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    Summary
    EudraCT Number:2017-002566-50
    Sponsor's Protocol Code Number:8951-CL-0103
    National Competent Authority:Italy - Italian Medicines Agency
    Clinical Trial Type:EEA CTA
    Trial Status:Ongoing
    Date on which this record was first entered in the EudraCT database:2020-07-10
    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 ConcernedItaly - Italian Medicines Agency
    A.2EudraCT number2017-002566-50
    A.3Full title of the trial
    A Phase 2 Study of Zolbetuximab (IMAB362) as Monotherapy or in Combination with mFOLFOX6 in Subjects with Metastatic or Locally Advanced Unresectable Gastric or Gastroesophageal Junction (GEJ) Adenocarcinoma whose Tumors have High or Intermediate Claudin (CLDN) 18.2 Expression
    Studio di Fase 2 su Zolbetuximab (IMAB362) in Monoterapia o in Associazione con mFOLFOX6 in Soggetti con Adenocarcinoma Gastrico o della Giunzione Gastroesofagea (GGE) Metastatico o Localmente Avanzato Non Operabile con un livello di Espressione Alto o Intermedio del Gene Claudin (CLDN) 18.2
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    A Phase 2 Study of Zolbetuximab (IMAB362) as Monotherapy or in Combination with mFOLFOX6 in Subjects with Metastatic or Locally Advanced Unresectable Gastric or Gastroesophageal Junction (GEJ) Adenocarcinoma whose Tumors have High or Intermediate Claudin (CLDN) 18.2 Expression
    Studio di Fase 2 su Zolbetuximab (IMAB362) in Monoterapia o in Associazione con mFOLFOX6 in Soggetti con Adenocarcinoma Gastrico o della Giunzione Gastroesofagea (GGE) Metastatico o Localmente Avanzato Non Operabile con un livello di Espressione Alto o Intermedio del Gene Claudin (CLDN) 18.2
    A.3.2Name or abbreviated title of the trial where available
    ILUSTRO
    ILUSTRO
    A.4.1Sponsor's protocol code number8951-CL-0103
    A.5.4Other Identifiers
    Name:INDNumber:129598
    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 SponsorASTELLAS PHARMA GLOBAL DEVELOPMENT, INC.
    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 supportAstellas Pharma Global Development, Inc. (APGD)
    B.4.2CountryUnited States
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationAstellas Pharma Europe B.V.
    B.5.2Functional name of contact pointService Desk - Global Clinical Dev.
    B.5.3 Address:
    B.5.3.1Street AddressSylviusweg 62
    B.5.3.2Town/ cityLeiden
    B.5.3.3Post code2333 BE
    B.5.3.4CountryNetherlands
    B.5.4Telephone number0031715455878
    B.5.5Fax number0031715455224
    B.5.6E-mailcontact@nl.astellas.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 Yes
    D.2.5.1Orphan drug designation numberEU/3/10/803
    D.3 Description of the IMP
    D.3.1Product nameZolbetuximab
    D.3.2Product code IMAB362
    D.3.4Pharmaceutical form Powder 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 INNZolbetuximab
    D.3.9.1CAS number 1496553-00-4
    D.3.9.2Current sponsor codeIMAB362
    D.3.9.3Other descriptive namemonoclonal IgG antibody
    D.3.9.4EV Substance CodeSUB190351
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number20
    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
    Metastatic or Locally Advanced Unresectable Gastric or Gastroesophageal Junction (GEJ) Adenocarcinoma
    Adenocarcinoma Gastrico o della Giunzione Gastroesofagea (GGE) Metastatico o Localmente Avanzato Non Operabile
    E.1.1.1Medical condition in easily understood language
    advanced cancer of the stomach or the gastroesophageal junction
    Cancro avanzato dello stamaco o della giunzione gastroesofagea
    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 LLT
    E.1.2Classification code 10066354
    E.1.2Term Adenocarcinoma of the gastroesophageal junction
    E.1.2System Organ Class 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 21.1
    E.1.2Level LLT
    E.1.2Classification code 10071114
    E.1.2Term Metastatic gastric adenocarcinoma
    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 10001150
    E.1.2Term Adenocarcinoma gastric
    E.1.2System Organ Class 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    E.1.3Condition being studied is a rare disease Yes
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    To determine the objective response rate (ORR) of Zolbetuximab as a single agent as assessed by an independent central reader
