dose of study drug. For men who are sexually active with women of childbearing potential: agree to use a condom with spermicidal foam/gel/film/cream/suppository during the study and for 5 months after the last dose
    of study drug. Contraception must be consistent with local regulations regarding the use of birth control methods for subjects participating in clinical trials. Women and men must agree not to donate eggs (ova, oocytes) or sperm, respectively, during the study and for 5 months after the last dose of study drug.
    Examples of highly effective methods include:
    – user-independent methods: implantable progestogen-only hormone contraception associated with inhibition of ovulation; intrauterine device; intrauterine hormonereleasing system; vasectomized partner;
    – user-dependent methods: combined (estrogen- and progestogen-containing) hormonal contraception associated with inhibition of ovulation: oral, intravaginal, and transdermal; progestogen-only hormone contraception associated with inhibition of ovulation: oral and injectable.
    Note: If the childbearing potential changes after start of the study or the risk of pregnancy changes, a woman must begin a highly effective method of contraception, as described throughout the inclusion criteria. If reproductive status is questionable, additional evaluation should be considered. It should be noted that interaction between hormonal contraception and the combination of the study drugs have not been studied.
    Therefore, it is unknown whether the study drugs may reduce the efficacy of the contraceptive method.
    – Sexual abstinence
    (True sexual abstinence is considered a highly effective method only if defined as refraining from heterosexual intercourse during the entire period of risk associated with the study intervention. The reliability of true sexual abstinence needs to be evaluated in relation to the duration of the study and the preferred and usual lifestyle of the subject. Periodic abstinence [eg, calendar, ovulation, symptothermal, postovulation methods], declaration of abstinence for the duration of exposure to the study drugs, and withdrawal are not acceptable methods of contraception)
    10. Women of childbearing potential must have a negative pregnancy test at screening within ≤7 days of Cycle 1 Day 1 (first dose of study drug) using a highly sensitive pregnancy test
    11. Sign an informed consent form (Molecular and Full-Study ICF) indicating that he or she understands the purpose of and procedures required for the study, and is willing and able to participate in the study. Consent is to be obtained prior to the initiation of any study-related tests or procedures that are not part of standard-of-care for the subject’s disease.
    12. Willing and able to adhere to the prohibitions and restrictions specified in this protocol.
    1. >/= 18 años de edad
    2. Demostración histológica de carcinoma de células transicionales del urotelio. Se aceptan los componentes menores (<50% en conjunto) de variantes histológicas como la diferenciación glandular o escamosa, o la evolución a fenotipos más agresivos, como el sarcomatoide o el micropapilar
    3. Enfermedad en Estadio IV (enfermedad metastásica o no resecable, cT4b, N+ o M+)
    4. Cumplimiento de los criterios adecuados de elegibilidad molecular (en su determinación mediante cribado por el laboratorio central). Los tumores deben presentar como mínimo 1 de las siguientes translocaciones: FGFR2- BICC1, FGFR2-CASP7, FGFR3-TACC3, FGFR3-BAIAP2L1; o 1 de las siguientes mutaciones del gen del FGFR3: R248C, S249C, G370C, Y373C. Debe poder disponerse de tejido tumoral del sujeto para determinación de su elegibilidad molecular y para estudio del PD-L1
    5. Antes de la aleatorización, progresión documentada de la enfermedad según RECIST 1.1, lo que se define como toda progresión que precise un cambio de tratamiento
    6. Tratamiento sistémico previo:
    Fase 1b: cualquier número de líneas previas de tratamiento
    Fase 2: progresión tras 1 o 2 líneas previas de quimioterapia
    7. Estado funcional (PS) del ECOG de Grado 0 o 1
    8. Valores de laboratorio en la selección para hematología, bioquímica y cardiovascular: consultar protocolo
    9. Antes de la primera dosis del fármaco del estudio:
    Las mujeres de potencial reproductor y los hombres fértiles que sean sexualmente activos deberán mostrar su conformidad en utilizar un método anticonceptivo altamente (esto es, con una tasa de fracasos <1%/año) durante el estudio y los 5 meses siguientes a la última dosis del fármaco del estudio. Para hombres que son sexualmente activos con mujeres de potencial reproductor: aceptar de usar un condón con espuma espermicida/gel/película/crema/supositorio durante el estudio y los 5 meses siguientes a la última dosis del fármaco del estudio.
