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    Summary
    EudraCT Number:2017-004810-25
    Sponsor's Protocol Code Number:205678
    National Competent Authority:Spain - AEMPS
    Clinical Trial Type:EEA CTA
    Trial Status:Completed
    Date on which this record was first entered in the EudraCT database:2018-05-21
    Trial results View 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 number2017-004810-25
    A.3Full title of the trial
    A Phase II, Open Label, Randomized, Two-Arm Study to Investigate the Efficacy and Safety of Two Doses of the Antibody Drug Conjugate GSK2857916 in Participants with Multiple Myeloma Who Had 3 or More Prior Lines of Treatment, Are Refractory to a Proteasome Inhibitor and an Immunomodulatory Agent and Have Failed an Anti-CD38 Antibody (DREAMM 2)
    Estudio de fase II, abierto, aleatorizado y de dos grupos para investigar la eficacia y la seguridad de dos dosis del conjugado anticuerpo-fármaco GSK2857916 en participantes con mieloma múltiple que han recibido tres o más líneas previas de tratamiento, son refractarios a un inhibidor del proteosoma y un inmunomodulador y no han respondido a un anticuerpo anti-CD38 (DREAMM 2).
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    Open-label, randomized study of two doses of GSK2857916 in participants with relapsed/refractory multiple myeloma who have failed prior treatment with an anti-CD38 antibody
    Estudio abierto, aleatorizado, de dos dosis de GSK2857916 en participantes con mieloma múltiple recurrente / refractario que no han respondido al tratamiento previo con un anticuerpo anti-CD38.
    A.3.2Name or abbreviated title of the trial where available
    GSK2857916, PH 2, monotherapy, Q3W, Safety and Efficacy study in multiple myeloma pts
    A.4.1Sponsor's protocol code number205678
    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 SponsorGlaxoSmithKline, S.A.
    B.1.3.4CountrySpain
    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 supportGlaxoSmithKline, Research and Development Ltd
    B.4.2CountryUnited States
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationGlaxoSmithKline
    B.5.2Functional name of contact pointCentro de Información
    B.5.3 Address:
    B.5.3.1Street AddressC/Severo Ochoa, 2 (P.T.M.)
    B.5.3.2Town/ cityTres Cantos (Madrid)
    B.5.3.3Post code28760
    B.5.3.4CountrySpain
    B.5.4Telephone number34902202700
    B.5.5Fax number34918070479
    B.5.6E-mailes-ci@gsk.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 numberEMA/OD/077/17
    D.3 Description of the IMP
    D.3.1Product nameGSK2857916
    D.3.2Product code GSK2857916
    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 INNHumanized IgG1 antibody drug conjugate
    D.3.9.1CAS number N/A
    D.3.9.2Current sponsor codeGSK2857916
    D.3.9.3Other descriptive nameGSK2857916
    D.3.9.4EV Substance CodeSUB130430
    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 Yes
    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 Yes
    D.3.11.13.1Other medicinal product typeGSK2857916 es un anticuerpo IgG1 humanizado conjugado con maleimidocaproil monometil auristatin fenilalanina (mcMMAF).
    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 Yes