    Determinare il tasso di risposta obiettiva (ORR) di Zolbetuximab come agente singolo valutato da un lettore centrale indipendente
    E.2.2Secondary objectives of the trial
    - To evaluate pharmacokinetics of Zolbetuximab, oxaliplatin and fluorouracil (5-FU)
    - To assess the safety and tolerability of Zolbetuximab as a single agent and in combination with 5-fluorouracil, leucovorin and oxaliplatin (mFOLFOX6)
    - To assess the effects of Zolbetuximab and mFOLFOX6 on Claudin (CLDN) 18.2 expression
    - To assess the immunomodulatory effects of Zolbetuximab as a single agent and in combination with mFOLFOX6
    - To assess the immunogenicity of Zolbetuximab
    - To evaluate health-related quality of life (HRQoL)
    - To evaluate disease control rate (DCR), duration of response (DOR), progression free survival (PFS) and overall survival (OS) of Zolbetuximab as a single agent
    - To assess ORR and PFS of Zolbetuximab in combination with mFOLFOX6
    - Valutare la farmacocinetica di Zolbetuximab, oxaliplatino e fluorouracile (5-FU)
    - Valutare la sicurezza e la tollerabilità di Zolbetuximab come agente singolo e in associazione con 5 fluorouracile, leucovorina e oxaliplatino (mFOLFOX6)
    - Valutare gli effetti di Zolbetuximab e mFOLFOX6 sull¿espressione del gene della claudina (CLDN) 18.2
    - Valutare gli effetti immunomodulatori di Zolbetuximab come agente singolo e in associazione con mFOLFOX6
    - Valutare l'immunogenicità di Zolbetuximab
    - Valutare la qualità della vita correlata alla salute (HRQoL)
    - Valutare il tasso di controllo della malattia (DCR), la durata della risposta (DOR), la sopravvivenza libera da progressione (PFS) e la sopravvivenza complessiva (OS) di Zolbetuximab come agente singolo
    - Valutare l'ORR e la PFS di Zolbetuximab in associazione con mFOLFOX6
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1. Institutional Review Board (IRB)/Independent Ethics Committee (IEC) approved written informed consent and privacy language as per national regulations must be obtained from the subject or legally authorized representative prior to any study-related procedures (including withdrawal of prohibited medication, if applicable).
    2. Subject is considered an adult according to local regulation at the time of signing informed consent.
    3. Female subject is eligible to participate if she is not pregnant [See Appendix 12.6 Contraception Requirements] and at least one of the following conditions applies:
    a. Not a woman of child-bearing potential (WOCBP) as defined in Appendix 12.6 Contraception Requirements
    OR
    b. WOCBP who agrees to follow the contraceptive guidance as defined in Appendix 12.6 Contraception Requirements throughout the treatment period and for at least 6 months after the final study drug administration.
    4. Female subject must agree not to breastfeed starting at screening and throughout the study period, and for 6 months after the final study drug administration.
    5. Female subject must agree not to donate ova starting at screening and throughout the study period, and for 6 months after the final study drug administration.
    6. A sexually active male subject with a female partner(s) who is of child-bearing potential must agree to use contraception as detailed in Appendix 12.6 Contraception Requirements during the treatment period and for at least 6 months after the final study drug administration.
    7. Male subject must agree not to donate sperm starting at screening and throughout the study period, and for 6 months after the final study drug administration.
    8. Male subject with a pregnant or breastfeeding partner(s) must agree to remain abstinent or use a condom for the duration of the pregnancy or time partner is
    breastfeeding throughout the study period and for 6 months after the final study drug administration.
    9. Subject has histologically confirmed gastric or GEJ adenocarcinoma.
    10.Subject has radiographically-confirmed, locally advanced, unresectable or metastatic disease within 28 days prior to the first dose of study treatment.
    11.Subject has measurable disease according to RECIST 1.1 within 28 days prior to the first dose of study treatment. For subjects with only 1 measurable lesion and prior
    radiotherapy, the lesion must be outside the field of prior radiotherapy or must have documented progression following radiation therapy.
