Flag of the European Union EU Clinical Trials Register Help

Clinical trials

The European Union Clinical Trials Register   allows you to search for protocol and results information on:
  • interventional clinical trials that were approved in the European Union (EU)/European Economic Area (EEA) under the Clinical Trials Directive 2001/20/EC
  • clinical trials conducted outside the EU/EEA that are linked to European paediatric-medicine development

  • EU/EEA interventional clinical trials approved under or transitioned to the Clinical Trial Regulation 536/2014 are publicly accessible through the
    Clinical Trials Information System (CTIS).


    The EU Clinical Trials Register currently displays   43865   clinical trials with a EudraCT protocol, of which   7286   are clinical trials conducted with subjects less than 18 years old.   The register also displays information on   18700   older paediatric trials (in scope of Article 45 of the Paediatric Regulation (EC) No 1901/2006).

    Phase 1 trials conducted solely on adults and that are not part of an agreed paediatric investigation plan (PIP) are not publicly available (see Frequently Asked Questions ).  
     
    Examples: Cancer AND drug name. Pneumonia AND sponsor name.
    How to search [pdf]
    Search Tips: Under advanced search you can use filters for Country, Age Group, Gender, Trial Phase, Trial Status, Date Range, Rare Diseases and Orphan Designation. For these items you should use the filters and not add them to your search terms in the text field.
    Advanced Search: Search tools
     