    D.2.5.1Orphan drug designation numberEMA/OD/077/17
    D.3 Description of the IMP
    D.3.1Product nameGSK2857916
    D.3.2Product code GSK2857916
    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 INNHumanized IgG1 antibody drug conjugate
    D.3.9.1CAS number N/A
    D.3.9.2Current sponsor codeGSK2857916
    D.3.9.3Other descriptive nameGSK2857916
    D.3.9.4EV Substance CodeSUB130430
    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 Yes
    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 Yes
    D.3.11.13.1Other medicinal product typeGSK2857916 es un anticuerpo IgG1 humanizado conjugado con maleimidocaproil monometil auristatin fenilalanina (mcMMAF).
    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
    Relapsed/Refractory Multiple Myeloma
    Mieloma Múltiple en Recaída/Refractario
    E.1.1.1Medical condition in easily understood language
    Relapsed/Refractory Multiple Myeloma
    Mieloma Múltiple en Recaída/Refractario
    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 LLT
    E.1.2Classification code 10028228
    E.1.2Term Multiple myeloma
    E.1.2System Organ Class 100000004864
    E.1.3Condition being studied is a rare disease No
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    To evaluate the clinical efficacy of 2 doses of GSK2857916 in participants with relapsed/refractory multiple myeloma
    Evaluar la eficacia clínica de 2 dosis de GSK2857916 en participantes con Mieloma Múltiple en Recaída/Refractario (MMRR)
    E.2.2Secondary objectives of the trial
    - To further evaluate the clinical measures of efficacy of GSK2857916 in participants with RRMM
    - To evaluate the safety of GSK2857916 in participants with RRMM.
    - To evaluate the pharmacokinetic profile of GSK2857916
    - To assess anti-drug antibodies (ADAs) against GSK2857916
    - Participant self-reported symptomatic adverse effects by evaluation of tolerability of GSK2857916
    - To evaluate disease and treatment related symptoms and impact on function and health-related quality-of-life
    - Evaluar más exhaustivamente las determinaciones clínicas de eficacia de GSK2857916 en pacientes con MMRR.
    - Evaluar la seguridad de GSK2857916 en participantes con MMRR.
    - Evaluar el perfil farmacocinético de GSK2857916
    - Evaluar los anticuerpos antifármaco (AAF) frente a GSK2857916.
    - Acontecimientos adversos sintomáticos autoinformados por el participante mediante la evaluación de la tolerabilidad de GSK2857916.
    - Evaluar la enfermedad y los síntomas relacionados con el tratamiento y su impacto sobre el funcionamiento y la calidad de vida relacionada con la salud.
    E.2.3Trial contains a sub-study Yes
    E.2.3.1Full title, date and version of each sub-study and their related objectives
    Full title:
    Protocol Title: A Phase II, Open Label, Randomized, Two-Arm Study to Investigate the
    Efficacy and Safety of Two Doses of the Antibody Drug Conjugate GSK2857916 in
    Participants with Multiple Myeloma Who Had 3 or More Prior Lines of Treatment, Are
    Refractory to a Proteasome Inhibitor and an Immunomodulatory Agent and Have Failed
    an Anti-CD38 Antibody (DREAMM 2)

