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    Summary
    EudraCT Number:2017-004810-25
    Sponsor's Protocol Code Number:205678
    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:2021-06-17
    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 ConcernedItaly - Italian Medicines Agency
    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)
    Studio di fase II, in aperto, randomizzato, a due bracci per valutare l¿efficacia e la sicurezza di due dosi del coniugato farmaco-anticorpo GSK2857916 nei partecipanti con mieloma multiplo che abbiano avuto 3 o pi¿ linee di trattamento precedenti, siano refrattari ad un inibitore del proteasoma e ad un agente immunomodulatore e siano andati incontro a fallimento terapeutico con un anticorpo 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
    Studio in aperto, randomizzato, su due dosi di GSK2857916 in partecipanti con mieloma multiplo recidivante/refrattario che abbiano subito fallimento terapeutico di un trattamento precedente con un anticorpo 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
    GSK2857916, PH 2, monoterapia, Q3W, studio di sicurezza e efficacia in pazienti con mieloma multiplo
    A.4.1Sponsor's protocol code number205678
    A.5.4Other Identifiers
    Name:NANumber:NA
    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 RESEARCH AND DEVELOPMENT
    B.1.3.4CountryUnited Kingdom
    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 Research & Development Ltd
    B.5.2Functional name of contact pointClinical Trials Helpdesk
    B.5.3 Address:
    B.5.3.1Street AddressIron Bridge Road, Stockley Park West
    B.5.3.2Town/ cityUxbridge, Middlesex
    B.5.3.3Post codeUB11 1BT
    B.5.3.4CountryUnited Kingdom
    B.5.4Telephone number004402089904466
    B.5.5Fax number004402089904466
    B.5.6E-mailGSKClinicalSupportHD@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 INNConiugato farmaco-anticorpo IgG1 umanizzato
    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 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 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 typeHumanized afucosylated (mcMMAF) coniug. antic IgG1
    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 Yes
    D.2.1.1.1Trade name DEXAMONO - 1MG/ML COLLIRIO, SOLUZIONE 20 CONTENITORI MONODOSE LDPE IN BUSTINA
    D.2.1.1.2Name of the Marketing Authorisation holderLABORATOIRES THEA
    D.2.1.2Country which granted the Marketing AuthorisationItaly
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameDEXAMONO
    D.3.2Product code NA
    D.3.4Pharmaceutical form Eye drops, solution
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPOcular use
    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) No
    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 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 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
    Relapsed/Refractory Multiple Myeloma
    Mieloma multiplo recidivante/refrattario
    E.1.1.1Medical condition in easily understood language
    Relapsed/Refractory Multiple Myeloma
    Mieloma multiplo recidivante/refrattario
    E.1.1.2Therapeutic area Diseases [C] - Cancer [C04]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 21.0
    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
    Valutare l¿efficacia clinica di 2 dosi di GSK2857916 nei partecipanti con mieloma multiplo recidivante/refrattario.
    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
    - Valutare ulteriormente le misurazioni cliniche dell¿efficacia di GSK2857916 nei partecipanti con RRMM.
    - Valutare la sicurezza di GSK2857916 nei partecipanti con RRMM.
    - Valutare il profilo farmacocinetico di GSK2857916
    - Valutare anticorpi antifarmaco (ADA) contro GSK2857916
    - Effetti indesiderati sintomatici auto-riferiti dai partecipanti mediante valutazione della tollerabilit¿ di GSK2857916.
    - Valutare la malattia, i sintomi correlati al trattamento e l¿impatto sulla funzione e la qualit¿ della vita collegata allo stato di salute.
    E.2.3Trial contains a sub-study Yes
    E.2.3.1Full title, date and version of each sub-study and their related objectives

    Other types of substudies
    Specify title, date and version of each substudy with relative objectives: 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)
    Version and date: 01 - 2018-04-02
    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

    Altre tipologie di sottostudi
    specificare il titolo, la data e la versione di ogni sottostudio con i relativi obiettivi: Titolo: Studio di fase II, in aperto, randomizzato, a due bracci per valutare l¿efficacia e la sicurezza di due dosi del coniugato farmaco-anticorpo GSK2857916 nei partecipanti con mieloma multiplo che abbiano avuto 3 o pi¿ linee di trattamento precedenti, sono refrattari ad un inibitore del proteasoma e ad un agente immunomodulatore e sono andati incontro a fallimento terapeutico con un anticorpo anti-CD38 (DREAMM 2).