    Los métodos anticonceptivos deberán concordar con las normativas locales al respecto para los sujetos participantes en ensayos clínicos. Las mujeres y los hombres deberán mostrar su conformidad en no donar óvulos o semen, respectivamente, durante el estudio y los 5 meses siguientes a la última dosis del fármaco del estudio.
    Son ejemplos de métodos anticonceptivos altamente efectivos los siguientes:
    – métodos independientes de la usuaria: anticonceptivo hormonal sólo con progestágeno, resultante en inhibición de la ovulación: implantable; dispositivo intrauterino; sistema intrauterino de liberación hormonal; pareja vasectomizada;
    – métodos dependientes de la usuaria: anticonceptivo hormonal combinado (con estrógeno y progestágeno), resultante en inhibición de la ovulación: oral, intravaginal y transdérmico; anticonceptivo hormonal sólo con progestágeno, resultante en inhibición de la ovulación: oral e inyectable.
    Nota: Si el potencial reproductor o el riesgo de embarazo se modificaran después del inicio del estudio, la mujer deberá comenzar con un método anticonceptivo altamente efectivo, tal como se describe en los criterios de inclusión. Si el estado reproductor fuera dudoso, se deberá considerar su evaluación adicional. Debe señalarse que no se ha estudiado la posibilidad de interacción entre la anticoncepción hormonal y la combinación de los fármacos del estudio, por lo que se desconoce si estos podrían reducir la eficacia del método anticonceptivo.
    –Abstinencia sexual
    (La abstinencia sexual real solamente se considera como método altamente efectivo cuando consiste en la abstención de relaciones heterosexuales durante todo el periodo de riesgo relacionado con el tratamiento del estudio. Deberá evaluarse la fiabilidad de la abstinencia sexual real en relación con la duración del estudio y el método de vida preferido y habitual de los sujetos. Abstinencia periódica [p. Ej., Calendario, ovulación, sintomatología termal, métodos de post-ovulación], declaración de abstinencia mientras dure la exposición a los fármacos del estudio y coito interrumpido no son métodos aceptables de anticoncepción)
    10. Las mujeres de potencial reproductor deberán arrojar un resultado negativo de una prueba de embarazo en la selección, en el plazo de ≤7 días antes del Ciclo 1 Día 1 (primera dosis del fármaco del estudio), mediante una prueba de embarazo de elevada sensibilidad
    11. Firma del documento de consentimiento informado (DCI molecular y para el estudio completo) atestiguando que comprende el objetivo de los procedimientos del estudio y que está de acuerdo y puede participar en el estudio. El consentimiento deberá obtenerse antes del inicio de cualquier examen o procedimiento del estudio que no formen parte de la atención habitual por la enfermedad del sujeto
    12. Voluntad y capacidad de respetar las prohibiciones y restricciones que se especifican en este protocolo
    E.4Principal exclusion criteria
    1. Treatment with any other investigational agent or participation in another clinical study with therapeutic intent within 30 days prior to Cycle 1 Day 1. For Phase 1b, subjects who have received the following prior antitumor therapy:
    - Received nitrosoureas and mitomycin C within 6 weeks.
    2. Chemotherapy within 3 weeks of Cycle 1 Day 1.
    3. Prior anti-PD-1, anti-PD-L1, or anti-PD-L2 therapy.
    4. Active malignancies (ie, requiring treatment change in the last 24 months) other than urothelial cancer (except skin cancers within the last 24 months that are considered completely cured).
    5. Symptomatic central nervous system metastases.
    6. Prior FGFR inhibitor treatment.
    7. Radiation therapy </= 30 days prior to planned Cycle 1 Day 1.
    8. History of uncontrolled cardiovascular disease including:
    a. Unstable angina, myocardial infarction, ventricular fibrillation, Torsades de Pointes, cardiac arrest, or known congestive heart failure Class III-V within the preceding 3 months; cerebrovascular accident or transient ischemic attack within the preceding 3 months.
    b. Corrected QT interval (QTc) prolongation as confirmed by triplicate assessment at screening (QTc by Fridericia’s formula [QTcF]>480 milliseconds).
    c. Pulmonary embolism or other venous thromboembolism within the preceding 2 months.