    Date and version:
    01

    Objective:
    To evaluate the effect of topical corticosteroids on corneal findings in up to 30 participants who will receive monocular topical corticosteroids for the first 4 cycles
    Título del protocolo: Estudio de fase II, abierto, aleatorizado y de dos grupos para investigar la eficacia y la seguridad de dos dosis del conjugado anticuerpo-fármaco GSK2857916 en participantes con mieloma múltiple que han recibido tres o más líneas previas de tratamiento, son refractarios a un inhibidor del proteosoma y un inmunomodulador y no han respondido a un anticuerpo anti-CD38 (DREAMM 2)

    Fecha y versión: 02/ABR/18 - 01

    Objetivo:
    Evaluar el efecto de los corticoesteroides tópicos en los hallazgos corneales en hasta 30 participantes que recibirán corticoesteroides tópicos monoculares durante los 4 primeros ciclos.
    E.3Principal inclusion criteria
    Participants are eligible to be included in the study only if all of the following criteria
    apply:
    1. Provide signed written informed consent, which includes compliance with the requirements and restrictions listed in the consent form
    2. Male or female, 18 years or older (at the time consent is obtained)
    3. Eastern Cooperative Oncology Group (ECOG) performance status of 0-2 (Appendix 8 of the protocol)
    4. Histologically or cytologically confirmed diagnosis of MM as defined according
    to IMWG, [Rajkumar, 2014] criteria, and
    a) Has undergone stem cell transplant or is considered transplant ineligible, and
    b) Has failed at least 3 prior lines of anti-myeloma treatments, including an anti- CD38 antibody (e.g., daratumumab) alone or in combination, and is refractory to an IMiD (i.e., lenalidomide or pomalidomide), and to a proteasome inhibitor (i.e., bortezomib, ixazomib or carfilzomib). The number of prior lines of therapy will be determined according to the guidelines in Rajkumar 2015.
    5. Has measurable disease with at least one of the following:
    a. Serum M-protein ≥0.5 g/dL (≥5 g/L)
    b. Urine M-protein ≥200 mg/24h
    c. Serum FLC assay: Involved FLC level ≥10 mg/dL (≥100 mg/L) and an abnormal serum free light chain ratio (<0.26 or >1.65)
    6. Participants with a history of autologous stem cell transplant are eligible for study participation provided the following eligibility criteria are met:
    a. transplant was >100 days prior to study enrolment
    b. no active infection(s)
    c. participant meets the remainder of the eligibility criteria outlined in this protocol
    7. Adequate organ system functions as defined in Table 9 of the protocol p54.
    8. Female Participants: Contraceptive use by men or women should be consistent with local regulations regarding the methods of contraception for those participating in clinical studies.
    A female participant is eligible to participate if she is not pregnant or breastfeeding, and at least one of the following conditions applies:
    - Is not a woman of childbearing potential (WOCBP)
    OR
    - Is a WOCBP and using a contraceptive method that is highly effective (with a failure rate of <1% per year), preferably with low user dependency, during the intervention period and for at least 80 days after the last dose of study intervention and agrees not to donate eggs (ova, oocytes) for the purpose of reproduction during this period. The investigator should evaluate the effectiveness of the contraceptive method in relationship to the first dose of study intervention.
    A WOCBP must have a negative highly sensitive serum pregnancy test (as required by local regulations) within 72 hours before the first dose of study intervention. The investigator is responsible for review of medical history, menstrual history, and recent sexual activity to decrease the risk for inclusion of a woman with an early undetected pregnancy.
    9. Male Participants: Contraceptive use by men or women should be consistent with local regulations regarding the methods of contraception for those participating in clinical studies.
    Male participants are eligible to participate if they agree to the following during the intervention period and for at least 140 days:
    - Refrain from donating sperm
    PLUS either:
    - Be abstinent from heterosexual intercourse as their preferred and usual lifestyle (abstinent on a long term and persistent basis) and agree to remain abstinent.
    OR
    - Must agree to use contraception/barrier as detailed below:
    Agree to use a male condom and female partner to use an additional highly effective contraceptive method with a failure rate of <1% per year as when having sexual intercourse with a woman of childbearing potential who is not currently pregnant.
    10. All prior treatment-related toxicities (defined by National Cancer Institute- Common Toxicity Criteria for Adverse Events (NCI-CTCAE), version 4.03, must be ≤Grade 1 at the time of enrolment except for alopecia and Grade 2 peripheral neuropathy.