    Versione e data: 01 - 2.4.2018
    Obiettivo: Valutare l¿effetto dei corticosteroidi topici sui referti corneali in un numero massimo di 30 partecipanti che riceveranno corticosteroidi topici monoculari per i primi 4 cicli
    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.
    I partecipanti sono considerati idonei all’inclusione nello studio solo se soddisfano tutti i criteri di seguito indicati:
    1. Soggetti che forniscono e firmano il consenso informato scritto, che comprende la compliance con i requisiti e le limitazioni elencate nel modulo di consenso
    2. Uomo o donna di età pari o superiore a 18 anni (al momento del consenso)
    3. Performance status secondo l’Eastern Cooperative Oncology Group (ECOG) tra 0 e 2
    4. Diagnosi di MM confermata dall’esame istologico o citologico secondo i criteri dell’IMWG (RAJKUMAR,2014), e
    a. Soggetti sottoposti a trapianto di cellule staminali o considerati non idonei al trapianto, e
    b. Soggetti con fallimento terapeutico di almeno 3 linee di trattamenti anti-mieloma precedenti, tra cui un anticorpo anti-CD38 (ad es. daratumumab) in monoterapia o in terapia combinata, e refrattari ad un IMiD (vale a dire, lenalidomide o pomalidomide), e ad un inibitore del proteasoma (vale a dire, bortezomib, ixazomib o carfilzomib).
    Il numero delle precedenti linee di terapia sarà determinato in accordo alle linee guida RAJKUMAR 2015.
    5. Soggetti con malattia misurabile con almeno uno dei reperti seguenti:
    a. Proteina M sierica =0,5 g/dL (=5 g/L)
    b. Proteina M nelle urine =200 mg/24h
    c. Saggio FLC sieriche: Implica un livello di FLC =10 mg/dL (=100 mg/L) e un rapporto anomalo siero/catene leggere libere (<0,26 o >1,65)
    6. I partecipanti con anamnesi di trapianto autologo di cellule staminali sono idonei a partecipare allo studio a condizione che i seguenti criteri di eleggibilità siano soddisfatti:
    a. il trapianto è avvenuto >100 giorni prima dell’arruolamento nello studio
    b. assenza di infezioni attive
    c. il partecipante soddisfa i restanti criteri di eleggibilità esposti nel presente protocollo
    7. Funzionalità adeguata di sistemi e organi in base alla definizione riportata nella Tabella 9 del protocollo pag. 54.
    8. Partecipanti di sesso femminile: L’uso dei contraccettivi da parte dei pazienti di sesso maschile e di sesso femminile deve essere coerente con la normativa locale riguardante i metodi contraccettivi per coloro che partecipano a studi clinici.
    Le donne sono eleggibili per la partecipazione se non sono in gravidanza o in allattamento e se almeno una delle condizioni indicate di seguito risulta applicabile:
    • Non si tratta di una donna in età fertile O
    • Si tratta di una donna in età fertile e sta utilizzando un metodo contraccettivo altamente efficace (con un tasso di insuccesso <1% l’anno), preferibilmente con scarsa dipendenza dell’utilizzatore, durante il periodo di intervento e per almeno 80 giorni dopo l’ultima dose del farmaco sperimentale e che acconsente a non donare ovuli a scopo riproduttivo durante questo periodo. Lo sperimentatore deve valutare l’efficacia del metodo contraccettivo in relazione alla prima dose del farmaco sperimentale.
    Una donna in età fertile deve avere esito negativo al test di gravidanza ad alta sensibilità condotto sul siero (come richiesto dai regolamenti locali) nelle 72 ore prima della prima dose del farmaco sperimentale.
    Lo sperimentatore è responsabile dell’esame di anamnesi, anamnesi mestruale e attività sessuale recente per ridurre il rischio di inclusione di donne in gravidanza in fase iniziale non rilevata.
    9. Partecipanti di sesso maschile: L’uso dei contraccettivi da parte dei pazienti di sesso maschile e di sesso femminile deve essere coerente con i regolamenti locali riguardanti i metodi contraccettivi per coloro che partecipano a studi clinici.

    Sono eleggibili per la partecipazione se acconsentono a quanto segue per il periodo di intervento e per almeno 140 giorni:
    • Astenersi dal donare sperma PIU’:
    • Essere astinenti da rapporti eterosessuali come loro stile di vita preferito e abituale (astinenza a lungo termine e persistente) e accettare di rimanere astinenti. O
    • Devono acconsentire all’uso di un metodo contraccettivo/metodo di barriera descritto qui di seguito:
    Acconsentire all’uso del profilattico e far utilizzare al partner di sesso femminile un ulteriore contraccettivo altamente efficace con un tasso di insuccesso <1% l’anno quando hanno rapporti sessuali con una donna in età fertile che non è attualmente in gravidanza.
