E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Unresectable, locally advanced recurrent or metastatic esophageal squamous cell carcinoma (ESCC) |
Carcinoma esofágico epidermoide (ESCC) recurrente localmente avanzado o metastásico, no resecable |
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E.1.1.1 | Medical condition in easily understood language |
Unresectable, locally advanced recurrent or metastatic esophageal squamous cell carcinoma (ESCC) |
Carcinoma esofágico epidermoide (ESCC) recurrente localmente avanzado o metastásico, no resecable |
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E.1.1.2 | Therapeutic area | Diseases [C] - Cancer [C04] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.0 |
E.1.2 | Level | LLT |
E.1.2 | Classification code | 10055476 |
E.1.2 | Term | Esophageal squamous cell carcinoma |
E.1.2 | System Organ Class | 100000004864 |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
- To evaluate and compare the PFS assessed per RECIST version (v) 1.1 following treatment with tislelizumab in combination with chemotherapy compared to placebo in combination with chemotherapy when given as first-line treatment in patients with unresectable, locally advanced recurrent or metastatic ESCC
- To evaluate and compare the overall survival (OS) following treatment with tislelizumab in combination with chemotherapy compared to placebo in combination with chemotherapy when given as first-line treatment in patients with unresectable, locally advanced recurrent or metastatic ESCC |
-Evaluar y comparar la supervivencia sin progresión (PFS) de acuerdo a los Criterios de Evaluación de la Respuesta en Tumores Sólidos (RECIST) versión (v) 1.1, tras el tratamiento con tislelizumab en combinación con quimioterapia, frente a placebo en combinación con quimioterapia, en su administración como tratamiento de primera línea en pacientes con carcinoma esofágico epidermoide (ESCC) recurrente localmente avanzado o metastásico, no resecable.
-Evaluar y comparar la supervivencia global (OS) tras el tratamiento con tislelizumab en combinación con quimioterapia, frente a placebo en combinación con quimioterapia, en su administración como tratamiento de primera línea en pacientes con ESCC recurrente localmente avanzado o metastásico, no resecable. |
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E.2.2 | Secondary objectives of the trial |
- To evaluate and compare the efficacy of tislelizumab in combination with chemotherapy compared to placebo in combination with chemotherapy as a first-line treatment in unresectable, locally advanced recurrent or metastatic ESCC as measured by ORR and DOR assessed per RECIST v1.1
- To evaluate and compare Patient Reported Outcomes (PROs) of health-related quality of life (HRQoL) between tislelizumab in combination with chemotherapy compared to placebo in combination with chemotherapy
- To compare the safety between tislelizumab in combination with chemotherapy and placebo in combination with chemotherapy |
-Evaluar y comparar la eficacia de tislelizumab en combinación con quimioterapia, frente a placebo en combinación con quimioterapia, como tratamiento de primera línea en el ESCC recurrente localmente avanzado o metastásico, no resecable, en su medición mediante la tasa de respuesta objetiva (ORR) y la duración de la respuesta (DOR) según el BIRC de acuerdo a RECIST v1.1. -Evaluar y comparar los resultados comunicados por los pacientes (PROs) de la calidad de vida relacionada con la salud (HRQoL) de tislelizumab en combinación con quimioterapia, frente a placebo en combinación con quimioterapia. - Comparar la seguridad entre tislelizumab en combinación con quimioterapia, frente a placebo en combinación con quimioterapia. |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
• Pathologically (histologically) confirmed diagnosis of ESCC • Stage IV unresectable ESCC at first diagnosis OR unresectable, locally advanced recurrent or metastatic disease with a treatment free interval of at least 6 months after definitive treatment - Staging by AJCC 7th Edition |
-Diagnóstico de ESCC confirmado anatomopatológicamente (histológicamente). -ESCC en Estadio IV, según AJCC 7th Edition (Edge et al 2010), no resecable en el diagnóstico inicial O BIEN enfermedad recurrente localmente avanzada o metastásica, no resecable, con un intervalo sin tratamiento de como mínimo 6 meses si hubiera recibido tratamiento con intención curativa. |
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E.4 | Principal exclusion criteria |
• Palliative radiation treatment for ESCC within 4 weeks of study treatment initiation • Prior systemic therapy for unresectable, locally advanced recurrent or metastatic ESCC • Received prior therapies targeting PD-1, PD-L1 or PD-L2 • Patients with evidence of fistula (either esophageal/bronchial or esophageal/aorta) • Uncontrollable pleural effusion, pericardial effusion, or ascites requiring frequent drainage or medical intervention (clinically significant recurrence requiring an additional intervention within 2 weeks of intervention) • Evidence of complete esophageal obstruction not amenable to treatment • Unintentional weight loss >=5% within one month prior to randomization or other indicators of severe malnutrition - Severe malnutrition may be determined using the Nutritional Risk Index (Shirasu, et al. 2018) • Patients receiving chemotherapy doublet C (platinum and paclitaxel) must not have peripheral neuropathy >=Grade 2 at baseline • Patients who recur after definitive surgery and are eligible for non-palliative radiation therapy and/or chemoradiotherapy. |