    11. (France only) A participant will be eligible for inclusion in this study only if either affiliated to or a beneficiary of a social security category.
    1. Se proporciona el consentimiento informado escrito firmado, que incluye el cumplimiento con los requisitos y restricciones indicados en el formulario del consentimiento.
    2. Hombre o mujer, de 18 años o más (en el momento de obtención del consentimiento).
    3. Estado funcional del Eastern Cooperative Oncology Group (ECOG) de 0 a 2.
    4. Diagnóstico de MM con confirmación histológica o citológica conforme a la definición de los criterios de IMWG, 2014 y
    a. Se ha sometido a trasplante de progenitores hematopoyéticos o no se considera elegible para trasplante.
    b. Presenta un fracaso con un mínimo de 3 líneas previas de tratamientos antimieloma, incluyendo un anticuerpo antiCD38 (p. ej., daratumumab) en monoterapia o en combinación, y es refractario a un IMiD (es decir, lenalidomida o pomalidomida) y a un inhibidor de proteasoma (es decir, bortezomib, ixazomib o carfilzomib).
    Mieloma refractario se define como la enfermedad que no responde al tratamiento principal o de rescate, o que progresa en los 60 días desde la última terapia. Una enfermedad no respondedora se define como el fracaso en el logro de una respuesta mínima o el desarrollo de progresión de la enfermedad (PE) durante el tratamiento.
    5. Presenta enfermedad medible con, al menos, una de las siguientes condiciones:
    a. Proteína M en suero ≥ 0,5 g/dl (≥ 5 g/l).
    b. Proteína M en orina ≥ 200 mg/24 h.
    c. Análisis de CLL en suero: implica un nivel de CLL ≥ 10 mg/dl (≥ 100 mg/l) y cociente anómalo de cadena ligera libre en suero (< 0,26 o > 1,65).
    6. Los sujetos con antecedentes de trasplante autólogo de progenitores hematopoyéticos son elegibles para participar en el estudio siempre y cuando se cumplan los siguientes criterios de elegibilidad:
    a. el trasplante se efectuó > 100 días antes de la inclusión en el estudio.
    b. no presenta infecciones activas.
    c. el participante cumple el resto de criterios de elegibilidad indicados en este protocolo.
    7. Función del sistema de órganos adecuada según lo propuesto en la Tabla 9. de la página 54 del Protocolo
    8. Participantes femeninas: El uso de anticonceptivos por parte de hombres y mujeres debe ser coherente con la normativa local sobre los métodos anticonceptivos para participantes en estudios clínicos.
    Una paciente femenina es elegible para participar si no está embarazada o en periodo de lactancia y se cumple, al menos, una de las siguientes condiciones:
    - No es una mujer en edad fértil (MEF).
    O
    - Es una MEF y utiliza un método anticonceptivo altamente eficaz (con una tasa de fracaso de < 1% al año), preferiblemente con una baja dependencia del usuario, durante el periodo terapéutico y, al menos, en los 80 días posteriores a la última dosis del tratamiento del estudio y acepta no donar óvulos (huevos, ovocitos) con fines de reproducción durante este periodo. El investigador debe evaluar la eficacia del método anticonceptivo en relación con la primera dosis de la terapia del estudio.
    Una MEF debe presentar una prueba sérica de embarazo de elevada sensibilidad con resultado negativo (según lo requerido por la normativa local) en las 72 horas antes de la primera dosis del tratamiento del estudio.
    El investigador es responsable de revisar el historial médico, antecedentes menstruales y actividad sexual reciente para reducir el riesgo de inclusión de una mujer con un embarazo no detectado precozmente.
    9. Participantes masculinos: El uso de anticonceptivos por parte de hombres y mujeres debe ser coherente con la normativa local sobre los métodos anticonceptivos para participantes en estudios clínicos.
    Los sujetos varones son elegibles para participar si aceptan lo siguiente durante el periodo de tratamiento y, al menos, a lo largo de 140 días:
    - Abstenerse de donar esperma.
    MÁS:
    - Practicar la abstinencia del contacto heterosexual como su estilo de vida preferido y habitual (abstinencia a largo plazo y de manera persistente) y aceptar mantener la abstinencia.
    O BIEN
    - Debe aceptar utilizar un método anticonceptivo/de barrera según lo indicado a continuación:
    Acepta usar un preservativo masculino y la pareja femenina debe utilizar un método anticonceptivo de gran eficacia adicional con una tasa de fracaso < 1% al año durante una relación sexual con una mujer en edad fértil que no está embarazada en ese momento.
    10. Todas las toxicidades relacionadas con el tratamiento previas (definidas por los criterios de toxicidades comunes para acontecimientos adversos del Instituto Nacional de Cáncer de EEUU (NCI-CTCAE), versión 4.03) deben ser de grado ≤ 1 en el momento de la inclusión salvo alopecia y neuropatía periférica de grado 2.
