E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Unresectable Stage IV Urothelial Cancer |
Cáncer urotelial irresecable en estadio IV |
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E.1.1.1 | Medical condition in easily understood language |
Bladder cancer or cancer of the urinary collecting system that has spread to other parts of the body or is not treatable with surgery |
Cáncer de vejiga o cáncer del sistema colector urinario que se ha diseminado a otras partes del cuerpo o no se puede tratar con cirugía |
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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 | LLT |
E.1.2 | Classification code | 10022880 |
E.1.2 | Term | Invasive bladder cancer stage IV |
E.1.2 | System Organ Class | 100000004864 |
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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 |
To assess the efficacy of durvalumab + olaparib combination therapy compared with durvalumab + placebo in terms of PFS in the subset of patients with HRR mutation (HRRm) |
Evaluar la eficacia del tratamiento combinado con durvalumab + olaparib en comparación con durvalumab + placebo en cuanto a SSP en el subgrupo de pacientes con RRHm. |
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E.2.2 | Secondary objectives of the trial |
Key secondary objective: To assess the efficacy of durvalumab + olaparib combination therapy compared with durvalumab + placebo in the subset of randomized patients with HRRm. Endpoint: OS.
Additional secondary objectives: To assess the efficacy of durvalumab + olaparib combination therapy compared with durvalumab + placebo in the subset of randomized patients with HRRm. Endpoint: DoR, ORR, APF6 (patients Alive and Progression Free at 6 months), OS18.
To assess the PK of durvalumab and olaparib in both treatment arms
To investigate the immunogenicity of durvalumab in both treatment arms
To assess disease-related symptoms and HRQoL in patients with UC treated with durvalumab + olaparib combination therapy compared with durvalumab + placebo in the subset of randomized patients with HRRm |
Objetivo secundario fundamental: Evaluar la eficacia del tratamiento combinado con durvalumab + olaparib en comparación con durvalumab + placebo en el subgrupo de pacientes aleatorizados con RRHm Variable principal: SG
Objetivos secundarios adicionales: Evaluar la eficacia del tratamiento combinado con durvalumab + olaparib en comparación con durvalumab + placebo en el subgrupo de pacientes aleatorizados con RRHm Variable principal: DR, TRO y VSP6 (pacientes vivos y libres de progresión a los 6 meses), SG18
Evaluar la FC de durvalumab y olaparib en ambos grupos de tratamiento
Investigar la inmunogenicidad de durvalumab en ambos grupos de tratamiento
Evaluar los síntomas relacionados con la enfermedad y la CVRS en pacientes con CU tratados con durvalumab + olaparib en combinación en comparación con durvalumab + placebo en el subgrupo de pacientes aleatorizados con RRHm |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
1. Provision of signed and dated, written ICF 3. 4 2. Histologically or cytologically documented TCC/UC of the urothelium (including renal pelvis, ureters, urinary bladder, and urethra) also meeting the following: Unresectable, Stage IV disease; No prior systemic therapy for unresectable, Stage IV disease. 3. Ineligible for cisplatin-based chemotherapy defined as meeting one of the following criteria: CrCl <60 mL/min calculated by Cockcroft-Gault equation; Common Terminology Criteria for Adverse Events (CTCAE) Grade ≥2 audiometric hearing loss (25 dB in 2 consecutive wave ranges); CTCAE Grade ≥2 peripheral neuropathy; New York Heart Association Class III heart failure; ECOG 2. 4. Known tumor HRR mutation status prior to randomization. 5. World Health Organization (WHO)/ECOG performance status of 0, 1, or 2. 6. Patients with at least 1 RECIST 1.1 target lesion at baseline. 7. Ability to swallow oral medications. 8. Evidence of post-menopausal status, or negative urinary or serum pregnancy test for female pre-menopausal patients. |
