E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Glioblastoma |
Glioblastoma |
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E.1.1.1 | Medical condition in easily understood language |
Most aggressive and most common primary brain tumor |
el más agresivo y común de los cánceres primaries del cerebro |
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E.1.1.2 | Therapeutic area | Diseases [C] - Cancer [C04] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.0 |
E.1.2 | Level | SOC |
E.1.2 | Classification code | 10029104 |
E.1.2 | Term | Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
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E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.0 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10018336 |
E.1.2 | Term | Glioblastoma |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
The primary objective of this study is to compare overall survival in patients receiving Marizomib in combination with standard treatment with patients receiving standard treatment only. |
El objetivo principal de este estudio es comparar la supervivencia global en pacientes que reciben Marizomib en combinación con el tratamiento estándar con pacientes que reciben sólo el tratamiento estándar. |
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E.2.2 | Secondary objectives of the trial |
Secondary objective is to compare PFS in the two treatment arms in the whole population. |
El objetivo secundario es comparar la supervivencia sin progresión (SSP) en los dos grupos de tratamiento en la población total. |
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E.2.3 | Trial contains a sub-study | Yes |
E.2.3.1 | Full title, date and version of each sub-study and their related objectives |
Neurocognitive testing, imaging. |
Pruebas neurocognitivas, imágenes. |
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E.3 | Principal inclusion criteria |
- Histologically confirmed newly diagnosed glioblastoma (WHO grade IV) - Tumor resection (gross total or partial), or biopsy only - Availability of FFPE tumor block or 24 unstained slides for MGMT analysis - Patient must be eligible for standard TMZ/RTTMZ - Karnofsky performance score (KPS) ≥ 70 (Appendix E) - Recovered from effects of surgery, postoperative infection and other complications of surgery (if any) - The patient is at least 18 years of age on day of signing informed consent - Stable or decreasing dose of steroids for at least 1 week prior to inclusion - The patient has a life expectancy of at least 3 months - Patient has undergone a brain MRI within 14 days of randomization but after intervention (resection or biopsy) - The patient shows adequate organ functions as assessed by the specified laboratory values within 2 weeks prior to randomization defined as adequate bone marrow, renal and hepatic function - Women of child bearing potential (WOCBP) must have a negative urine or serum pregnancy test within 7 days prior to the first dose of study treatment. - Patients of childbearing / reproductive potential must agree to use adequate birth control measures, as defined by the investigator, during the study treatment period and for at least 6 months after the last study treatment. A highly effective method of birth control is defined as those which result in low failure rate (i.e. less than 1% per year) when used consistently and correctly. Patients must also agree not to donate sperm during the study and for 6 months after receiving the last dose of study treatment. - Women who are breast feeding must agree to discontinue nursing prior to the first dose of study treatment and until 6 months after the last study treatment. - Ability to take oral medication - Ability to understand the requirements of the study, provide written informed consent and authorization of use and disclosure of protected health information, and agree to abide by the study restrictions and return for the required assessments. - Before patient registration/randomization, written informed consent must be given according to ICH/GCP, and national/local regulations. |
• Glioblastoma de nuevo diagnóstico histológicamente confirmado (grado IV de la OMS) • Resección tumoral (macroscópica total o parcial) o solamente biopsia • Disponibilidad de bloque tumoral en FFPE o 24 frotis sin teñir para el análisis de MGMT • El paciente debe ser apto para el tratamiento de referencia TMZ/RTTMZ • Puntuación del estado funcional de Karnofsky (PFK) ≥70 • Recuperación de los efectos de la cirugía, infección posoperatoria y otras complicaciones quirúrgicas (si las hubiera) • El paciente tiene al menos 18 años de edad el día de la firma del consentimiento informado • Dosis estable o decreciente de corticoesteroides durante al menos 1 semana antes de la inclusión • El paciente tiene una esperanza de vida de al menos 3 meses • El paciente se ha sometido a una RMN cerebral en los 14 días anteriores