    < Back to search results

    Print Download

    Summary
    EudraCT Number:2018-000789-13
    Sponsor's Protocol Code Number:ISA101b-HN-01-17
    National Competent Authority:Spain - AEMPS
    Clinical Trial Type:EEA CTA
    Trial Status:Ongoing
    Date on which this record was first entered in the EudraCT database:2018-08-07
    Trial 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 number2018-000789-13
    A.3Full title of the trial
    A Randomized, Double-blind, Placebo-Controlled, Phase 2 Study of Cemiplimab Versus the Combination of Cemiplimab With ISA101b in the Treatment of Subjects With HPV16-Positive Platin-Resistant Oropharyngeal Cancer (OPC)
    Estudio de fase II, aleatorizado, con doble enmascaramiento y controlado con placebo de cemiplimab en comparación con la combinación de cemiplimab más ISA101b en el tratamiento de sujetos con cáncer orofaríngeo (COF) VPH-16 positivo resistente al platino
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    An experimental study in men and women with head and neck cancer to test the safety, tolerability and the effects of addition of a vaccine directed against an infection with Human Papilloma virus Type 16 (HPV16) in combination with an antibody that activate part of the immune system
    Estudio experimental en hombres y mujeres con cáncer de cabeza y cuello para evaluar la seguridad, tolerabilidad y los efectos de la adición de una vacuna contra una infección por el virus del papiloma humano tipo 16 (HPV16) en combinación con un anticuerpo que activa parte del sistema inmune
    A.4.1Sponsor's protocol code numberISA101b-HN-01-17
    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 SponsorISA Therapeutics B.V.
    B.1.3.4CountryNetherlands
    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 supportISA Therapeutics B.V.
    B.4.2CountryNetherlands
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationISA Therapeutics B.V.
    B.5.2Functional name of contact pointClinical Department
    B.5.3 Address:
    B.5.3.1Street AddressJ.H Oortweg 19-21
    B.5.3.2Town/ cityLeiden
    B.5.3.3Post code2333 CH
    B.5.3.4CountryNetherlands
    B.5.4Telephone number317133 22 310
    B.5.5Fax number317122 22 311
    B.5.6E-mailinfo@isa-pharma.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 No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameHuman Papilloma Virus (HPV) type 16 E6/E7 synthetic long peptide (SLP®) vaccine
    D.3.2Product code ISA101b
    D.3.4Pharmaceutical form Powder and solvent for suspension for injection
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPSubcutaneous use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNH-Aspartyl-L-lysyl-L-cysteinyl-L-leucyl-L-lysyl- L-phenylalanyl –L-tyrosyl-L-seryl-Llysyl-L isoleucyl-L-seryl-L-glutamyl-L-tyrosyl-L-arginyl-L-histid
    D.3.9.1CAS number 1218771-50-6
    D.3.9.2Current sponsor codeD-3082-L Trifluoroacetate or D-3082-L
    D.3.9.3Other descriptive nameD-3082-L TRIFLUOROACETATE
    D.3.9.4EV Substance CodeSUB124635
    D.3.10 Strength
    D.3.10.1Concentration unit µg microgram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number100
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNL-Leucyl-L-tyrosyl-L-cysteinyl-L-tyrosyl-L-glutamyl-L-glutaminyl-L-leucyl-Lasparaginyl-L-aspartyl-L-seryl-L-seryl-L-glutamyl-L-glutamyl-L-glutamyl-L
    D.3.9.1CAS number 1218907-64-2
    D.3.9.2Current sponsor codeL-3972-T Trifluoroacetate or L-3972-T
    D.3.9.3Other descriptive nameT-3853-P TRIFLUOROACETATE
    D.3.9.4EV Substance CodeSUB124640
    D.3.10 Strength
    D.3.10.1Concentration unit µg microgram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number100
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNL-Leucyl-L-tyrosyl-L-cysteinyl-L-tyrosyl-L-glutamyl-L-glutaminyl-L-leucyl-Lasparaginyl-L-aspartyl-L-seryl-L-seryl-L-glutamyl-L-glutamyl-L-glutamyl-L
    D.3.9.1CAS number 1218907-64-2
    D.3.9.2Current sponsor codeL-3972-T Trifluoroacetate or L-3972-T
    D.3.9.3Other descriptive nameL-3972-T TRIFLUOROACETATE
    D.3.9.4EV Substance CodeSUB124637
    D.3.10 Strength
    D.3.10.1Concentration unit µg microgram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number100
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNL-Methionyl-L-histidyl-glycyl-L-aspartyl-L-threonyl-L-prolyl-L-threonyl-L-leucyl-Lhistidyl-L glutamyl-L-tyrosyl-L-methionyl-L-leucyl-L-aspartyl-L-leu
    D.3.9.1CAS number 1218907-32-4
    D.3.9.2Current sponsor codeM-4148-E Trifluoroacetate or M-4148-E
    D.3.9.3Other descriptive nameM-4148-E TRIFLUOROACETATE
    D.3.9.4EV Substance CodeSUB124638
    D.3.10 Strength
    D.3.10.1Concentration unit µg microgram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number100
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNH-L-Arginyl-L-cysteinyl-L-isoleucyl-L-asparaginyl-L-cysteinyl-L-glutaminyl-L-lysyl-Lprolyl-L-leucyl-L-cysteinyl-L-prolyl-L-glutamyl-L-glutamyl-L-lysy
    D.3.9.1CAS number 1218907-21-1
    D.3.9.2Current sponsor codeR-4019-T Trifluoroacetate or R-4019-T
    D.3.9.3Other descriptive nameR-4019-T TRIFLUOROACETATE
    D.3.9.4EV Substance CodeSUB124639
    D.3.10 Strength
    D.3.10.1Concentration unit µg microgram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number100
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNL-Threonyl-L-leucyl-L-arginyl-L-leucyl-L-cysteinyl-L-valyl-L-glutaminyl-L-seryl-Lthreonyl-L-histidyl-L-valyl-L-aspartyl-L-isoleucyl-L-arginyl-L-threo
    D.3.9.1CAS number 1218908-02-1
    D.3.9.2Current sponsor codeT-3853-P Trifluoroacetate or T-3853-P
    D.3.9.3Other descriptive nameT-3853-P TRIFLUOROACETATE
    D.3.9.4EV Substance CodeSUB124640
    D.3.10 Strength
    D.3.10.1Concentration unit µg microgram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number100