    9. Known to be seropositive for human immunodeficiency virus or acquired immune deficiency syndrome.
    10. Any of the following:
    - Evidence of serious active viral, bacterial, or uncontrolled systemic fungal infection.
    - Active autoimmune disease or a documented history of autoimmune disease that requires systemic steroids or immunosuppressive agents
    - Grade 3 or higher toxicity effects from previous treatment with immunotherapy
    - Psychiatric conditions (eg, alcohol or drug abuse), dementia, or altered mental status.
    - Any other issue that would impair the ability of the subject to receive or tolerate the planned treatment at the investigational site, to understand informed consent or any condition for which, in the opinion of the investigator, participation would not be in the best interest of the subject (eg, compromise the well-being) or that could prevent, limit, or confound the protocol-specified assessments.
    11. Pulmonary compromise requiring supplemental oxygen use to maintain adequate oxygenation.
    12. Active or chronic hepatitis B or hepatitis C disease as determined by hepatitis B surface antigen (HBsAg), hepatitis B core antibody, or hepatitis C antibody (anti- HCV) positivity at screening. If positive, further testing of quantitative levels to rule out active infection is required.
    13. Not recovered from reversible toxicity of prior anticancer therapy (except toxicities which are not clinically significant such as alopecia, skin discoloration, or Grade 1 neuropathy).
    14. Impaired wound healing capacity defined as skin/decubitus ulcers, chronic leg ulcers, known gastric ulcers, or unhealed incisions.
    15. Allergies, hypersensitivity, or intolerance to erdafitinib or JNJ-63723283 or their excipients
    16. Corneal or retinal abnormality likely to increase risk of eye toxicity such as but not but not limited to:
    - History of or current evidence of central serous retinopathy (CSR) or retinal vein occlusion (RVO).
    - Active wet, age related macular degeneration.
    - Diabetic retinopathy with macular edema.
    - Uncontrolled glaucoma (as per local standard of care).
    - Corneal pathology such as keratitis, keratoconjunctivitis, keratopathy, corneal abrasion, inflammation or ulceration
    17. Use of oral or parenteral CYP3A4 inhibitors (ie, ketoconazole, clarithromycin).
    18. Has taken immunosuppressive doses of systemic medications, such as corticosteroids (doses >10 mg/day prednisone or equivalent), within 2 weeks before the planned first dose of study drug.
    19. Vaccinated with a live attenuated vaccine within 28 days prior to the first dose of study drug and for 3 months after receiving the last dose of study drug. Annual inactivated influenza vaccine is permitted.
    20. Pregnant or breast-feeding, or planning to become pregnant while enrolled in this study or within 5 months after receiving the last dose of study drug.
    21. Plans to father a child while enrolled in this study or within 5 months after receiving the last dose of study drug.
    22. Major surgery within 4 weeks of enrollment, or will not have adequately recovered from the toxicity and/or complications from the intervention prior to starting therapy, or has surgery planned during the time the subject is expected to participate in the study or within 2 weeks after the last dose of study drug administration. (Note: subjects with planned surgical procedures to be conducted under local anesthesia
    may participate.)