    10. Tutte le precedenti tossicità correlate al trattamento (secondo la definizione dei criteri comuni di tossicità per gli eventi avversi del National Cancer Institute (NCI-CTCAE)), versione 4.03, devono essere =1° grado all’epoca dell’arruolamento tranne alopecia e neuropatia periferica di 2° grado.
    In Francia, un soggetto risulterà eleggibile per l’inclusione nello studio solo se affiliato o beneficiario di una categoria di previdenza sociale.
    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.
    I partecipanti che soddisfano uno qualsiasi di questi criteri non sono eleggibile per l’assegnazione al trattamento:
    1. Terapia sistemica anti-mieloma somministrata <14 prima, o plasmaferesi nei 7 giorni prima della prima dose di farmaco sperimentale
    2. Amiloidosi sintomatica, sindrome POEMS attiva (polineuropatia, organomegalia, endocrinopatia, gammopatia monoclonale e alterazioni cutanee), leucemia delle plasmacellule attiva al momento dello screening.
    3. Pregresso trapianto allogenico di cellule staminali (SCT)
    4. Malattia dell’epitelio corneale in corso tranne cheratopatia puntata lieve
    5. Uso di un farmaco sperimentale entro 14 giorni o cinque emivite, a seconda di quale dei due sia il più breve, prima della prima dose del farmaco di studio. Trattamento precedente con un anticorpo monoclonale nei 30 giorni prima di ricevere la prima dose dei farmaci sperimentali. Terapia precedente mirata al BCMA.
    6. Evidenze di emorragia attiva delle mucose o interna
    7. Qualsiasi intervento chirurgico maggiore eseguito nelle ultime quattro settimane
    8. Presenza di condizioni renali attive (infezione, necessità di dialisi o qualsiasi altra condizione che potrebbe influire sulla sicurezza del partecipante). I partecipanti con proteinuria isolata derivante dal MM sono eleggibili, a condizione che soddisfino i criteri di inclusione presenti nella Tabella 9 del Protocollo pag.54.
    9. Qualsiasi disturbo psichiatrico o medico grave e/o instabile preesistente o altre condizioni (tra cui anomalie alle analisi di laboratorio) che potrebbero interferire con la sicurezza del partecipante, l’ottenimento del consenso informato o la compliance alle procedure previste dallo studio.
    10. Malattia instabile del fegato o delle vie biliari in corso secondo valutazione dello sperimentatore, definita dalla presenza di ascite, encefalopatia, coagulopatia, ipoalbuminemia, varici esofagee o gastriche, ittero persistente o cirrosi. Nota: La malattia epatica cronica stabile (tra cui sindrome di Gilbert o calcoli asintomatici) o il coinvolgimento epatobiliare del tumore è accettabile se il partecipante soddisfa tutti gli altri criteri di inclusione.
    11. Le patologie maligne diverse dalla malattia oggetto di studio sono escluse, ad eccezione di qualsiasi altra patologia maligna da cui il partecipante risulti libero da più di 2 anni e che, a parere degli sperimentatori principali e del Medical Monitor GSK, non influirà sulla valutazione degli effetti del trattamento oggetto del presente studio clinico sulla patologia maligna attualmente studiata (MM).
    12. Evidenze di rischio cardiovascolare, inclusa una qualsiasi delle seguenti:
    a. Intervallo QTcF =470 msec (i valori dell’intervallo QT devono essere corretti per la frequenza cardiaca usando la formula di Fridericia [QTcF])
    b. Evidenze di aritmie incontrollate clinicamente significative in corso, tra cui anomalie clinicamente significative dell’ECG come blocco atrioventricolare (AV) di 2° (tipo II) o di 3° grado.
    c. Anamnesi di infarto miocardico, sindromi coronariche acute (inclusa angina instabile), angioplastica coronarica, posizionamento di stent o innesto di bypass negli ultimi 6 mesi prima dello screening.
    d. Insufficienza cardiaca di classe III o IV in base al sistema di classificazione funzionale della New York Heart Association
    e. Ipertensione incontrollata
    13. Reazione da ipersensibilità nota immediata o ritardata o idiosincrasia verso farmaci chimicamente correlati a GSK2857916, o a uno qualsiasi dei componenti del farmaco sperimentale.