    11. En Francia, únicamente los sujetos afiliados o beneficiarios de una categoría de la Seguridad Social se considerarán elegibles para la inclusión en este estudio.
    E.4Principal exclusion criteria
    Participants satisfying any of these criteria are not eligible for assignment to treatment:
    1. Systemic anti-myeloma therapy within <14 days, or plasmapheresis within 7 days prior to the first dose of study drug
    2. Symptomatic amyloidosis, active ‘polyneuropathy, organomegaly, endocrinopathy, myeloma protein, and skin changes’ (POEMS) syndrome, active plasma cell leukemia at the time of screening.
    3. Prior allogeneic stem cell transplant
    4. Current corneal epithelial disease except mild punctate keratopathy
    5. Use of an investigational drug within 14 days or five half-lives, whichever is shorter, preceding the first dose of study drug. Prior treatment with a monoclonal antibody within 30 days of receiving the first dose of study drugs. Prior BCMA targeted therapy.
    6. Evidence of active mucosal or internal bleeding
    7. Any major surgery within the last four weeks
    8. Presence of active renal condition (infection, requirement for dialysis or any other condition that could affect participant’s safety). Participants with isolated proteinuria resulting from MM are eligible, provided they fulfil criteria given in Table 9 within the protocol p54
    9. Any serious and/or unstable pre-existing medical, psychiatric disorder or other conditions (including lab abnormalities) that could interfere with participant’s safety, obtaining informed consent or compliance to the study procedures.
    10. Current unstable liver or biliary disease per investigator assessment defined by the presence of ascites, encephalopathy, coagulopathy, hypoalbuminemia, esophageal or gastric varices, persistent jaundice, or cirrhosis. Note: Stable chronic liver disease (including Gilbert’s syndrome or asymptomatic gallstones) or hepatobiliary involvement of malignancy is acceptable if participant otherwise meets entry criteria.
    11. Malignancies other than disease under study are excluded, except for any other malignancy from which the participant has been disease-free for more than 2 years and, in the opinion of the principal investigators and GSK Medical Monitor, will not affect the evaluation of the effects of this clinical trial treatment on the currently targeted malignancy (MM).
    12. Evidence of cardiovascular risk including any of the following:
    a. QTcF interval ≥470 msecs (the QT interval values must be corrected for heart rate by Fridericia’s formula [QTcF])
    b. Evidence of current clinically significant uncontrolled arrhythmias, including clinically significant ECG abnormalities such as 2nd degree (Type II) or 3rd degree atrioventricular (AV) block.
    c. History of myocardial infarction, acute coronary syndromes (including unstable angina), coronary angioplasty, or stenting or bypass grafting within six months of Screening.
    d. Class III or IV heart failure as defined by the New York Heart Association functional classification system [NYHA, 1994]
    e. Uncontrolled hypertension
    13. Known immediate or delayed hypersensitivity reaction or idiosyncrasy to drugs chemically related to GSK2857916, or any of the components of the study treatment.
    14. Pregnant or lactating female.
    15. Active infection requiring antibiotic, antiviral, or antifungal treatment.
    16. Known HIV infection.
    17. Presence of hepatitis B surface antigen (HBsAg), or hepatitis B core antibody (HBcAb at screening or within 3 months prior to first dose of study treatment
    18. Positive hepatitis C antibody test result or positive hepatitis C RNA test result at screening or within 3 months prior to first dose of study treatment.
    Note: Participants with positive Hepatitis C antibody due to prior resolved disease can be enrolled, only if a confirmatory negative Hepatitis C RNA test is obtained.
    Note: Hepatitis RNA testing is optional and participants with negative Hepatitis C antibody test are not required to also undergo Hepatitis C RNA testing.
    1. Tratamiento antimieloma sistémico en <14 días o plasmaféresis en los 7 días previos a la primera dosis del fármaco del estudio.
    2. Amiloidosis sintomática, síndrome de POEMS activo (polineuropatía, organomegalia, endocrinopatía, proteína de mieloma y cambios cutáneos), leucemia de células plasmáticas activa en el momento de la selección.
    3. Trasplante alogénico de progenitores hematopoyéticos (TPH) previo.
    4. Enfermedad epitelial corneal actual salvo queratopatía punteada leve