a la aleatorización y después de la intervención (resección o biopsia) • El paciente muestra funciones orgánicas adecuadas según la evaluación de los valores analíticos especificados en las 2 semanas anteriores a la aleatorización, definidos como una función adecuada de la médula ósea, renal y hepática dentro de los siguientes intervalos: • LEU ≥3×109/l • RAN ≥1,5×109/l • Recuento de plaquetas ≥100×109/l con independencia de que se reciba transfusión • Hemoglobina ≥10 g/dl • Bilirrubina total ≤1,5 LSN • ALT, AST, fosfatasa alcalina (FA) ≤2,5 × LSN • Creatinina sérica <1,5 x LSN o aclaramiento de creatinina (CrCl) >30 ml/min (usando la fórmula de Cockcroft-Gault) • Las mujeres en edad fértil (MEF) deben tener una prueba de embarazo en orina o suero negativa dentro de los 7 días previos a la primera dosis del tratamiento del estudio. • Las pacientes en edad fértil/con capacidad para concebir deben acceder a utilizar métodos anticonceptivos adecuados, de acuerdo con lo definido por el investigador, durante el periodo de tratamiento del estudio y durante al menos 6 meses tras la última dosis del tratamiento del estudio. Un método de regulación de la natalidad altamente eficaz se define como aquel que tiene una baja tasa de fallo (es decir, inferior al 1 % anual) cuando se usa de manera sistemática y correcta. Los pacientes deben aceptar además no donar esperma durante el estudio y durante los 6 meses posterioresde haber recibido la última dosis del tratamiento del estudio. • Las mujeres que estén en periodo de lactancia, deben acceder a interrumpirlo antes de la primera dosis del tratamiento del estudio y hasta 6 meses después del último tratamiento del estudio. • Capacidad para tomar medicamentos orales • Capacidad para comprender los requisitos del estudio, proporcionar el consentimiento informado por escrito y la autorización para el uso y divulgación de información de salud protegida y acceder a cumplir las restricciones del estudio y acudir a las evaluaciones requeridas. • Antes del registro/la aleatorización del paciente, se debe dar el consentimiento informado por escrito conforme a las ICH/BPC y a los reglamentos nacionales/locales. |
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E.4 | Principal exclusion criteria |
- Patients with known IDH mutation (IDH mutation testing should be considered for younger patients or patients with tumors with atypical features) - Prior treatment for glioblastoma other than surgery; prior RT to brain and/or prior chemotherapy for lower grade glioma. Placement of BCNU wafer during surgery is not allowed - Planned additional treatment with Tumor-Treating Fields - Known hypersensitivity to the active substance or any of the excipients in the IV formulation - History of thrombotic or hemorrhagic stroke or myocardial infarction in past 6 months - Congestive heart failure (New York Heart Association Class III to IV, see Appendix C), symptomatic ischemia, conduction abnormalities uncontrolled by conventional intervention, and myocardial infarction within 6 months prior to first dose - Concurrent severe or uncontrolled medical disease (e.g., active systemic infection, diabetes, hypertension, coronary artery disease, psychiatric disorder) that, in the opinion of the investigator, would compromise the safety of the patient or compromise the ability of the patient to complete the study - Known history or current evidence of active Hepatitis B (e.g., positive HBV surface antigen) or C (e.g., HCV RNA [qualitative] is detected) - Known or current evidence of Human Immunodeficiency Virus (HIV) (positive HIV-1/2 antibodies) - Prior or second invasive malignancy, except non-melanoma skin cancer, completely resected cervical or prostate cancer (with PSA of less than or equal to 0.1 ng/ml). Other cancers for which the subject has completed potentially curative treatment more than 3 years prior to study entry are allowed. - Presence of any psychological, familial, sociological or geographical condition potentially hampering compliance with the study protocol and follow-up schedule; those conditions should be discussed with the patient before registration in the trial |
• Pacientes con mutación de IDH conocida (la prueba de mutación de IDH debería considerarse en pacientes jóvenes o con tumores con características atípicas) • Tratamiento previo para el glioblastoma diferente de la cirugía; RT previa al cerebro y/o quimioterapia previa para glioma de bajo grado. No se permite la colocación de implantes de BCNU durante la cirugía • Tratamiento adicional programado con terapia de campo de tumores (Tumor-Treating Fields) • Hipersensibilidad conocida al principio activo o a cualquiera de los excipientes de la formulación i.v. • Antecedentes de accidente cerebrovascular trombótico o hemorrágico o infarto de miocardio en los últimos 6 meses • Insuficiencia cardíaca congestiva (clase III a IV de la New York Heart Association), isquemia