    12.Subject's tumor sample has CLDN18.2 expression (defined as moderate to strong membranous
    staining by central IHC testing) as follows:
    Cohorts 1A and 2: CLDN18.2 high expression (= 75% of tumor cells)
    Cohorts 1B: CLDN18.2 high or intermediate expression (= 50% of tumor cells)
    13.Cohorts 1A and 1B Only: Subject has disease progression on or after at least 2 prior regimens for their advanced disease, including fluoropyrimidine and platinum-containing chemotherapy, and if appropriate, HER2/neu-targeted therapy.
    14.Cohort 2 Only:
    Subject has not received prior systemic anti-cancer therapy for their advanced disease (subject may have received neoadjuvant and/or fluorouracil-containing adjuvant chemotherapy as long as it has been completed = 6 months before the first dose of study treatment).
    Subject has a gastric or GEJ tumor that is HER2-negative as determined by local or central testing.
    15.Cohorts 1A and 2: Subject must have an additional available tumor specimen collected within 3 months prior to the first dose of study
    treatment. Subject is an appropriate candidate for a tumor biopsy and is amenable to undergo a tumor biopsy during the screening period (if applicable)
    and treatment period as indicated in the Schedule of Assessments.
    16.Subject agrees not to participate in another interventional study while on treatment.
    17.Subject has ECOG performance status 0 to 1.
    18.Subject has predicted life expectancy = 12 weeks in the opinion of the investigator.
    19....
    (see the protocol for details).
    1. Il soggetto o il rappresentante legalmente autorizzato deve fornire il modulo di consenso informato scritto e l’informativa sulla privacy, approvati dal comitato etico indipendente (CEI) secondo le normative nazionali (per es., l’autorizzazione ai sensi della legge sulla portabilità e responsabilità dell’assicurazione sanitaria [HIPAA] per i centri negli Stati Uniti), prima di qualsiasi procedura correlata allo studio (incluso il ritiro di farmaci vietati, se applicabile).
    2. Il soggetto è considerato un adulto secondo le normative locali al momento della firma del modulo di consenso informato.
    3. Il soggetto di sesso femminile è idoneo a partecipare se non è in stato di gravidanza [vedere Appendice 12.6 Requisiti per la contraccezione] e soddisfa almeno una delle seguenti condizioni:
    a. non è una donna in età fertile (WOCBP) come definito nell’Appendice 12.6 Requisiti per la contraccezione, OPPURE
    b. è una WOCBP che acconsente a seguire le linee guida definite nell’Appendice 12.6 Requisiti per la contraccezione per tutto il periodo di trattamento e per almeno 6 mesi dopo la somministrazione finale del farmaco sperimentale.
    4. Il soggetto di sesso femminile deve acconsentire a non allattare al seno a partire dallo screening, per tutta la durata dello studio e per 6 mesi dopo la somministrazione finale del farmaco sperimentale.
    5. Il soggetto di sesso femminile deve acconsentire a non donare ovuli a partire dallo screening, per tutta la durata dello studio e per 6 mesi dopo la somministrazione finale del farmaco sperimentale.
    6. Un soggetto di sesso maschile sessualmente attivo con una o più compagne in età fertile deve acconsentire a usare metodi contraccettivi tra quelli indicati nell’Appendice 12.6 Requisiti per la contraccezione durante il periodo di trattamento e per almeno 6 mesi dopo la somministrazione finale del farmaco sperimentale.
    7. Il soggetto di sesso maschile deve acconsentire a non donare sperma a partire dallo screening, per tutta la durata del periodo dello studio e per almeno 6 mesi dopo la somministrazione finale del farmaco sperimentale.
    8. Il soggetto di sesso maschile con compagna/e in stato di gravidanza o in fase di allattamento al seno deve accettare di mantenere l’astinenza o usare il preservativo durante tutto il periodo della gravidanza o dell’allattamento, per l’intero periodo dello studio e per 6 mesi dopo la somministrazione finale del farmaco sperimentale.
    9. Il soggetto presenta un adenocarcinoma gastrico o GGE istologicamente confermato.
    10. Il soggetto presenta malattia metastatica o localmente avanzata non operabile radiologicamente confermata entro i 28 giorni precedenti alla prima dose di trattamento dello studio.
    11. Il soggetto presenta malattia misurabile in base ai criteri RECIST 1.1 entro i 28 giorni precedenti alla prima dose di trattamento dello studio. Per i soggetti con solo 1 lesione misurabile e radioterapia precedente, la lesione deve essere al di fuori del campo della radioterapia precedente oppure deve presentare progressione documentata dopo la radioterapia.
