E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Ovarian cancer |
Carcinoma ovarico |
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E.1.1.1 | Medical condition in easily understood language |
Ovarian cancer |
Tumore dell'ovaio |
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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 | 22.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10026311 |
E.1.2 | Term | Malignant neoplasm of ovary and other uterine adnexa |
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 | 10061535 |
E.1.2 | Term | Ovarian neoplasm |
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 | 10061344 |
E.1.2 | Term | Peritoneal neoplasm |
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 | Yes |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To demonstrate that rechallenge with pegylated liposomal doxorubicin (PLD) with the combination of trabectedin (Yondelis®) is active (objective response rate) in relapsed ovarian cancer patients who have already received pegylated liposomal doxorubicin and progress within 6-12 months after the end of last platinum or in fully platinum sensitive patients not able to receive or not willing to receive other platinum treatments |
Dimostrare che il rechallenge con la combinazione doxorubicina liposomiale pegilata (PLD) e trabectedina (Yondelis®) è attivo (tasso di risposta obiettiva) nelle pazienti con recidiva di carcinoma ovarico che hanno già ricevuto PLD ed hanno recidivato entro 6-12 mesi dalla fine dell’ultimo platino o oltre 12 mesi dall’ultimo platino e non sono in grado di ricevere o non sono disposte a ricevere altri trattamenti al platino. |
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E.2.2 | Secondary objectives of the trial |
• Traslational end point*: to define the correlation between genetic assessment, including BRCA1/2 genes, and Epithelial ovarian cancer (EOC) treatment and prognosis and to investigate how genetic pattern evolves over treatments • To analyze safety profile, progression free survival (PFS), overall survival (OS), following retreatment with trabectedin and PLD. • To evaluate the time from enrollment to subsequent chemotherapy and the overall survival counted from the administration of subsequent chemotherapy. • Duration of Response • Clinical benefit rate at 24 week • To evaluate serological response of CA-125. • To analyze the quality of life (QoL) using the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-C30 (QLQ-C30) and the Quality of Life Questionnaire-OV28 (QLQ-OV28) *Only selected centre will participate to this endpoint |
• Endpoint traslazionale *: definire la correlazione tra valutazione genetica, inclusi i geni BRCA1/2, trattamento e prognosi nel carcinoma ovarico epiteliale (EOC) e valutare come il modello genetico si evolve nel corso dei trattamenti. • Analizzare il profilo di sicurezza, la sopravvivenza libera da progressione (PFS), la sopravvivenza globale (OS), del trattamento ripetuto con trabectedina e PLD. • Valutare il tempo di inizio alla successiva chemioterapia e la sopravvivenza globale dalla somministrazione della successiva linea. • Durata della Risposta • Tasso di beneficio clinico a 24 settimane • Valutare la risposta sierologica del CA-125. • Analizzare la qualità di vita (QoL) utilizzando the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-C30 (QLQ-C30) and the Quality of Life Questionnaire-OV28 (QLQ-OV28) * Solo i centri selezionati parteciperanno a questo endpoint |
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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 |
Pharmacogenetics Version: 12.0 Date: 23/03/2020 Title: RECHALLENGE WITH PEGYLATED LIPOSOMAL DOXORUBICIN ADDED TO TRABECTEDIN IN RECURRENT OVARIAN CANCER: A MULTICENTER, PROSPECTIVE TRIAL. (REPRAB study- MITO 36) Objectives: to define the correlation between genetic assessment, including BRCA1/2 genes, and Epithelial ovarian cancer (EOC) treatment and prognosis and to investigate how genetic pattern evolves over treatments
Life quality Version: 12.0 Date: 23/03/2020 Title: RECHALLENGE WITH PEGYLATED LIPOSOMAL DOXORUBICIN ADDED TO TRABECTEDIN IN RECURRENT OVARIAN CANCER: A MULTICENTER, PROSPECTIVE TRIAL. (REPRAB study- MITO 36) Objectives: To analyze the quality of life (QoL) using the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-C30 (QLQ-C30) and the Quality of Life Questionnaire-OV28 (QLQ-OV28)
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Farmacogenetica Versione: 12.0 Data: 23/03/2020 Titolo: RECHALLENGE CON DOXORUBICINA LIPOSOMALE PEGILATA IN AGGIUNTA ALLA TRABECTEDINA NELLA RECIDIVA DI TUMORE OVARICO: STUDIO PROSPETTICO MULTICENTRICO (REPRAB study – MITO 36). Obiettivi: definire la correlazione tra valutazione genetica, inclusi i geni BRCA1/2, trattamento e prognosi nel carcinoma ovarico epiteliale (EOC) e valutare come il modello genetico si evolve nel corso dei trattamenti.