-Radioterapia paliativa por ESCC en el plazo de las 4 semanas anteriores al inicio del tratamiento del estudio -Tratamiento sistémico previo por ESCC no resecable, recurrente localmente avanzado o metastásico -Pacientes con evidencia de fístula (esofágica/bronquial o esofágica/aorta) -Derrame pleural, pericárdico o ascitis no controlables que precisan drenajes frecuentes o intervención médica (recurrencia clínicamente importante que requiere intervención adicional en el plazo de las 2 semanas siguientes a la intervención) -Evidencia de obstrucción esofágica completa no susceptible de tratamiento -Recepción de tratamientos previos dirigidos frente a PD-1, PD-L1 o PD-L2 - Pérdida de peso no intencionada >= 5% en el plazo de 1 mes antes de la aleatorización u otro indicador de desnutrición severa (la desnutrición severa puede determinarse mediante el Nutritional Risk Index, Shirasu, et al. 2018) |
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E.5 End points |
E.5.1 | Primary end point(s) |
PFS - defined as the time from the date of randomization to the date of first documentation of disease progression assessed per RECIST v1.1 or death, whichever occurs first
OS - defined as the time from the date of randomization until the date of death due to any cause |
PFS - definida como el tiempo transcurrido desde la fecha de la aleatorización hasta la fecha de la primera documentación de progresión de la enfermedad por el BIRC de acuerdo a RECIST v1.1 o la muerte, dependiendo de la primera de estas situaciones que tenga lugar OS - definida como el tiempo transcurrido desde la fecha de la aleatorización hasta la fecha de la muerte por cualquier causa |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
PFS and OS – analysis will be carried out at approximately 31 months |
PFS y OS – los análisis se llevarán a cabo a los 31 meses aproximadamente |
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E.5.2 | Secondary end point(s) |
- ORR - defined as the proportion of patients whose best overall response (BOR) is complete response (CR) or partial response (PR) - DOR - defined as the time from the first determination of an objective response until the first documentation of progression - HRQoL assessment of the patient’s overall health status - PFS, ORR, and DOR - The incidence and severity of adverse events |
-ORR - definida como el porcentaje de pacientes cuya mejor respuesta global (best overall response, BOR) es respuesta completa (complete response, CR) o respuesta parcial (partial response, PR) según el BIRC de acuerdo a RECIST v1.1 -DOR - definida como el tiempo transcurrido desde la primera determinación de una respuesta objetiva hasta la primera documentación de progresión de la enfermedad según el BIRC de acuerdo a RECIST v1.1 o la muerte, dependiendo de la primera de estas situaciones que tenga lugar -Evaluación de la HRQoL del estado general de salud del paciente mediante el índice europeo EORTC QLQ-C30, el módulo europeo específico para el cáncer de esófago EORTC QLQ-OES18 y el instrumento genérico del estado de salud EuroQol 5D (EQ-5D-5L) -PFS, ORR y DOR en su evaluación según el investigador de acuerdo a RECIST v1.1 -Incidencia y severidad de los acontecimientos adversos (adverse events, AEs) de acuerdo a los National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE) v4.03 |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
ORR - As assessed per RECIST v1.1 DOR - As assessed per RECIST v1.1 or death, whichever comes first HRQoL - European EORTC QLQ-C30 index, the European esophageal cancer specific module EORTC QLQ-OES18, and the generic health state instrument EuroQol 5D (EQ-5D-5L) PFS, ORR, and DOR- As assessed by the investigator per RECIST v1.1 - The incidence and severity of adverse events according to NCI-CTCAE v4.03 |
ORR - De acuerdo a RECIST v1.1 DOR - De acuerdo a RECIST v1.1 o muerte, cualquiera que ocurra antes. HRQoL - Indice Europeo QLQ-C30, EORTC QLQ-OES18, EuroQol 5D (EQ-5D-5L) PFS, ORR, y DOR- De acuerdo al criterio del investigador por RECIST v1.1 Incidencia y seriedad de los efectos adversos de acuerdo a NCI-CTCAE v4.03 |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | Yes |
E.6.7 | Pharmacodynamic | No |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | No |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | No |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | Yes |
E.6.13.1 | Other scope of the trial description |
Immunogenicity, Tolerability |
Inmunogenicidad, tolerabilidad |
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E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | No |
E.7.3 | Therapeutic confirmatory (Phase III) | Yes |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | Yes |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | Yes |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 2 |
E.8.3 |
The trial involves single site in the Member State concerned
| No |
E.8.4 | The trial involves multiple sites in the Member State concerned | Yes |
E.8.4.1 | Number of sites anticipated in Member State concerned | 9 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 57 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
Australia |
Belgium |
China |
Czech Republic |
France |
Germany |
Italy |
Japan |
Korea, Republic of |
Poland |
Romania |
Russian Federation |
Spain |
Taiwan |
United Kingdom |
United States |
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E.8.7 | Trial has a data monitoring committee | Yes |
E.8.8 |
Definition of the end of the trial and justification where it is not the last
visit of the last subject undergoing the trial
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LVLS |
Última visita del último paciente |
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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 | 1 |
E.8.9.1 | In the Member State concerned months | 10 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 2 |
E.8.9.2 | In all countries concerned by the trial months | 6 |
E.8.9.2 | In all countries concerned by the trial days | 0 |