    1. Tratamiento con cualquier otro agente en investigación o participación en otro estudio clínico con intención curativa en el plazo de los 30 días anteriores al Ciclo 1 Día 1. Para la fase 1b, sujetos que hayan recibido anteriormente cualquiera de los siguientes tratamientos antineoplásicos:
    -Nitrosoureas o mitomicina C en el plazo de las 6 semanas anteriores
    2. Quimioterapia en el plazo de las 3 semanas anteriores al Ciclo 1 Día 1
    3. Tratamiento previo con anti-PD-1, anti-PD-L1 o anti-PD-L2
    4. Neoplasias malignas activas (esto, que haya precisado cambio de tratamiento en los 24 últimos meses) distintas del cáncer urotelial (excepto los tumores cutáneos en el plazo de los 24 últimos meses que se consideren completamente curados)
    5. Metástasis sintomáticas en sistema nervioso central
    6. Tratamiento previo con inhibidores del FGFR
    7. Radioterapia </= 30 días antes del Ciclo 1 Día 1 programado
    8. Antecedente de enfermedad cardiovascular no controlada, como:
    a. Angina inestable, infarto de miocardio, fibrilación ventricular, torsades de Pointes, parada cardiaca o insuficiencia cardíaca congestiva de Clase III-V en el plazo de los 3 meses anteriores; accidente cerebrovascular o ataque isquémico transitorio en el plazo de los 3 meses anteriores
    b. Prolongación del intervalo QT corregido (QTc), confirmado mediante su medición por triplicado (QTc con la fórmula de Fridericia [QTcF] >480 mseg) en la selección
    c. Embolismo pulmonar u otro tromboembolismo venoso en el plazo de los 2 meses anteriores
    9. Seropositividad del virus de inmunodeficiencia humana o síndrome de inmunodeficiencia adquirida
    10. Cualquiera de los siguientes:
    -Evidencia de infección vírica o bacteriana activas graves o de fúngica sistémica no controlada
    -Enfermedad autoinmunitaria activa o historia documentada de enfermedad autoinmunitaria que precisa corticosteroides sistémicos o agentes inmunosupresores
    -Toxicidad de Grado 3 o superior resultante de la inmunoterapia previa
    -Trastornos psiquiátricos (por ejemplo, alcoholismo o drogadicción), demencia o trastorno mental
    -Cualquier otro problema que pueda afectar a la capacidad del sujeto para recibir o tolerar el tratamiento previsto en el centro del estudio o para comprender el consentimiento informado, o cualquier proceso que, en opinión del Investigador, contraindique la participación del sujeto en el estudio
    11. Proceso pulmonar que requiera oxígenoterapia suplementaria para mantener una oxigenación adecuada
    12. Hepatitis B o C activas o crónicas en la selección, según evidencia por positividad del antígeno de superficie de la hepatitis B, el anticuerpo core de la hepatitis B o el anticuerpo de la hepatitis C. En caso de positividad, se precisa cuantificación ulterior de sus niveles para descartar una infección activa
    13. Ausencia de resolución de una toxicidad potencialmente reversible del tratamiento antineoplásico previo
    14. Afectación de la capacidad de cicatrización, lo que se define como úlceras cutáneas/de decúbito, úlceras crónicas en piernas, úlceras gástricas conocidas o incisiones no cicatrizadas
    15. Alergia, hipersensibilidad o intolerancia al erdafitinib o a JNJ-63723283 o a sus excipientes
    16. Anomalía corneal o retiniana que pueda aumentar el riesgo de toxicidad ocular, tal como, entre otras:
    -Antecedente de o evidencia actual de retinopatía serosa central o de oclusión venosa retiniana
    -Degeneración macular relacionada con la edad, húmeda y activa
    -Retinopatía diabética con edema macular
    -Glaucoma no controlado
    -Patología corneal, como queratitis, queratoconjuntivitis, queratopatía, abrasión, inflamación o ulceración corneales
    17. Uso de inhibidores de CYP3A4 orales o parenterales
    18. Recepción de dosis inmunosupresoras de medicamentos sistémicos, como corticosteroides (dosis >10 mg/día de prednisona o equivalente), en el plazo de las 2 semanas anteriores a la primera dosis programada del fármaco del estudio
    19. Recepción de una vacuna con gérmenes vivos atenuados en el plazo de los 28 días anteriores a la primera dosis del fármaco del estudio y en los 3 meses siguientes a la recepción de la última dosis del fármaco del estudio
    20. Embarazo o lactancia natural, o planificación de embarazo durante la participación en el estudio o en los 5 meses siguientes a la recepción de la última dosis del fármaco del estudio
    21. En el caso de los varones, planificación de engendrar un hijo durante la participación en el estudio o en los 5 meses siguientes a la recepción de la última dosis del fármaco del estudio
    22. Cirugía mayor en el plazo de las 4 semanas anteriores a la inclusión en el estudio o ausencia de recuperación adecuada de la toxicidad y/o las complicaciones de la intervención antes del comienzo del tratamiento, o planificación de cirugía durante el período que es previsible que el sujeto participe en el estudio o en el plazo de las 2 semanas siguientes a la última dosis del fármaco del estudio
    E.5 End points
    E.5.1Primary end point(s)
    Phase 1b (Dose Escalation)
    - Incidence of DLT
    - Incidence of AEs

    Phase 2
    - ORR (PR or better) per RECIST 1.1
    - Incidence of AEs
    Fase 1b (Escalamiento de dosis)
    - Incidencia de toxicidades limitantes de la dosis
    - Incidencia de acontecimientos adversos

    Fase 2
    - Tasa de respuesta global (overall response rate, ORR) (respuesta parcial [PR] o mejor) según los Response Evaluation Criteria in Solid Tumors (RECIST) 1.1
    - Incidencia de acontecimientos adversos
    E.5.1.1Timepoint(s) of evaluation of this end point
    Throughout the study
    Durante todo el estudio
    E.5.2Secondary end point(s)
    Phase 1b and 2
    - Plasma erdafitinib and serum JNJ-63723283 concentrations.