Qualita' della vita Versione: 12.0 Data: 23/03/2020 Titolo: RECHALLENGE CON DOXORUBICINA LIPOSOMALE PEGILATA IN AGGIUNTA ALLA TRABECTEDINA NELLA RECIDIVA DI TUMORE OVARICO: STUDIO PROSPETTICO MULTICENTRICO (REPRAB study – MITO 36). Obiettivi: Analizzare la qualità di vita (QoL) utilizzando the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-C30 (QLQ-C30) and the Quality of Life Questionnaire-OV28 (QLQ-OV28)
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E.3 | Principal inclusion criteria |
• Female aged = 18 years • Histologically or cytologically documented invasive epithelial ovarian cancer, primary peritoneal carcinoma, or fallopian tube cancer • Partially platinum sensitive patients or fully platinum sensitive patients not able to receive or not willing to receive other platinum treatments, who have previously received PLD(carboplatin-pegylated liposomal doxorubicin or pegylated liposomal doxorubicin alone). • ECOG PS 0-1. • Subject has radiographically-documented measurable disease, as per RECIST 1.1 at study entry (CA-125 rise not supported by radiological evidence of disease is not accepted as criteria for defining progression). • Be able to receive IV dexamethasone or an equivalent IV corticosteroid. • Have all of the following: hemoglobin =9 g/dL (without transfusion in the prior 7 days). Subjects may be enrolled into the study while receiving recombinant erythropoietin provided they have received recombinant erythropoietin for at least 4 weeks before the first dose of study drug. albumin >25 g/L absolute neutrophil count (ANC) >1,500/µL platelet count >100,000/µL (without transfusion in the prior 7 days) either a serum creatinine <=1.5 mg/dL or a calculated glomerular filtration rate >60 mL/min/1.73 m2 (Cockcroft-Gault) CPK <2.5 x upper limit of normal (ULN) • Have total bilirubin <xULN. If total bilirubin is > 1,5xULN, measure direct and indirect bilirubin to evaluate for Gilbert’s syndrome (if direct bilirubin is within normal range, subject may be eligible). • Have alkaline phosphatase (ALP) <=2.5xULN; if the ALP is >2.5xULN, then an ALP liver fraction or 5' nucleotidase must be <ULN (as reported in absolute units of measure). • Have AST and ALT <=2.5xULN. • Have LVEF by MUGA scan or 2D-ECHO within normal limits for the institution. • Patients with child-bearing potential using (or willing to use) effective contraception during treatment and 3 months ahead unless they are postmenopausal (at least 12 months consecutive amenorrhea, in the appropriate age group and without other known or suspected cause), or have been sterilized surgically • Evidence of not pregnancy status as documented by a negative beta-human chorionic gonadotropin (ß-hCG) test • Not breastfeeding women • Adequate recovery from acute toxicity of any prior treatment |
• Età = 18 anni • Diagnosi istologica o citologica documentata di carcinoma ovarico epiteliale invasivo, carcinoma peritoneale primario o carcinoma delle tube di Falloppio • Pazienti parzialmente sensibili al platino o completamente sensibili al platino che non sono in grado o non sono disposti a ricevere altri trattamenti aa base di platino, e che hanno precedentemente ricevuto doxorubicina liposomiale pegilata (in associazione con carboplatino o da sola). • Eastern Cooperative Oncology Group (ECOG) Performance Status (PS) 0-1. • Le pazienti all'ingresso nello studio deve avere malattia misurabile documentata radiograficamente, come da criteri RECIST 1.1 (l'aumento del CA-125 non supportato dall'evidenza radiologica di malattia non è accettato come criterio per definire la progressione). • La paziente deve poter assumere desametasone endovena o altro corticosteroide equivalente. • I seguenti parametri devono essere rispettati: • emoglobina > 9 g/dL (senza trasfusioni nei 7 giorni precedenti). I soggetti possono essere arruolati nello studio durante il trattamento con eritropoietina a condizione che abbiano ricevuto l’ultima dose 4 settimane prima della prima dose del farmaco in studio. • albumina >25 g/L • Valore assoluto dei neutrofili (ANC) >1,500/µL • conta piastrinica >100,000/µL (senza trasfusioni nei 7 giorni precedenti) • creatinina sierica <=1.5 mg/dL o un indice di filtrazione glomerulare >60 mL/min/1.73 m2 (Cockcroft-Gault) • CPK <2.5 x limite superiore normale (ULN) • Bilirubina totale <1.5 xULN. Se la bilirubina totale > 1,5xULN, eseguire dosaggio della bilirubina diretta e indiretta per valutare diagnosi di Sindrome di Gilbert (se la bilirubina diretta è normale, il soggetto può entrare nello studio). • Fosfatasi alcalina (ALP) <=2.5xULN • AST e ALT <=2.5xULN. • LVEF valutata tramite MUGA o 2D-ECO entro il valore normale • Le pazienti non devono avere potenziale riproduttivo quindi verranno arruolate solo pazienti in postmenopausa (almeno 12 mesi consecutivi di amenorrea, nella fascia di età appropriata e senza altra causa nota o sospetta), o sottoposte a sterilizzazione chirurgica. • Recupero adeguato della tossicità acuta di qualsiasi trattamento precedente |
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E.4 | Principal exclusion criteria |