    5. Uso de un fármaco en investigación en 14 días o cinco semividas, lo que sea más breve, antes de la primera dosis del fármaco del estudio. Tratamiento previo con un anticuerpo monoclonal en los 30 días tras recibir la primera dosis de los fármacos del estudio. Terapia dirigida a BCMA previa.
    6. Evidencias de hemorragia interna o de la mucosa activa.
    7. Cualquier cirugía mayor en las últimas cuatro semanas.
    8. Presencia de una afección renal activa (infección, requisito de diálisis o cualquier otra condición que pueda afectar la seguridad del participante). Los sujetos con proteinuria aislada debida al MM son elegibles, siempre y cuando cumplan todos los criterios de inclusión.
    9. Cualquier trastorno psiquiátrico, médico preexistente grave e/o inestable u otras afecciones (incluyendo anomalías de laboratorio) que puedan interferir con la seguridad del paciente, obtención del consentimiento informado o cumplimiento con los procedimientos del estudio.
    10. Enfermedad biliar o hepática inestable actual según la evaluación del investigador definida por la presencia de ascitis, encefalopatía, coagulopatía, hipoalbuminemia, varices esofágicas o gástricas, ictericia persistente o cirrosis. Nota: Se acepta la presencia de hepatopatía crónica estable (incluyendo síndrome de Gilbert o cálculos biliares asintomáticos) o afectación hepatobiliar de la neoplasia maligna si el sujeto cumple los criterios de inclusión.
    11. Se excluyen las neoplasias malignas distintas de la enfermedad del estudio, salvo cualquier otra neoplasia no presentada por el participante durante más de 2 años y que, en opinión de los investigadores principales y el Monitor Médico de GSK, no afectará la evaluación de los efectos de este tratamiento del ensayo clínico sobre la neoplasia maligna objetivo actual (MM).
    12. Evidencias de riesgo cardiovascular incluyendo cualquiera de los siguientes:
    a. Intervalo QTcF ≥470 ms (los valores del intervalo QT se deben corregir para la frecuencia cardiaca conforme a la fórmula de Fridericia [QTcF]).
    b. Indicios de arritmias actualmente no controladas y clínicamente significativas, incluyendo anomalías del ECG clínicamente significativas como bloqueo auriculoventricular (AV) de 2º (tipo II) o 3er grado.
    c. Antecedentes de infarto de miocardio, síndromes coronarios agudos (incluyendo angina inestable), angioplastia coronaria o implante de Stent o injerto de derivación en los 6 meses de la selección.
    d. Insuficiencia cardiaca de clase III o IV según se define en el sistema de clasificación funcional de la New York Heart Association.
    e. Hipertensión no controlada.
    13. Reacción de hipersensibilidad inmediata o retardada conocida o idiosincrasia a fármacos químicamente relacionados con GSK2857916, o cualquiera de los componentes del tratamiento del estudio.
    14. Mujeres embarazadas o en periodo de lactancia.
    15. Infección activa que requiere tratamiento antibiótico, antiviral o antifúngico.
    16. Infección por VIH conocida.
    17. Presencia del antígeno de superficie de hepatitis B (HBsAg) o anticuerpo nuclear de hepatitis B (HBcAb) en la selección o en los 3 meses previos a la primera dosis del tratamiento del estudio.
    18. Resultado positivo en la prueba de anticuerpos de hepatitis C o resultado positivo en la prueba de ARN de hepatitis C en la selección o en los 3 meses previos a la primera dosis del tratamiento del estudio.
    Nota: Se pueden incluir participantes con un resultado positivo para anticuerpos de hepatitis C debido a una enfermedad resuelta previa solo si se obtiene una prueba confirmatoria negativa sobre ARN de hepatitis C. Nota: La prueba de ARN de hepatitis es opcional y los participantes con un resultado negativo en la prueba de anticuerpos de hepatitis C no necesitan someterse al análisis del ARN
    E.5 End points
    E.5.1Primary end point(s)
    ORR, defined as the percentage of participants with a confirmed partial response (PR) or better (i.e., PR, very good partial response [VGPR], complete response [CR] and stringent complete response [sCR]), according to the 2016 International Myeloma Working Group (IMWG) Response Criteria by Independent Review Committee (IRC).
    TRG, definida como el porcentaje de sujetos con una respuesta parcial (RP) confirmada o mejor (es decir, RP, muy buena respuesta parcial [MBRP], respuesta completa [RC] y respuesta completa estricta [RCe]), según los criterios de respuesta del International Myeloma Working Group (IMWG) de 2016 por un Comité de Revisión Independiente (CRI).
    E.5.1.1Timepoint(s) of evaluation of this end point
    Every 3 weeks
    Cada 3 semanas
    E.5.2Secondary end point(s)
    Duration of response (DoR), defined as: the time from first documented evidence of PR or better until the earliest date of documented disease progression (PD) per IMWG; or death due to PD occurs among participants who achieve an overall response, i.e., confirmed PR or better.