sintomática, anomalías de la conducción no controladas mediante intervención convencional e infarto de miocardio en los 6 meses anteriores a la primera dosis • Enfermedad médica concurrente grave o no controlada (p. ej., infección sistémica activa, diabetes, hipertensión, arteriopatía coronaria, trastorno psiquiátrico) que, a criterio del investigador, comprometería la seguridad del paciente o su capacidad para completar el estudio • Historial conocido o evidencia actual de hepatitis B (p. ej., antígeno de superficie de VHB positivo) o C (p. ej., ARN del VHC [cualitativo] detectado) activa • Infección conocida o evidente por el virus de la inmunodeficiencia humana (VIH) (anticuerpos frente a VIH-1/2) • Neoplasia maligna invasiva previa o segunda neoplasia maligna invasiva, excepto cáncer de piel no melanoma, cáncer de cuello de útero o próstata (con PSA inferior o igual a 0,1 ng/ml) completamente extirpado. Se permite cualquierotro cáncer para el que el paciente haya recibido tratamiento potencialmente curativo más de 3 años antes de entrar en el estudio. • Presencia de cualquier afección psicológica, familiar, sociológica o geográfica que pudiera potencialmente afectar al cumplimiento del protocolo del estudio y el calendario de seguimiento; estas afecciones deben comentarse con el paciente antes de llevar a cabo el registro en el ensayo. |
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E.5 End points |
E.5.1 | Primary end point(s) |
Primary endpoint is Overall Survival |
El criterio de valorisación principal es la supervivencia general |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
From the date of randomization up to the date of death, assessed up to 49 months |
Desde la fecha de aleatorización hasta la fecha de fallecimiento, evaluada hasta 49 meses |
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E.5.2 | Secondary end point(s) |
Secondary endpoints are: 1. Progression free survival 2. Quality of Life (modified EORTC QLQ C30/BN20) 3. Mini Mental State Examination (MMSE) 4. Frequencies and percentages of worst Adverse Events (AEs) or Laboratory Event grades |
Los criterios de valorisación secundaria incluyen: 1. Supervivencia libre de progression 2. Calidad de vida (EORTC QLQ C30/BN20) 3. MMSE 4. Frecuencias y porcentajes de los peores eventos adversos (EA) o grados de eventos de laboratorio |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
1. From the date of randomization until the date of first objective progression or the date of patient's death whichever occurs first, assessed up to 49 months. 2. From randomization until progression, assessed up to 49 months. 3. From the date of randomization until end of treatment, assessed up to 49 months 4. From the date of randomization until end of treatment, assessed up to 49 months |
1. Desde la fecha de aleatorización hasta la fecha de la primera progresión objetiva o la fecha de fallecimiento del paciente, lo que ocurra primero, evaluado hasta 49 meses. 2. Desde la aleatorización hasta la progresión, evaluada hasta 49 meses. 3. Desde la fecha de aleatorización hasta el final del tratamiento, evaluado hasta 49 meses 4. Desde la fecha de aleatorización hasta el final del tratamiento, evaluado hasta 49 meses |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | No |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | Yes |
E.6.13.1 | Other scope of the trial description |
Surgery, Radiotherapy, Biobanking, QoL, Translational Research |
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E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | Yes |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | No |
E.8.1.5 | Parallel group | No |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | Yes |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 2 |
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.8.4.1 | Number of sites anticipated in Member State concerned | 3 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 50 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
Austria |
Belgium |
Canada |
Denmark |
France |
Germany |
Italy |
Netherlands |
Norway |
Spain |
Sweden |
Switzerland |
United Kingdom |
United States |
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E.8.7 | Trial has a data monitoring committee | Yes |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
|
End of study occurs when all of the following criteria have been satisfied: 1. Thirty days after all patients have stopped protocol treatment 2. The trial is mature for the analysis of the primary endpoint as defined in the protocol 3. The database has been fully cleaned and frozen for this analysis |
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 4 |
E.8.9.1 | In the Member State concerned months | 1 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 4 |
E.8.9.2 | In all countries concerned by the trial months | 1 |
E.8.9.2 | In all countries concerned by the trial days | 0 |