• Non epithelial ovarian or mixed epithelial/non epithelial tumors (e.g., Mullerian tumors) • Patients who did not respond to last platinum-based therapy or in whom last relapse occurred < 6 months from the last dose of platinum • Bowel obstruction, sub-occlusive disease or the presence of symptomatic brain metastases • Known hypersensitivity to any of the components of PLD or trabectedin i.v. formulation • Previous treatment with Trabectedin • Known hypersensitivity to dexamethasone • Less than 4 weeks from last dose of therapy with any investigational agent, or chemotherapy. • History of another neoplastic disease (except basal cell carcinoma or cervical carcinoma in situ adequately treated) unless in remission for 3 years or longer • Myocardial failure within six months before enrolment, New York Heart Association (NYHA) Class II or worse heart failure, uncontrolled angina, severe uncontrolled ventricular arrhythmias, clinically significant pericardial disease, or electrocardiographic evidence of acute ischemic or active conduction system abnormalities • Known significant chronic liver disease, such as cirrhosis or active hepatitis (potential subjects who test positive for hepatitis B surface antigen or hepatitis C antibodies are allowed provided they do not have active disease requiring antiviral therapy). Also known history of liver carcinoma and cholangitis with abnormal liver functionality • Concurrent severe medical problems or any unstable medical condition unrelated to malignancy, which would significantly limit full compliance with the study or expose the patient to extreme risk or decreased life expectancy • Breastfeeding women • Pregnant women • Known clinically relevant CNS metastases • Psychiatric disorder that prevents compliance with protocol • Patients with concurrent serious or uncontrolled infection • Patients in need of yellow fever vaccine while on study chemotherapy • Active infection • Any other unstable medical condition |
• Tumori ovarici non epiteliali o misti (ad es. Tumori mulleriani) • Pazienti che non hanno risposto all'ultima terapia a base di platino o con recidiva <6 mesi dall'ultima dose di platino • Occlusione intestinale, malattia subocclusiva o presenza di metastasi cerebrali sintomatiche • Ipersensibilità nota a uno dei componenti in studio (doxorubicina liposomiale pegilata o TRABECTEDINA) • Precedente trattamento con Trabectedina • Ipersensibilità conosciuta al desametasone • Meno di 4 settimane dall'ultima dose di terapia con qualsiasi agente sperimentale o chemioterapico. • Anamensi positiva per altra malattia neoplastica (tranne il carcinoma a cellule basali o il carcinoma cervicale in situ adeguatamente trattato) a meno che non sia in remissione da più di 3 anni. • Insufficienza miocardica nei sei mesi prima dell'arruolamento, insufficienza cardiaca di classe > II secondo la New York Heart Association (NYHA), angina incontrollata, aritmie ventricolari non controllate gravi, malattia pericardica clinicamente significativa o evidenza elettrocardiografica di ischemia acuta o di anomalie del sistema di conduzione in fase attiva. • Malattia epatica cronica significativa nota, come cirrosi o epatite attiva (sono consentiti soggetti che risultano positivi all'antigene di superficie dell'epatite B o agli anticorpi dell'epatite C purché non abbiano una malattia attiva che richiede una terapia antivirale). Storia nota anche di carcinoma epatico e colangite con funzionalità epatica anormale • Gravi problemi medici concomitanti o qualsiasi condizione medica instabile non correlata alla neoplasia, che limiterebbero in modo significativo la piena partecipazione del paziente allo studio o esporrebbero il paziente a un rischio elevato o a una riduzione dell'aspettativa di vita • Metastasi del SNC clinicamente sintomatiche • Disordini psichiatrici che potrebbero influenzare la partecipazione del paziente al protocollo di studio • Pazienti con infezioni in fase attiva • Donne in gravidanza • Donne che allattano al seno • Pazienti che necessitano di un vaccino contro la febbre gialla durante lo studio • Altre condizioni mediche gravi |
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E.5 End points |
E.5.1 | Primary end point(s) |
Response and progression will be evaluated according to the Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 |
Tasso di risposta e progressione valutate secondo RECIST 1.1. |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
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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 | No |
E.6.4 | Safety | No |
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 | 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 | No |
E.8.1.1 | Randomised | No |
E.8.1.2 | Open | No |
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) | No |
E.8.2.2 | Placebo | No |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 1 |
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 | 14 |
E.8.5 | The trial involves multiple Member States | No |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | No |
E.8.6.2 | Trial being conducted completely outside of the EEA | Information not present in EudraCT |
E.8.7 | Trial 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
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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 | 0 |
E.8.9.1 | In the Member State concerned months | 36 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 0 |
E.8.9.2 | In all countries concerned by the trial months | 36 |
E.8.9.2 | In all countries concerned by the trial days | 0 |