    Clinical benefit rate (CBR), defined as the percentage of participants with a confirmed minimal response (MR) or better according to the 2016 International Myeloma Working Group (IMWG) Response Criteria by Independent Review Committee (IRC).

    Time to response, defined as the time between the date of first dose and the first documented evidence of response (PR or better).

    Progression-free survival, defined as the time from first dose until the earliest date of documented disease progression (PD) per IMWG, or death due to any cause.

    Time to progression, defined as the time from first dose until the earliest date of documented PD per IMWG, or death due to PD.

    Overall survival, defined as the time from first dose until death due to any cause.

    The safety profile of GSK2857916 will be evaluated in participants with RRMM as assessed through: standard clinical and laboratory tests (hematology and chemistry, physical examination, vital sign measurements, and diagnostic tests) through the collection of adverse events (AEs) and serious adverse events (SAEs) AEs of special interest ocular findings on ophthalmic exam

    Plasma concentrations of GSK2857916 Derived pharmacokinetic parameter values (e.g., AUC, Cmax, tmax, t½), as data permit.

    Incidence and titers of ADAs against GSK2857916

    Symptomatic adverse effects and related impacts as measured by the PRO-CTCAE, NEI-VFQ-25 and OSDI

    Health-related quality-of-life as measured by the EORTC QLQ-C30 and EORTC QLQ-MY20
    1. Duración de la respuesta (DdR), se define como: tiempo desde el primer indicio documentado de RP o mejor hasta la fecha más temprana de progresión de la enfermedad (PE) documentada conforme a IMWG; o muerte debido a PE en sujetos que logran una respuesta global, es decir, RP confirmada o mejor.

    Tasa de beneficio clínico (TBC), se define como el porcentaje de participantes con una respuesta mínima (RM) confirmada o mejor según los criterios de respuesta del International Myeloma Working Group (IMWG) por un Comité de Revisión Independiente (CRI).

    Tiempo hasta la respuesta, se define como el tiempo entre la fecha de la primera dosis y el primer indicio documentado de respuesta (RP o mejor).

    Supervivencia libre de progresión, se define como el tiempo desde la primera dosis hasta la fecha más temprana de progresión de la enfermedad (PE) documentada conforme a IMWG, o muerte por cualquier causa.

    Tiempo hasta la progresión, se define como el tiempo desde la primera dosis hasta la fecha más temprana de PE documentada conforme a IMWG, o muerte debida a PE.

    Supervivencia global, se define como el tiempo desde la primera dosis hasta la muerte por cualquier causa.

    El perfil de seguridad de GSK2857916 se evaluará en los participantes utilizando: pruebas clínicas y de laboratorio estándar (hematología y bioquímica, exploración física, determinación de las constante vital y pruebas diagnósticas) mediante la recopilación de los acontecimientos adversos (AA) y acontecimientos adversos graves (AAG); AA de especial interés; hallazgos oculares durante un examen oftálmico

    Concentraciones plasmáticas de GSK2857916. Valores de los parámetros farmacocinéticos derivados (p. ej., ABC, Cmáx, tmáx, t½), según lo permitan los datos.

    Incidencia y valores de AAF frente a GSK2857916.

    Efectos adversos sintomáticos e impacto asociado utilizando PRO-CTCAE, NEI-VFQ-25 y OSDI.

    Calidad de vida relacionada con la salud conforme a lo determinado por QLQ-C30 y QLQ-MY20 de OEITC.
    E.5.2.1Timepoint(s) of evaluation of this end point
    Response assessments will be every 3 weeks or as clinically indicated. After discontinuation of treatment PFS will be every 3 weeks and OS will be every 3 months.
    Las evaluaciones de la respuesta serán cada 3 semanas o según esté clínicamente indicado. Después de la interrupción del tratamiento, las visitas de seguimiento libre de progresión serán cada 3 semanas y las visitas de seguimiento de supervivencia serán cada 3 meses.
    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 No
    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 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 concerned10
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA30
    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
    Australia
    Canada
    France
    Germany
    Italy
    Spain
    United Kingdom
    United States
    E.8.7Trial 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
    LVLS
    Última visita del último paciente.
    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 months
    E.8.9.1In the Member State concerned days
    E.8.9.2In all countries concerned by the trial years2
    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: 95
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 60
    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 state12
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 64
    F.4.2.2In the whole clinical trial 155
    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)
    The investigator is responsible for ensuring that consideration has been given to the post-study care of the participant’s medical condition.

    Refer to Section 9 of the protocol and the SOA (Table 1) for follow-up assessments of participants who are to be followed for disease progression and survival after they permanently discontinue from study treatment.
    El investigador es responsable de garantizar que se haya tenido en cuenta la atención de la afección médica del participante posterior al estudio.

    Consulte la Sección 9 del protocolo y la tabla de actividades para ver qué evaluaciones de seguimiento de los participantes se deben seguir para la progresión de la enfermedad y la supervivencia después de que se interrumpa permanentemente el tratamiento del estudio.
    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 Decision2018-07-16
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2018-05-25
    P. End of Trial
    P.End of Trial StatusCompleted
    P.Date of the global end of the trial2022-03-31
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