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNL-Aspartyl-L-lysyl-L-lysyl-L-glutaminyl-L-arginyl-L-phenylalanyl-L-histidyl-Lasparaginyl-L-isoleucyl-L-arginyl-glycyl-L-arginyl-L-tryptophanyl-L-thre.
    D.3.9.1CAS number 1218907-24-4
    D.3.9.2Current sponsor codeD-3954-L Trifluoroacetate or D-3954-L
    D.3.9.3Other descriptive nameD-3954-L TRIFLUOROACETATE
    D.3.9.4EV Substance CodeSUB124641
    D.3.10 Strength
    D.3.10.1Concentration unit µg microgram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number100
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNL-Histidyl-L-tyrosyl-L-cysteinyl-L-tyrosyl-L-seryl-L-leucyl-L-tyrosyl-glycyl-L-threonyl-L-threonyl-L leucyl-L-glutamyl-L-glutaminyl-L-glutaminyl-L-tyr
    D.3.9.1CAS number 1218771-56-2
    D.3.9.2Current sponsor codeH-3035-R Trifluoroacetate or H-3035-R
    D.3.9.3Other descriptive nameH-3035-R TRIFLUOROACETATE
    D.3.9.4EV Substance CodeSUB124642
    D.3.10 Strength
    D.3.10.1Concentration unit µg microgram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number100
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNL-Lysyl-L-glutaminyl-L-glutaminyl-L-leucyl-L-leucyl-L-arginyl-L-arginyl-L-glutamyl-Lvalyl-L-tyrosyl-L-aspartyl-L-phenylalanyl-L-alanyl-L-phenylalanyl
    D.3.9.1CAS number 1218771-40-4
    D.3.9.2Current sponsor codeK-3118-N Trifluoroacetate or K-3118-N
    D.3.9.3Other descriptive nameK-3118-N TRIFLUOROACETATE
    D.3.9.4EV Substance CodeSUB124643
    D.3.10 Strength
    D.3.10.1Concentration unit µg microgram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number100
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNL-Leucyl-L-prolyl-L-glutaminyl-L-leucyl-L-cysteinyl-L-threonyl-L-glutamyl-L-leucyl-Lglutaminyl-L threonyl-L-threonyl-L-isoleucyl-L-histidyl-L-asparty
    D.3.9.1CAS number 1218907-04-0
    D.3.9.2Current sponsor codeL-3863-Y Trifluoroacetate or L-3863-Y
    D.3.9.3Other descriptive nameL-3863-Y TRIFLUOROACETATE
    D.3.9.4EV Substance CodeSUB124644
    D.3.10 Strength
    D.3.10.1Concentration unit µg microgram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number100
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNL-Methionyl-L-histidyl-L-glutaminyl-L-lysyl-L-arginyl-L-threonyl-L-alanyl-L-methionyl-L phenylalanyl-L-glutaminyl-L-aspartyl-L-prolyl-L-glutaminyl-L-g
    D.3.9.1CAS number 1218907-00-6
    D.3.9.2Current sponsor codeM-3878-D Trifluoroacetate or M-3878-D
    D.3.9.3Other descriptive nameM-3878-D TRIFLUOROACETATE
    D.3.9.4EV Substance CodeSUB124645
    D.3.10 Strength
    D.3.10.1Concentration unit µg microgram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number100
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNL-Arginyl-L-aspartyl-L-leucyl-L-cysteinyl-L-isoleucyl-L-valyl-L-tyrosyl-L-arginyl-Laspartyl-glycyl-L asparaginyl-L-prolyl-L-tyrosyl-L-alanyl-L-valyl-
    D.3.9.1CAS number 1218771-49-3
    D.3.9.2Current sponsor codeR-3083-I Trifluoroacetate or R-3083-I
    D.3.9.3Other descriptive nameR-3083-I TRIFLUOROACETATE
    D.3.9.4EV Substance CodeSUB124646
    D.3.10 Strength
    D.3.10.1Concentration unit µg microgram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number100
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.8INN - Proposed INNL-Tyrosyl-glycyl-L-threonyl-L-threonyl-L-leucyl-L-glutamyl-L-glutaminyl-L-glutaminyl-L-tyrosyl-L asparaginyl-L-lysyl-L-prolyl-L-leucyl-L-cysteinyl-L-a
    D.3.9.1CAS number 1218907-20-0
    D.3.9.2Current sponsor codeY-3755-K Trifluoroacetate or Y-3755-K
    D.3.9.3Other descriptive nameY-3755-K TRIFLUOROACETATE
    D.3.9.4EV Substance CodeSUB124647
    D.3.10 Strength
    D.3.10.1Concentration unit µg microgram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number100
    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 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 No
    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 No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameCemiplimab
    D.3.2Product code REGN2810
    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 INNCemiplimab
    D.3.9.1CAS number 1801342-60-8
    D.3.9.2Current sponsor codeREGN2810
    D.3.9.3Other descriptive nameHuman IgG4 Isotype Monoclonal (GDF8) Antibody
    D.3.9.4EV Substance CodeSUB179369
    D.3.10 Strength
    D.3.10.1Concentration unit mg milligram(s)
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number350
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin No
    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 No
    D.8 Information on Placebo
    D.8 Placebo: 1
    D.8.1Is a Placebo used in this Trial?Yes
    D.8.3Pharmaceutical form of the placeboSolvent for...
    D.8.4Route of administration of the placeboSubcutaneous use
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    HPV16-Positive Platin-Resistant Oropharyngeal Cancer (OPC)
    Cáncer orofaríngeo (COF) VPH-16 positivo resistente al platino
    E.1.1.1Medical condition in easily understood language
    Head and neck cancer with human papilloma virus type 16 infection
    Cáncer de cabeza y cuello con infección por el virus del papiloma humano tipo 16
    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 PT
    E.1.2Classification code 10031098
    E.1.2Term Oropharyngeal cancer recurrent
    E.1.2System Organ Class 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps)
    E.1.3Condition being studied is a rare disease No
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    Primary objective:
    To evaluate if the addition of ISA101b to cemiplimab results in improved overall response rate (ORR) compared to cemiplimab alone, according to Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 by independent review.