    12. Il campione tumorale del soggetto presenta l’espressione di CLDN18.2 (definita come colorazione membranosa da moderata a forte in base ai test IIC centrali), nel modo seguente:
    • Coorti 1A e 2: Livello di espressione alta di CLDN18.2 (= 75% di cellule tumorali)
    • Coorte 1B: Livello di espressione alta o intermedia di CLDN18.2 (= 50% di cellule tumorali)
    13. Solo coorti 1A e 1B:
    • Il soggetto presenta progressione della malattia durante o dopo almeno 2 regimi precedenti per la malattia avanzata, compresa chemioterapia contenente fluoropirimidina e platino e, se appropriato, terapia mirata a HER2/neu.
    14. ...
    (Si prega di far riferimento al protocollo per maggiori dettagli)
    E.4Principal exclusion criteria
    1. Subject has had prior severe allergic reaction or intolerance to known ingredients of zolbetuximab or other monoclonal antibodies, including humanized or chimeric antibodies.
    2. Subject has known immediate or delayed hypersensitivity or contraindication to any component of study treatment.
    3. Subject has received other investigational agents or devices concurrently or within 28 days prior to first dose of study treatment.
    4. Subject has received systemic immunosuppressive therapy, including systemic corticosteroids 14 days prior to first dose of study treatment. Subjects using a
    physiologic replacement dose of hydrocortisone or its equivalent (defined as up to 30 mg per day of hydrocortisone or up to 10 mg per day of prednisone) or a single dose of systemic corticosteroids are allowed.
    5. Subject has gastric outlet syndrome or persistent recurrent vomiting.
    6. Subject with recent gastric bleeding or symptomatic subjects with proven gastric ulcers that would preclude the subject from participation per investigator judgment.
    7. Subject has known active central nervous system metastases and/or carcinomatous meningitis.
    8. Subject has a known history of a positive test for human immunodeficiency virus (HIV) infection or known active hepatitis B (positive hepatitis B surface antigen
    [HBsAg]) or hepatitis C infection. Subjects who are negative for HBsAg, but hepatitis B core antibody positive, will have a hepatitis B DNA test performed and if positive will be excluded. Subjects with positive serology, but negative hepatitis C virus RNA test results, are eligible.
    9. Subject has had within 6 months prior to first dose of study treatment any of the following:
    unstable angina, myocardial infarction, ventricular arrhythmia requiring intervention or hospitalization for heart failure.
    10. Subject has active infection requiring systemic therapy.
    11. Subject has active autoimmune disease that has required systemic treatment in the past 2 years.
    12. Subject has a clinically significant disease or co-morbidity that in the opinion of the investigator may adversely affect the safe delivery of treatment within this study or
    make the subject unsuitable for study participation. Subject has psychiatric illness or social situations that would preclude study compliance per investigator's judgment.
    13. Subject has psychiatric illness or social situations that would preclude study compliance per investigator's judgment.
    14. Subject has had a major surgical procedure = 28 days before start of study treatment.
    a. Subject without complete recovery from a major surgical procedure = 14 days before start of study treatment.
    15. Subject has had radiotherapy = 14 days (Cohort 1) and = 28 days (Cohort 2) prior to start of study treatment. Subject who received palliative radiotherapy to peripheral
    bone metastases = 14 days prior to start of study treatment and has recovered from all acute toxicities is allowed.
    16. Subject has another past or active malignancy, which is likely to require treatment per investigator's clinical judgment.
    17. Cohort 2 Only, subject has any of the following:
    - Prior severe allergic reaction or intolerance to any component of mFOLFOX6 chemotherapeutics in this study.
    - Known dihydropyrimidine dehydrogenase deficiency (DPD) (screening for DPD deficiency should be conducted per local requirements).
    - Known peripheral neuropathy > Grade 1 (absence of deep tendon reflexes as the sole neurological abnormality does not render the subject ineligible).
    - Sinusoidal obstruction syndrome, formerly known as veno-occlusive disease, if present, should be stable or improving per investigator's judgment.
    - History of clinically significant ventricular arrhythmias (i.e., sustained ventricular tachycardia, ventricular fibrillation, or Torsades de Pointes).
    - QTc interval > 450 msec for male subjects; QTc interval > 470 msec for female subjects.
    - History or family history of congenital long QT syndrome.
    - ...

    (see the protocol for details).