1. Previsión del Consentimiento Informado fechado y firmado por escrito. 2. CU/CCT histológicamente o citológicamente documentados del urotelio (incluyendo la pelvis renal, los uréteres, la vejiga urinaria y la uretra) que también cumplen con los siguientes criterios: enfermedad Irresecable Estadio IV; No terapia sistémica previa para la enfermedad irresecable, Estadio IV. 3. Inelegibles para la quimioterapia basada en cisplatino definida cumpliendo alguno de los siguientes criterios: CrCL <60ml/min calculado por la ecuación de Cockcroft-Gault, Criterios de Terminología Comunes para Eventos Adversos (CTCEA) de pérdida auditiva audiometrica de grado ≥2 (25 dB en 2 rangos de onda consecutivas), CTCEA neuropatía periférica de Grado ≥ 2, insuficiencia cardiaca de clase III de la Asociación del Corazón de Nueva York; ECOG 2. 4. Tumor con la mutación de RRH conocida antes de la aleatorización. 5. Organización Mundial de la Salud (OMS)/estado de funcionamiento de la ECOG de 0,1, o 2. 6. Pacientes con al menos 1 lesión objetivo RECIST 1.1 al inicio del estudio. 7. Capacidad para tragar medicación oral. 8. Evidencia del estado post-menopaúsico, o prueba del embarazo urinaria o sérica negativa para las pacientes mujeres pre-menopaúsicas. |
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E.4 | Principal exclusion criteria |
1. Active or prior documented autoimmune or inflammatory disorders. 2. Other invasive malignancy within 5 years before the first dose of the IP. 3. Major surgical procedure within 28 days prior to the first dose 4. Brain metastases or spinal cord compression unless the patient’s condition is stable and off steroid for at least 14 days 5. History of active primary immunodeficiency. 6. Active infection including tuberculosis (TB) 7. History of allogenic organ transplantation. 8. Uncontrolled intercurrent illness 9. Prior exposure to a PARP inhibitor or immune-mediated therapy. 10. Any concurrent chemotherapy, IP, biologic, or hormonal therapy for cancer treatment. 11. Current or prior use of immunosuppressive medication within 14 days before the first dose of the IP. 12. No radiation therapy is allowed, unless it is (1) definitive radiation that had been administered at least 12 months prior; (2) palliative radiation to the brain, with associated criteria for stability or lack of symptoms; or (3) palliative radiation to painful bony lesions (this must comprise less than 30% of the bone marrow) or symptomatic pelvic soft tissue mass(es). 13. Receipt of live attenuated vaccine within 30 days prior to the first dose of the IP. 14. Patients with a known hypersensitivity to durvalumab, olaparib, or any of the excipients of the products. 15. Female patients who are pregnant or breastfeeding or male or female patients of reproductive potential who are not willing to employ effective birth control from screening to 90 days after the last dose of durvalumab. |
1. Enfermedades autoinmunes o inflamatorias activas o documentadas previamente. 2. Otra neoplasia maligna invasiva dentro de los 5 años anteriores de la primera dosis del PI. 3. Procedimientos quirúrgico importante dentro de los 28 dias previos a la primera dosis. 4. Metástasis cerebral o compresión de la medula espinal al menos que la condición del paciente sea estable y fuera de esteroides al menos 14 dias. 5. Antecedentes de inmunodeficiencia primaria activa. 6. Infección activa incluyendo tuberculosis (TB). 7. Antecedentes de un trasplante de órgano alogénico. 8. Enfermedades intercurrentes no controlada. 9. Exposición previa a un inhibidor de PRAP o terapia mediada por inmunidad. 10. Cualquier quimioterapia concurrente, PI, biológica, o terapia hormonal para el tratamiento del cáncer. 11. Uso actual o previo de medicación inmunosupresora dentro de los 14 dias anteriores de la primera dosis del PI. 12. La terapia radioactiva no está permitida, a menos que (1) la radiación definitiva haya sido administrada al menos 12 meses antes; (2) radiación paliativa para el cerebro, criterios asociados con la estabilidad o ausencia de síntomas; o (3)radiación paliativa al lesiones oseas dolorosas (tiene que comprender menos del 30% de la medula ósea) o masa del tejido blando pélvico sintomático. 13. Haber recibido una vacuna viva atenuada dentro de los 30 dias previos a la primera dosis de PI. 14. Pacientes con hipersensibilidad conocida a durvalumab, olaparib, o cualquiera de los excipientes de los productos. 15. Pacientes mujeres que estén embarazadas o dando el pecho o pacientes masculinos o femeninos con potencial reproductivo que no están dispuestos a utilizar métodos anticonceptivos eficaces desde el cribado hasta 90 días después de la última dosis de durvalumab. |