    Primary Safety Objective:
    To assess the safety and tolerability of the combination of cemiplimab plus ISA101b compared
    to placebo plus cemiplimab.
    Objetivo principal:
    Evaluar si la adición de ISA101b al cemiplimab produce una tasa de respuesta global (TRG) mejorada en comparación con el cemiplimab en monoterapia, según los criterios de evaluación de la respuesta en tumores sólidos (RECIST) 1.1 mediante revisión independiente.

    Objetivo principal de seguridad:
    Evaluar la seguridad y la tolerabilidad de la combinación de cemiplimab + ISA101b en comparación con placebo + cemiplimab.
    E.2.2Secondary objectives of the trial
    - To compare the overall response rate and other clinical outcome parameters in patients being treated with cemiplimab and ISA101b, and cemiplimab only, with patients concurrently being treated with standard therapy with a registered anti-programmed cell death (PD) 1 inhibitor such as nivolumab or pembrolizumab (historical controls).

    - Duration of response (DOR) by independent review in subjects randomized to receive ISA101b + cemiplimab compared to placebo + cemiplimab.

    - Time to response (TTR) by independent review in subjects randomized to receive ISA101b + cemiplimab compared to placebo + cemiplimab.

    - Progression-free survival (PFS) by independent review in subjects randomized to receive ISA101b + cemiplimab compared to placebo + cemiplimab. The PFS rate at 6 months will also be compared.

    - Median overall survival (OS) in subjects randomized to receive ISA101b plus cemiplimab compared to placebo + cemiplimab. The OS rate at 12 months will also be compared.
    -Evaluar laTRG y otros resultados clínicos en sujetos que reciben placebo+cemiplimab o ISA101b+cemiplimab en comparación con laTRG y otros resultados históricos observados en el cáncer orofaríngeo causado por el virus del papiloma humano con otros anticuerpos de muerte celular programada(anti-PD-1)(nivolumab o pembrolizumab).
    -Duración de la respuesta mediante revisión independiente en sujetos aleatorizados para recibir ISA101b+cemiplimab en comparación con placebo+cemiplimab.
    -Tiempo hasta la respuesta mediante revisión independiente en sujetos aleatorizados para recibir ISA101b+cemiplimab en comparación con placebo+cemiplimab.
    -Supervivencia sin progression mediante revisión independiente en sujetos aleatorizados para recibir ISA101b+cemiplimab en comparación con placebo+cemiplimab.Se comparará la tasa de la SSP a 6meses.
    -Supervivencia general en sujetos aleatorizados para recibir ISA101b+cemiplimab en comparación con placebo+cemiplimab.Se comparará la tasa de la SG a 12meses.
    E.2.3Trial contains a sub-study Yes
    E.2.3.1Full title, date and version of each sub-study and their related objectives
    Biomarker sub study:

    Objective:
    Correlative biomarkers to treatment response or AEs, such as but not limited to the following:
    Blood samples at baseline and during treatment for serum cytokines, whole blood for control of tumor mutation analysis, cell-free nucleic acids in plasma, PBMC characterization with profiles by multichannel fluorescence activated cell sorting (FACS), RNA sequence expression analysis (RNAseq), and HPV and control recall antigen-specific immune responses.
    Subestudio de biomarcadores:

    Objetivo:
    Biomarcadores relacionados con la respuesta al tratamiento o con AAs, tales como, entre otros, los siguientes:
    Muestras de sangre al inicio y durante el tratamiento de citoquinas séricas, sangre total para el control del análisis de mutación tumoral, ácidos nucleicos libres de células en plasma, caracterización de PBMC con perfiles por clasificación de células activadas por fluorescencia multicanal (FACS), análisis de expresión de secuencia de ARN (RNAseq) y, respuestas inmunes de memoria específicas de antígeno control y VPH.
    E.3Principal inclusion criteria
    1. Males and females, ≥ 18 years of age.
    2. Sign and date an IRB/IEC-approved written informed consent form.
    3. Be willing and able to comply with scheduled visits, treatment schedule, laboratory testing, and other requirements of the study.
    4. Diagnosed with histologically confirmed recurrent or metastatic HPV16 positive OPC, not amenable to any therapy with curative intent. Subjects with HPV16 positive squamous cell carcinoma (SCC) of occult primary site, presenting with lymph node(s) in the neck, are also eligible.
    5. HPV16 genotyping determined by a specified central reference laboratory with an established polymerase chain reaction (PCR)-based assay.
    6. Eastern Cooperative Oncology Group (ECOG) performance status of 0-1.
    7. Tumor progression or recurrence on or after platinum-containing chemotherapy for the treatment of primary metastatic or recurrent disease, or within 6 months of platinum containing chemotherapy administered as part of neo-adjuvant or adjuvant therapy.
    8. Measurable disease, defined as at least 1 lesion that can be accurately measured in at least 1 dimension with a minimum size of 10 mm by computed tomography (CT) scan or magnetic resonance imaging (MRI) per RECIST 1.1 criteria. Indicator lesions must not have been previously treated with surgery, radiation therapy, or radiofrequency ablation, unless there is documented progression after therapy.
    9. Fresh tumor tissue must be provided for biomarker correlative studies unless the investigator determines that this could impose a significant risk to the subject after discussion with Medical Monitor.
    10. Prior curative radiation therapy must have been completed at least 8 weeks prior to study drug administration. Prior focal palliative radiotherapy must have been completed at least 2 weeks before study drug administration.
    11. Screening laboratory values must meet the following criteria (using National Cancer Institute Common Terminology Criteria for Adverse Events [NCI CTCAE] v5.0) and should be obtained within 14 days prior to randomization:
    i) White blood cell count (WBC) ≥ 2/mL
    ii) Absolute neutrophil count (ANC) ≥ 1.5/mL
    iii) Platelets ≥ 100 x103/μL
    iv) Hemoglobin ≥ 9.0 g/dL
    v) Serum creatinine ≤ 1.5 x upper limit of normal (ULN) or creatinine clearance (CrCl)> 40 mL/min
    vi) Hepatic function:
    a. Total bilirubin ≤ 1.5 x ULN (if liver metastases ≤ 3 x ULN). Subjects with Gilbert’s Disease and total bilirubin up to 3 x ULN may be eligible if total bilirubin < 3.0 mg/dL.
    b. Transaminases (ALT and AST) ≤ 3 x ULN (or ≤ 5.0 x ULN, if liver metastases)
    c. Alkaline phosphatase ≤ 2.5 x ULN (or ≤ 5.0 x ULN, if liver or bone metastases)