    1. Il soggetto ha avuto una precedente reazione allergica grave o intolleranza a ingredienti noti di zolbetuximab o altri anticorpi monoclonali, compresi gli anticorpi umanizzati o chimerici.
    2. Il soggetto ha ipersensibilità immediata o ritardata nota o una controindicazione a qualsiasi componente del trattamento dello studio.
    3. Il soggetto ha ricevuto altri agenti o dispositivi sperimentali allo stesso tempo oppure entro i 28 giorni precedenti alla prima dose del trattamento dello studio.
    4. Il soggetto ha ricevuto terapia immunosoppressiva sistemica, compresi i corticosteroidi sistemici, nei 14 giorni precedenti alla prima dose del trattamento dello studio. I soggetti che utilizzano una dose fisiologica sostitutiva di idrocortisone o equivalente (definita come fino a 30 mg al giorno di idrocortisone o fino a 10 mg al giorno di prednisone) oppure una dose singola di corticosteroidi sistemici sono ammessi.
    5. Il soggetto presenta sindrome dello sbocco gastrico o vomito ricorrente persistente.
    6. Soggetti con sanguinamento gastrico recente o soggetti sintomatici con ulcere gastriche comprovate che impedirebbero la partecipazione in base al giudizio dello sperimentatore.
    7. Il soggetto presenta metastasi del sistema nervoso centrale attiva nota e/o meningite carcinomatosa.
    8. Il soggetto ha un’anamnesi nota di test positivo al virus dell’immunodeficienza umana (HIV) o infezione da epatite B (antigene di superficie dell’epatite B [HBsAg] positivo) o da epatite C attiva nota. I soggetti negativi all’HBsAg ma positivi all’anticorpo anti-core dell’epatite B dovranno sottoporsi a test del DNA dell’epatite B e, se positivi, saranno esclusi. I soggetti con sierologia positiva ma con risultati negativi del test dell’RNA dell’epatite C sono idonei.
    9. Il soggetto ha avuto, entro i 6 mesi precedenti alla prima dose di trattamento dello studio: angina instabile, infarto miocardico, aritmia ventricolare richiedente intervento o ricovero per insufficienza cardiaca.
    10. Il soggetto ha infezione attiva richiedente terapia sistemica.
    11. Il soggetto presenta una malattia autoimmune attiva che ha richiesto trattamento sistemico negli ultimi 2 anni.
    12. Il soggetto presenta una malattia o una comorbilità clinicamente significativa che, nell’opinione dello sperimentatore, può influenzare negativamente la somministrazione sicura del trattamento all’interno di questo studio oppure rendere il soggetto inadatto alla partecipazione allo studio. Il soggetto presenta malattia psichiatrica o situazioni sociali che impedirebbero la conformità allo studio a giudizio dello sperimentatore.
    13. Il soggetto presenta malattia psichiatrica o situazioni sociali che impedirebbero la conformità allo studio a giudizio dello sperimentatore.
    14. Il soggetto si è sottoposto a una procedura chirurgica maggiore ¿28 giorni prima dell’inizio del trattamento dello studio.
    a. Il soggetto non mostra guarigione completa da una procedura chirurgica maggiore ¿14 giorni precedenti all’inizio del trattamento dello studio.
    15. Il soggetto si è sottoposto a radioterapia ¿14 giorni (Coorte 1) e ¿28 giorni (Coorte 2) prima dell’inizio del trattamento dello studio. Il soggetto che ha ricevuto radioterapia palliativa per le metastasi ossee periferiche ¿14 giorni prima dell’inizio del trattamento dello studio e si è ripreso da tutte le tossicità acute è ammesso.
    1. Il soggetto presenta un’altra malignità precedente o attiva probabilmente richiedente trattamento secondo il giudizio clinico dello sperimentatore.
    16. Solo per la Coorte 2, il soggetto presenta una qualsiasi tra le seguenti condizioni:
    • Precedente reazione allergica o intolleranza grave a qualsiasi componente dei chemioterapici mFOLFOX6 in questo studio.
    • Nota carenza di diidropirimidina deidrogenasi (DPD) (lo screening per la carenza di DPD deve essere condotto conformemente ai requisiti locali).
    • ...