    14. Donne in gravidanza o allattamento.
    15. Infezione attiva che richiede trattamento con antibiotici, antivirali o antimicotici.
    16. Infezione nota da HIV.
    17. Presenza dell’antigene di superficie dell’epatite B (HBsAg), o dell’anticorpo anticore dell’epatite B (HBcAb al momento dello screening o nei 3 mesi precedenti la prima dose del trattamento in studio)
    18. Esito positivo al test degli anticorpi dell’epatite C o esito positivo al test per la ricerca dell’RNA dell’epatite C al momento dello screening o nei 3 mesi precedenti la prima dose di trattamento dello studio.
    Nota: i partecipanti con anticorpi positivi contro il virus dell’epatite C a causa di una precedente patologia risolta possono essere arruolati soltanto se si ottiene un risultato negativo di conferma al test per la ricerca dell’RNA dell’epatite C.
    Nota: il test per la ricerca dell’RNA dell’epatite è facoltativo e i partecipanti con esito negativo al test per la ricerca degli anticorpi contro l’epatite C non sono tenuti a sottoporsi anche al test per la ricerca dell’RNA dell’epatite C.
    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).
    L’ORR, definita come la percentuale di partecipanti con risposta parziale (PR) o migliore (vale a dire, PR, risposta parziale molto buona [VGPR], risposta completa [CR] e risposta completa stringente [sCR]) confermata, secondo i criteri di risposta dell’International Myeloma Working Group (IMWG) del 2016 da parte del Comitato di Revisione Indipendente (IRC).
    E.5.1.1Timepoint(s) of evaluation of this end point
    Every 3 weeks
    Ogni 3 settimane
    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, t¿), 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; Durata della risposta (DoR), definita come: il tempo dalla prima evidenza documentata di PR o risposta migliore fino alla prima data di progressione della malattia (PD) secondo l¿IMWG; o decesso dovuto a PD sopraggiunto tra i partecipanti che raggiungono una risposta complessiva, vale a dire PR o risposta migliore confermata Tasso di beneficio clinico (CBR), definito come la percentuale di partecipanti con una risposta minima (MR) o migliore confermata secondo i criteri di risposta dell¿International Myeloma Working Group (IMWG) del 2016 da parte del Comitato di Revisione Indipendente (IRC). Tempo di risposta, definito come il tempo tra la data della prima dose e la data della prima evidenza documentata di risposta (PR o migliore). Sopravvivenza libera da progressione (PFS), definita in termini di tempo tra la prima dose e la prima data di progressione della malattia (PD) secondo l¿IMWG, o decesso dovuto a qualsiasi causa Tempo alla progressione, definito come il tempo tra la prima dose e la prima data di progressione della malattia (PD) secondo l¿IMWG, o decesso dovuto a PD Sopravvivenza complessiva (OS), definita in termini di intervallo tra la prima dose e il decesso dovuto a qualsiasi causa. Il profilo di sicurezza di GSK2857916 verr¿ valutato nei partecipanti con RRMM: le analisi cliniche e di laboratorio standard (profilo ematologico e chimico, esame obiettivo, misurazione dei parametri vitali e test diagnostici); annotazione degli eventi avversi (AE) e degli eventi avversi gravi (SAE); AE di interesse particolare; referti oculari all¿esame oftalmologico. Concentrazioni plasmatiche di GSK2857916 Valori dei parametri farmacocinetici derivati (ad es. AUC, Cmax, tmax, t¿), nella misura consentita dai dati Incidenza e titoli degli ADA contro GSK2857916 Effetti indesiderati sintomatici e impatti correlati come misurati dai questionari PRO-CTCAE, NEI-VFQ-25 e OSDI Qualit¿ della vita collegata allo stato di salute come misurata dai questionari EORTC QLQ-C30 e EORTC QLQ-MY20
    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
    Le valutazioni della risposta alla malattia saranno ogni 3 settimane o come clinicamente indicato. Dopo l'interruzione del trattamento la valutazione della sopravvivenza libera da progressione sar¿ ogni 3 settimane e la valutazione della sopravvivenza complessiva sar¿ ogni 3 mesi
    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 Yes
    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 Yes
    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 concerned4
    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 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
    Australia
    Canada
    United States
    France
    Germany
    Italy
    Spain
    United Kingdom
    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
    LVLS
    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 months0
    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 months0
    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: 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 state6
    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.
    Lo sperimentatore ¿ responsabile di garantire che sia stata presa in considerazione la cura post-studio delle condizioni mediche del partecipante.
    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 Decision2018-07-31
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2018-06-25
    P. End of Trial
    P.End of Trial StatusOngoing
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