    Note for subjects with hepatic metastases: If transaminase levels (aspartate aminotransferase [AST] and/or alanine aminotransferase [ALT]) > 3 x but ≤ 5 x ULN, total bilirubin must be ≤ 1.5 x ULN. If total bilirubin > 1.5 x but ≤ 3 x ULN, both transaminases (AST and ALT) must be ≤ 3 x ULN.

    Note regarding drug induced liver failure (DiLi): According to Hy's Law of Drug Induced Liver Injury a drug causes hepatocellular injury, generally defined as an elevated ALT or AST by 3-fold or greater above the upper limit of normal, combined with an elevation of serum total bilirubin of greater than 2× the upper limit of normal, without findings of cholestasis (defined as serum alkaline phosphatase activity less than 2× the upper limit of normal).

    i) Calcium levels must be normalized and maintained within normal limits for study entry and on treatment.
    ii) Subjects with an initial magnesium < 0.5 mmol/L (1.2 mg/dL) may receive corrective magnesium supplementation but should also continue to receive either prophylactic weekly infusion of magnesium and/or oral magnesium supplementation(e.g., magnesium oxide) at the investigator’s discretion. Levels should be up to 0.5 mmol/L (1.2 mg/dL) or higher before randomization.
    12. Subjects must have baseline oxygen saturation by pulse oximetry of ≥ 92% at rest on room air.
    13. Women of childbearing potential (WOCBP) must have a negative serum or urine pregnancy test within 24 hours prior to the start of study drug.
    14. Women must not be breastfeeding.
    15. WOCBP must agree to follow instructions for method(s) of contraception from the time of enrollment for the duration of treatment with study drug(s), and then for 6 months post treatment completion.
    16. Males who are sexually active with WOCBP must agree to follow instructions for methods of contraception for the duration of treatment with study drugs, and then for a total of 6 months post treatment completion.
    17. Azoospermic males and WOCBP who are continuously not heterosexually active are exempt from contraceptive requirements. However, they still must undergo pregnancy testing.
    1.Hombres y mujeres de ≥18 años de edad.
    2.Firmar y fechar un formulario de consentimiento informado por escrito aprobado por un comité de ética de la investigación.
    3.Querer y poder acudir a las visitas programadas y cumplir el plan de tratamiento, los análisis clínicos y otros requisitos del estudio.
    4.Tener COF VPH-16 positivo recidivante o metastásico confirmado mediante histología, no susceptible a ningún tratamiento con fines curativos.
    Los sujetos con carcinoma epidermoide (CE) VPH-16 positivo de localización primaria oculta que presenten ganglios linfáticos en el cuello también podrán participar.
    5.El genotipado del VPH-16 lo llevará a cabo el laboratorio de referencia central especificado usando un ensayo establecido basado en la reacción en cadena de la polimerasa (RCP).
    6.Estado funcional del Grupo Oncológico Cooperativo de la Costa Este <1762/>(ECOG) de 0-1.
    7.Progresión o recidiva del tumor en los 6 meses posteriores a la última dosis de quimioterapia con platino (hasta 2 líneas de quimioterapia anterior) administrada como tratamiento adyuvante o en el contexto de enfermedad primaria o recurrente.
    8.Enfermedad mensurable, definida como al menos una lesión que pueda medirse con precisión en al menos una dimensión, con un tamaño mínimo de 10 mm, mediante tomografía computarizada (TAC) o resonancia magnética (RM), según los criterios de RECIST 1.1.
    Las lesiones indicadoras no deben haberse tratado anteriormente con cirugía, radioterapia ni ablación por radiofrecuencia, a menos que exista progresión documentada después de la terapia.
    9.Debe proporcionarse tejido tumoral reciente para los estudios relacionados con biomarcadores, a menos que el investigador indique que esto puede suponer un riesgo significativo para el sujeto después de haberlo hablado con el monitor médico.
    10.La radioterapia curativa anterior debe haber finalizado al menos 8 semanas antes de la administración del fármaco del estudio.
    La radioterapia paliativa focal anterior debe haber finalizado al menos 2 semanas antes de la administración del fármaco del estudio.
    11.Los valores de selección del laboratorio deben cumplir los criterios siguientes (usando los criterios terminológicos comunes para acontecimientos adversos del National Cancer Institute) (National Cancer Institute-Common Terminology Criteria for Adverse Events [NCI CTCAE] v4.03) y deben obtenerse en los 14 días anteriores a la aleatorización:
    i) Cifra de leucocitos ≥2000/μl
    ii)Neutrófilos ≥1500/μl
    iii)Plaquetas ≥100 × 10<1936>3</1936>/μl
    iv)Hemoglobina ≥9,0 g/dl
    v)Creatinina sérica≤1,5veces el límite superior de la normalidad(LSN)o aclaramiento de la creatinina (ACr)>40 ml/min (usando la fórmula de Cockcroft-Gault)
    vi)Función hepática:
    Bilirrubina total ≤1,5veces el LSN(si existe metástasis hepática,≤3veces el LSN).
    Los sujetos con enfermedad de Gilbert y bilirrubina total inferior a 3 veces el LSN podrán participar en el estudio si la bilirrubina total <3,0 mg/dl
    Transaminasas ≤3 veces el LSN (o ≤5,0 veces el LSN si hay metástasis hepática)
    Fosfatasa alcalina ≤2,5 veces el LSN (o ≤5,0 veces el LSN si hay metástasis hepática)
    Nota para los sujetos con metástasis hepática:Si los niveles de transaminasas (aspartato aminotransferasa [AST] o alanina aminotransferasa [ALT]) >3 veces pero ≤5 veces el LSN, la bilirrubina total debe ser ≤1,5 veces el LSN.Si la bilirrubina total >1,5veces pero ≤3veces el LSN,ambas transaminasas(AST y ALT)deben ser ≤3veces el LSN.
    Nota con respecto a la insuficiencia hepática inducida por fármacos (DiLi): según la Ley Hy de lesión hepática inducida por fármacos, un fármaco provoca lesión hepatocelular, generalmente definida como una ALT o AST elevada por 3 veces o más por encima del límite superior de la normalidad, combinada con una elevación de la bilirrubina total sérica superior a 2 veces el límite superior de la normalidad, sin hallazgos de colestasis (definida como actividad de la fosfatasa alcalina sérica inferior a 2 veces el límite superior de la normalidad).
    i)Los niveles de calcio deben normalizarse y mantenerse en los límites normales en el momento de entrar en el estudio y durante el tratamiento.
    Se permite el tratamiento médico de los niveles de calcio.
    Nota:Los niveles de calcio normales pueden basarse en calcio ionizado o ajustado para albúmina.
    ii)Los sujetos con magnesio inicial <0,5 mmol/l (1,2 mg/dl) podrán recibir suplementos de magnesio correctivos pero deben continuar recibiendo una infusión semanal profiláctica de magnesio o suplementos de magnesio por vía oral(por ejemplo, óxido de magnesio)según el criterio del investigador.
    12.Los sujetos deben tener una saturación de oxígeno en la visita inicial medida con pulsioximetría ≥92% en reposo.
    13.Las mujeres fértiles deben tener un resultado negativo en la prueba de embarazo en suero u orina en las 24horas anteriores al comienzo de la administración del fármaco del estudio.
    14.Las mujeres no deben estar amamantando.
    (Continua en el protocol)
    E.4Principal exclusion criteria
    1. Subjects with known active brain metastases or leptomeningeal metastases. Subjects with brain metastases are eligible if these have been treated and there is no MRI (or CT scan where MRI is contraindicated) evidence of progression for at least 4 weeks after treatment is complete. Base of skull involvement without definitive evidence of dural or brain parenchymal involvement is acceptable. Subjects who require treatment with immunosuppressive doses of systemic corticosteroids (more than 10 mg/day prednisone equivalents) for at least 2 weeks prior to study drug administration.
    2. Any serious or uncontrolled medical disorder that, in the opinion of the investigator, may increase the risk associated with study participation or study drug administration, impair the ability of the subject to receive protocol therapy, or interfere with the interpretation of study results.
    3. History of other malignancy ≤ 3 years prior to entry into this trial with the exception of basal cell or squamous cell skin carcinoma which were treated with local resection only, OR carcinoma in situ of the cervix, prostate or breast, OR low grade non-muscle invasive superficial bladder cancer (TaLG)/carcinoma in situ of the bladder.
    4. Subjects with active, known, diagnosed or suspected autoimmune disease. Subjects suffering from vitiligo, type I diabetes mellitus, residual hypothyroidism due to autoimmune thyroiditis only requiring thyroid hormone replacement therapy, or psoriasis not requiring systemic treatment can be enrolled.
    5. Patients diagnosed with active interstitial lung disease (ILD)/pneumonitis or a history of ILD/pneumonitis or another condition requiring immunosuppressive doses of systemic medication such as systemic corticosteroids or absorbed topical corticosteroids (doses ≥ 10 mg/day prednisone or equivalent) or other immunosuppressive medications within 14 days of study drug administration. Inhaled or topical corticosteroids and adrenal replacement doses < 10 mg daily prednisone or equivalent are permitted.
    6. Prior treatment with an anti-PD-1 antibody (e.g., nivolumab, pembrolizumab, cemiplimab), as well as anti-PD-L1, anti-PD-L2, anti-CTLA-4 antibody, or any other antibody or drug specifically targeting T-cell co-stimulation or immune checkpoint pathways.
    7. Prior treatment with therapeutic anti-HPV vaccines including ISA101 or ISA101b. Subjects who have received a preventive HPV vaccine are allowed.