    (Si prega di far riferimento al protocollo per maggiori dettagli)
    E.5 End points
    E.5.1Primary end point(s)
    ORR of Zolbetuximab as a single agent by independent review
    ORR di Zolbetuximab come agente singolo in base a revisione indipendente
    E.5.1.1Timepoint(s) of evaluation of this end point
    The primary analysis will occur once all subjects have progressed, died, discontinued form the study or provided at least 1 post-baseline disease assessment, whichever occurs first.
    L’analisi primaria verrà effettuata quando tutti i soggetti hanno mostrato progressione, sono deceduti, hanno interrotto lo studio o hanno fornito almeno 1 valutazione della malattia post-basale, a seconda di quale evento si verifichi per primo.
    E.5.2Secondary end point(s)
    - Pharmacokinetics of Zolbetuximab (Cohorts 1 and 2), oxaliplatin (Cohort 2) and 5-FU (Cohort 2) (AUCinf, AUCinf [%extrap], AUClast, AUCtau,, Cmax, Ctrough, tmax, t1/2, tlast, CL, Vz, as appropriate)
    - Safety and tolerability of single agent Zolbetuximab and in combination with mFOLFOX6 evaluated by AEs, ECG, vital signs, ECOG performance status and laboratory assessments (CTCAE version 4.03
    - Changes in tumor expression of CLDN18.2
    - Changes in immune-related biomarkers in tumor tissue and blood samples
    - Immunogenicity of Zolbetuximab as measured by the frequency of anti-drug antibody (ADA) positive subjects
    - HRQoL measured by the QLQ-C30, OG-25, GP, EuroQOL Five Dimensions Questionnaire (EQ-5D) and the HRU questionnaires
    - DCR, DOR, PFS and OS of Zolbetuximab as a single agent by independent review
    - ORR and PFS of Zolbetuximab in combination with mFOLFOX6 by independent review
    - Farmacocinetica di Zolbetuximab (Coorti 1 e 2), oxaliplatino (Coorte 2) e 5-FU (Coorte 2) (AUCinf, AUCinf [% estrap], AUClast, AUCtau, Cmax, Ctrough, tmax, t1/2, tlast, CL, Vz, ove opportuno)
    - Sicurezza e tollerabilità di Zolbetuximab come agente singolo e in associazione con mFOLFOX6 valutate in base ad AE, ECG, segni vitali, stato di validità ECOG e valutazioni di laboratorio (CTCAE versione 4.03)
    - Variazioni nell¿espressione tumorale di CLDN18.2
    - Variazioni nei biomarcatori immuno-correlati nei campioni di tessuto tumorale e di sangue
    - Immunogenicità di Zolbetuximab misurata dalla frequenza dei soggetti positivi agli anticorpi anti-farmaco (ADA)
    - HRQoL misurata dai questionari QLQ-C30, OG-25, GP, Questionario EuroQOL a cinque dimensioni (EQ-5D) e Questionario sull'utilizzo delle risorse sanitarie (HRU)
    - DCR, DOR, PFS e OS di Zolbetuximab come agente singolo in base a revisione indipendente
    - ORR e PFS di Zolbetuximab in associazione con mFOLFOX6 in base a revisione indipendente
    E.5.2.1Timepoint(s) of evaluation of this end point
    Secondary endpoints will be analyzed at the time of the primary analysis (once all subjects have progressed, died, discontinued form the study or provided at least 1 post-baseline disease assessment, whichever occurs first).
    L¿analisi secondaria verr¿ effettuata al momento dell'analisi primaria (quando tutti i soggetti hanno mostrato progressione, sono deceduti, hanno interrotto lo studio o hanno fornito almeno 1 valutazione della malattia post-basale, 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 Yes
    E.6.4Safety Yes
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic Yes
    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 Yes
    E.6.13.1Other scope of the trial description
    Biomarkers
    Biomarcatori
    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) 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 No
    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 EEA7
    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
    France
    Italy
    Korea, Republic of
    Taiwan
    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 study in all participating countries is defined as the last subject¿s last visit, or last contact.
    LVLS oppure ultimo contatto
    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 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: 41
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 61
    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 state20
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 31
    F.4.2.2In the whole clinical trial 102
    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)
    After the end of participation in the trial, patients will receive treatment according to current local medical practice.
    Dopo la fine della partecipazione allo studio i pazienti riceveranno un trattamento in accordo alla pratica locale corrente
    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 Decision2018-05-24
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2018-03-21
    P. End of Trial
    P.End of Trial StatusOngoing
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