    - Population PK parameters and metrics of systemic exposure of erdafitinib and JNJ-63723283
    - Detection of antibodies to JNJ-63723283 and effects on serum JNJ-63723283 levels

    Phase 2
    - Incidence of AEs, SAEs and laboratory values
    - Duration of response (DoR)
    - Time to response (TTR)
    - Progression-free survival (PFS)
    - OS
    - ORR per immune-related RECIST (iRECIST) criteria
    Fase 1b y 2
    - Concentraciones de erdafitinib en plasma y JNJ-63723283 en suero.
    - Parámetros de farmacocinética de la población y métricas de exposición sistémica de erdafitinib y JNJ-63723283
    - Detección de anticuerpos contra JNJ-63723283 y efectos en niveles séricos del JNJ-63723283

    Fase 2
    - Incidencia de acontecimientos adversos, acontecimientos adversos graves y valores de laboratorio
    - Duración de la respuesta
    - Tiempo de respuesta
    - Supervivencia sin progression
    - Supervivencia global
    E.5.2.1Timepoint(s) of evaluation of this end point
    Throughout the study
    Durante todo el estudio
    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 Yes
    E.6.7Pharmacodynamic Yes
    E.6.8Bioequivalence No
    E.6.9Dose response Yes
    E.6.10Pharmacogenetic No
    E.6.11Pharmacogenomic No
    E.6.12Pharmacoeconomic No
    E.6.13Others Yes
    E.6.13.1Other scope of the trial description
    Immunogenicity
    Biomarker
    Exploratory
    Inmunogenicidad
    Biomarcador
    Exploratorio
    E.7Trial type and phase
    E.7.1Human pharmacology (Phase I) Yes
    E.7.1.1First administration to humans No
    E.7.1.2Bioequivalence study No
    E.7.1.3Other Yes
    E.7.1.3.1Other trial type description
    Phase 1b (Dose Escalation) and Phase 2 (Dose Expansion)
    Fase 1b (Escalamiento de dosis) y Fase 2 (Ampliación de dosis)
    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 Yes
    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 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 concerned3
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA66
    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
    Germany
    Israel
    Italy
    Korea, Republic of
    Russian Federation
    Spain
    United Kingdom
    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 is defined as the last study assessment for the last subject on study or anytime the sponsor terminates the study, whichever comes first.
    El final del estudio se define como la última evaluación del estudio para el último sujeto en estudio o en cualquier momento en que el promotor finaliza el estudio, lo que ocurra primero.
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years2
    E.8.9.1In the Member State concerned months2
    E.8.9.1In the Member State concerned days0
    E.8.9.2In all countries concerned by the trial years2
    E.8.9.2In all countries concerned by the trial months2
    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: 57
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 58
    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 state5
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 77
    F.4.2.2In the whole clinical trial 115
    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)
    If the treating physician strongly believes that continuation of study treatment is in the best interest of a subject for whom imaging-based progression (RECIST-defined disease progression) has been observed, the sponsor’s medical monitor should be consulted for possible continuation of treatment. This clinical judgment decision should be based on the subject’s overall clinical condition, including performance status, clinical symptoms, and laboratory data.
    Si el médico tratante cree firmemente que la continuación del tratamiento del estudio es lo mejor para un sujeto para el que se ha observado progresión basada en imágenes (progresión de enfermedad definida por RECIST), se debe consultar al monitor médico del promotor para la posible continuación del tratamiento. Esta decisión clínica debe basarse en la condición clínica general del sujeto, incluido el estado funcional, los síntomas clínicos y los resultados de laboratorio.
    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 Decision2018-04-25
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2018-04-10
    P. End of Trial
    P.End of Trial StatusOngoing
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