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E.5 End points |
E.5.1 | Primary end point(s) |
Progression-free survival (PFS) |
Supervivencia sin progresión (SSP) |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
Patient level:
Assessment for treatment will be made every 4 weeks during the treatment period. |
Nivel del paciente:
Se debe evaluar el tratamiento cada 4 semanas durante el período de tratamiento. |
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E.5.2 | Secondary end point(s) |
Main secondary end point is: OS (overall survival)
Other secondary efficacy endpoints include: Duration of response (DoR) Objective Response Rate (ORR) Progression-free at 6 months (APF6) Patients alive at 18 months (OS18) Concentration of durvalumab and olaparib Presence of anti-drug antibodies (ADA) for durvalumab Patient reported outcome (PRO)including Global health status/QoL, assessed through questionnaire - EORTC QLQ-C30 |
Variable secundaria: SG (Supervivencia global)
Otras variables secundarias incluidas: Duración de la respuesta (DR) Tasa de repuesta objetiva (TRO) Sin progresión a los 6 meses (VSP6) Pacientes vivos a los 18 meses (SG18) Concentración de durvalumab y olaparib Presencia de anticuerpos contra el fármaco (ACF) dirigidos contra durvalumab Resultados comunicados por los pacientes(RCP) incluidos estado general de salud/calidad de vida, evaluados a través de un cuestionario QLQ-LC30 de la EORTC |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
OS (overall survival) and OS18 Assessment every month until 4 months post-treatment discontinuation; every 2 months thereafter.
Other secondary endpoints DoR, ORR, and APF6 will be assessed every 8 weeks (±1 week) for the first 48 weeks; then every 12 weeks (±1 week) thereafter until progression. Concentration of durvalumab and olaparib will be assessed three times, in Cycle 1, 2 and 4. Additional assessments at Day 30 post last dose for olaparib, 3 months post last dose for durvalumab. ADA for durvalumab will be assessed three times, in Cycle 1, 2 and 4, and 3 and 6 months post last dose of durvalumab.
PRO:Global health status assessment on day of first dose and every 4 weeks until 3 months post treatment discontinuation. |
SG (Supervivencia global) y SG18 Evaluación cada mes durante 4 meses después de interrumpir el tratamiento; cada 2 meses después.
Otras variables secundarias DR, TRO y VSP6 se evaluará cada 8 semanas (± 1 semana) durante las primeras 48 semanas; después cada 12 semanas (± 1 semana) hasta progresión. Se evaluará la concentración de durvalumab y olaparib tres veces, en los ciclos 1,2 y 4. Evaluaciones adicionales en el Día 30 después de la última dosis de olaparib, 3 meses después de la última dosis de durvalumab. Se evaluará ACF para durvalumab 3 veces, en los ciclos 1,2 y 4 y a los 3 y 6 meses después de la última dosis de durvalumab.
RCP: estado general de salud el día de la primera dosis y cada 4 meses hasta 3 meses después de la interrupción del tratamiento. |
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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 | Yes |
E.6.7 | Pharmacodynamic | Yes |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | Yes |
E.6.12 | Pharmacoeconomic | Yes |
E.6.13 | Others | No |
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) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
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 | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | Yes |
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) | No |
E.8.2.2 | Placebo | Yes |
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 | 6 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 6 |
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 |
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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
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The end of study is defined as the last expected visit/contact of the last patient undergoing the study. |
El fin del estudio se define como la ultima visita/contacto esperado del último paciente que participó en el estudio. |
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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 | 2 |
E.8.9.1 | In the Member State concerned days | |
E.8.9.2 | In all countries concerned by the trial years | 7 |
E.8.9.2 | In all countries concerned by the trial months | 6 |