    8. Grade 1 or greater toxicities attributed to systemic prior anti-cancer therapy other than alopecia, fatigue (NCI CTCAE), radiation dermatitis, laboratory abnormalities that are not considered clinically significant by the treating physician, before administration of study drug. Subjects with residual grade 1 toxicities or toxicities attributed to systemic prior anticancer therapy that have become chronic and are not expected to resolve, such as neuropathy after platinum based therapy, can be included in this trial.
    9. Treatment with any chemotherapy, biological therapy for cancer, or investigational therapy within 28 days of first administration of study treatment.
    10. Administration of any live vaccine within 30 days before first dose of study drug.
    11. Uncontrolled infection with human immunodeficiency virus (HIV), hepatitis B virus or
    hepatitis C virus, except for:
    - Subjects with HIV who have controlled infection (undetectable viral load and CD4 count above 350 cells/mm3 either spontaneously or on a stable antiviral regimen) are permitted.
    - Subjects with hepatitis B (HepBsAg+) virus who have controlled infection (serumhepatitis B virus DNA PCR that is below the limit of detection AND receiving antiviral therapy for hepatitis B) are permitted.
    - Subjects who are hepatitis C virus antibody positive (HCV Ab +) who have controlled infection (undetectable HCV RNA by PCR either spontaneously or in response to a successful prior course of anti-HCV therapy) are permitted.
    12. Known history of allergy to any of the drug components of ISA101/101b: e.g. ISA101/101b, Montanide, or Macrogolglycerol Ricinoleate, also known as cremophore.
    13. Known history of allergy to any of the drug components of cemiplimab and its excipients.
    14. History of severe hypersensitivity reaction to any human monoclonal antibody.
    15. Subjects who are compulsorily detained for treatment of either a psychiatric or physical (e.g., infectious disease) illness.
    1.Los sujetos con metástasis cerebrales activas o con metástasis leptomeníngeas conocidas no podrán participar.
    Los sujetos con metástasis cerebrales podrán participar si estas han sido tratadas y no existen pruebas mediante RM (o TAC si la RM está contraindicada) de progresión durante al menos 4 semanas después de haber finalizado dicho tratamiento.
    Se acepta la afectación de la base del cráneo sin pruebas definitivas de afectación parenquimatosa cerebral o de la duramadre.
    Tampoco deben necesitarse dosis inmunosupresoras de corticoesteroides sistémicos (>10 mg/día de equivalentes a la prednisona) durante al menos 2 semanas antes de la administración del fármaco del estudio.
    2.Cualquier trastorno médico grave o incontrolado que, según el criterio del investigador, pueda aumentar el riesgo asociado a la participación en el estudio o a la administración del fármaco del estudio, disminuir la habilidad del sujeto para recibir el tratamiento del protocolo o interferir con la interpretación de los resultados del estudio.
    3.Otro cáncer anterior activo en los 3 últimos años, excepto cánceres curables localmente que se hayan curado aparentemente, como carcinoma basocelular o espinocelular, cáncer de vejiga superficial, o carcinoma localizado de próstata, cuello del útero o mama.
    4.Sujetos con enfermedad autoinmune activa o conocida o con sospecha de enfermedad autoinmune.
    Podrán participar sujetos con vitíligo, diabetes mellitus de tipo 1, hipotiroidismo residual debido a una afección autoinmune que solo requiera reposición hormonal, psoriasis que no requiera tratamiento sistémico, o afecciones que no se espera que reaparezcan ante la ausencia de un desencadenante externo.
    5.Sujetos con una afección que requiera dosis de medicamentos inmunosupresores sistémicos, como esteroides o esteroides tópicos absorbidos (dosis ≥10 mg/día de prednisona o equivalente) u otros medicamentos inmunosupresores en los 14 días anteriores a la administración del fármaco del estudio.
    Están permitidas las dosis de esteroides inhalados o tópicos y las dosis de reposición suprarrenal equivalentes a <10 mg diarios de prednisona en ausencia de enfermedad autoinmune activa.
    6.Tratamiento anterior con anticuerpos anti-PD-1 (por ejemplo nivolumab, pembrolizumab, cemiplimab), así como anticuerpos anti-PD-L1, anti-PD-L2 o anti-CTLA-4, o cualquier otro anticuerpo o fármaco específicamente orientado a la coestimulación de los linfocitos T o de los puntos de control.
    7.Tratamiento anterior con vacunas contra el VPH, incluidas ISA101 o ISA101b.
    Los sujetos podrán haber recibido una vacuna preventiva contra el VPH.
    8.Toxicidades de grado 1 o mayor atribuidas a tratamientos sistémicos contra el cáncer anteriores que no sean alopecia ni fatiga (NCI CTCAE) antes de la administración del fármaco del estudio.
    Los sujetos con toxicidades atribuidas a tratamientos sistémicos contra el cáncer anteriores que no se prevé que se resuelvan y que provoquen secuelas a largo plazo, como neuropatía después del tratamiento con platino, podrán participar en el estudio.
    9.Tratamiento del cáncer con cualquier quimioterapia, radioterapia, terapia biológica, o tratamiento en investigación en los 28 días anteriores a la primera administración del tratamiento del estudio.
    10.Haber recibido una vacuna con microbios vivos en los 30 días anteriores a la primera administración del fármaco del estudio.
    11.Infección no controlada con el virus de inmunodeficiencia humana (VIH), virus de la hepatitis B o virus de la hepatitis C.
    Podrán participar los sujetos con VIH que tengan la infección controlada (carga viral no detectable y recuento de CD4 superior a 350 células/mm<2476>3</2476>, bien de forma espontánea, bien con un régimen antivírico estable).
    Podrán participar los sujetos con el virus de la hepatitis B (HepBsAg+) que tengan la infección controlada (ADN del virus de la hepatitis B en suero mediante RCP por debajo del límite de detección y que estén recibiendo tratamiento antivírico para la hepatitis B).
    Podrán participar los sujetos con anticuerpos del virus de la hepatitis C (VHC Ab+) que tengan la infección controlada (ARN del VHC no detectable por RCP, bien de forma espontánea, bien en respuesta a un curso de tratamiento contra el VHC anterior satisfactorio).
    12.Antecedentes de alergias a los componentes del fármaco del estudio ISA101b/ISAS101b, por ejemplo, ISA101/101b, Montanide o ricinoleato de macrogolglicerol, también llamado Cremophor.
    13.Antecedentes de alergia al cemiplimab y sus excipientes.
    14.Antecedentes de reacciones de hipersensibilidad a cualquier anticuerpo monoclonal humano.
    15.Sujetos que deben estar recluidos de manera obligatoria para el tratamiento de enfermedades psiquiátricas o físicas (por ejemplo, enfermedad infecciosa).
    E.5 End points
    E.5.1Primary end point(s)
    Primary Efficacy Endpoint:
    ORR by independent review in subjects randomized to receive ISA101b plus cemiplimab compared to cemiplimab alone.
    Criterio de valoración primario de eficacia:
    TGR por revisión independiente en sujetos aleatorizados para recibir ISA101b más cemiplimab en comparación con cemiplimab solo.
    E.5.1.1Timepoint(s) of evaluation of this end point
    Continuously throughout the study
    Continuamente a lo largo del estudio
    E.5.2Secondary end point(s)
    Safety endpoint:
    Frequency and severity of toxicity in subjects randomized to receive ISA101b plus cemiplimab compared to cemiplimab alone.
    Criterio de valoración de seguridad:
    Frecuencia y gravedad de la toxicidad en los sujetos aleatorizados para recibir ISA101b más cemiplimab en comparación con cemiplimab solo.
    E.5.2.1Timepoint(s) of evaluation of this end point
    Continuously throughout the study
    Continuamente a lo largo del estudio
    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 Yes
    E.6.4Safety Yes
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic Yes
    E.6.7Pharmacodynamic No
    E.6.8Bioequivalence No
    E.6.9Dose response No
    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 Yes
    E.8.1.1Randomised Yes
    E.8.1.2Open No
    E.8.1.3Single blind No
    E.8.1.4Double blind Yes
    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 Yes
    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 EEA24
    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
    Belgium
    Czech Republic
    France
    Germany
    Hungary
    Italy
    Netherlands
    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
    End of study is defined as the date of the last visit of the last subject (LVLS)
    El final del estudio se define como la fecha de la última visita del ultimo sujeto
    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 months9
    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 months9
    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: 82
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 82
    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 state1
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 118
    F.4.2.2In the whole clinical trial 164
    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)
    None
    Ninguno
    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 Decision2018-09-25
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2018-09-18
    P. End of Trial
    P.End of Trial StatusOngoing
    For support, Contact us.
    The status and protocol content of GB trials is no longer updated since 1 January 2021. For the UK, as of 31 January 2021, EU Law applies only to the territory of Northern Ireland (NI) to the extent foreseen in the Protocol on Ireland/NI. Legal notice
    As of 31 January 2023, all EU/EEA initial clinical trial applications must be submitted through CTIS . Updated EudraCT trials information and information on PIP/Art 46 trials conducted exclusively in third countries continues to be submitted through EudraCT and published on this website.

    European Medicines Agency © 1995-Sat Apr 27 04:59:23 CEST 2024 | Domenico Scarlattilaan 6, 1083 HS Amsterdam, The Netherlands
    EMA HMA