E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Patients with Stage I-III Limited Disease Small-Cell Lung Cancer (LDSCLC) |
Pazienti affetti da Carcinoma Polmonare a Piccole Cellule con malattia limitata (LD-SCLC) stadio I-III. |
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E.1.1.1 | Medical condition in easily understood language |
Specific type of lung cancer called "Small Cell Lung Cancer" (SCLC) |
Tipologia specifica di tumore polmonare chiamata "Carcinoma Polmonare a Piccole Cellule" (SCLC). |
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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 | 21.1 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10041069 |
E.1.2 | Term | Small cell lung cancer limited stage |
E.1.2 | System Organ Class | 10029104 - Neoplasms benign, malignant and unspecified (incl cysts and polyps) |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
- To assess the efficacy of durvalumab monotherapy as well as durvalumab in combination with tremelimumab therapy compared to placebo in terms of PFS. - To assess the efficacy of durvalumab in combination with tremelimumab therapy compared to placebo in terms of OS. |
- Valutare l’efficacia del Durvalumab in monoterapia e l’efficacia del Durvalumab in associazione con il Tremelimumab rispetto al placebo in termini di PFS. - Valutare l’efficacia del Durvalumab in associazione con il Tremelimumab rispetto al placebo in termini di OS. |
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E.2.2 | Secondary objectives of the trial |
To Assess: a) the efficacy of durvalumab compared to placebo in terms of OS. B) the efficacy of durvalumab and durvalumab and tremelimumab compared to placebo in terms of ORR, PFS18a, PFS24a, TTDM, OS24, OS36, and PFS2. c) the efficacy of durvalumab and tremelimumab compared to durvalumab in terms of PFS, OS and ORR, d) disease-related symptoms and HRQoL in patients treated with durvalumab or durvalumab and tremelimumab compared to placebo using the EORTC QLQ-C30 v3 and QLQ-LC13. e) the PK of durvalumab and durvalumab and tremelimumab. f) the immunogenicity of durvalumab and durvalumab and tremelimumab. g) the relationship between a patient’s tumor mutational burden (TMB) measured in tumor and/or blood and efficacy outcomes with mono and combination therapy. h) safety and tolerability of durvalumab and durvalumab and tremelimumab compared to placebo |
Valutare: a)efficacia della monoter a base di Durva rispetto al placebo in OS b)efficacia del Durva in monoter e della terap di Durva in associaz con Treme rispetto al placebo in ORR,PFS18a,PFS24a,TTDM,OS24,OS36ePFS2 c)efficacia della terap a base di Durva in associaz con Treme rispetto al Durva in monoter in PFS,OSS,ORR d)sintomi correlati alla patolog e HRQoL in pz trattati con Durva in monoter o del Durva in associaz con Treme rispetto al placebo usando EORTC QLQ-C30 v3 e QLQ-LC13 e)farmacocinetica (PK) del Durva in monoter e del Durva in associaz con Treme f)immunogen del Durva in monoter e del Durva in associaz con Treme g)relaz tra tasso di mutaz tumor del pz (TMB) misurato nel tumore e/o nel sangue e risultati di efficacia relativi alla monoter e della terapia combinata. h)profili di sicurezza e tollerab del Durva e della combinaz Durva e Treme rispetto al placebo |
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
a) Histologically or cytologically documented limited-stage SCLC (Stage I-III SCLC [T any, N any, M0] i.e., patients whose disease can be encompassed within a radical radiation portal - Patients with Stage I to IIA disease must be medically inoperable. b) Received 4 cycles of platinum-based chemotherapy concurrent with RT, which must be completed within 1 to 42 days prior to first dose of IP. The chemotherapy regimen must contain platinum and etoposide, as per local standard-of-care regimens. c) The radiotherapy must have commenced no later than the end of Cycle 2 of chemotherapy and patients must have received a total dose of radiation of 60 to 66 Gy for standard QD radiation schedules or 45 Gy for hyperfractionated BID radiation schedules. d) Patients must have achieved CR, PR, or SD and not have progressed following definitive, platinum-based, concurrent CRT. e) World Health Organization (WHO)/Eastern Cooperative Oncology Group (ECOG) performance status (PS) of 0 or 1 at enrolment and randomization. f) Provision of an archived tumour tissue block (or at least 15 newly cut unstained slides, where available) =3 years old, where such samples exist in a quantity sufficient to allow for analysis (refer to the Laboratory Manual for details). g) A recent (=3 months) tumour biopsy* (taken following completion of the most recent therapy) is an optional requirement, provided that a biopsy procedure is technically feasible and the procedure is not associated with unacceptable clinical risk. |
a) SCLC con malattia limitata confermata attraverso esami istologici o citologici (Stage I-III SCLC [T qualsiasi , N qualsiasi, M0], vale a dire pazienti la cui malattia sia possibile includere all’interno di un unico volume di irradiazione ad intento radicale-Pazienti con malattia da Stadio I a IIA devono essere medicalmente inoperabili. b) Il paziente deve aver eseguito 4 cicli di chemioterapia a base di platino concomitante a Radio Terapia, completati entro 1 giorno e fino a 42 giorni prima della prima dose di farmaco di studio. La chemioterapia deve essere a base di platino ed etoposide, come previsto dal trattamento standard locale. c) la radioterapia deve essere iniziata non oltre la fine del Ciclo 2 di chemioterapia ed i pazienti devono aver ricevuto una dose complessiva di radiazioni da 60 a 66 Gy secondo programmi standard una volta al giorno o 45 Gy nel caso di radioterapia iperfrazionata eseguita due volte al giorno. d) i pazienti devono aver raggiunto Risposta Completa (CR) , Risposta Parziale (PR) o stabilità di malattia (SD) e non essere andati in progressione di malattia a seguito della Chemioradio terapia (CRT) concomitante a base di platino. e) Performance status (PS) del World Health Organization (WHO)/Eastern Cooperative Oncology Group (ECOG) di 0 o 1 all’arruolamento e alla randomizzazione. f) fornire un blocchetto di tessuto tumorale (o, se disponibili, almeno 15 slides tagliate recentemente non marcate) non più vecchio di 3 anni, qualora questi campioni fossero disponibili in quantità sufficienti per effettuare l’analisi (fare riferimento al Manuale di Laboratorio per i dettagli). g) una biopsia opzionale recente (non più vecchia di 3 mesi e prelevata una volta terminata la terapia più recente), qualora la biopsia sia tecnicamente fattibile e che la procedura non sia associata a un rischio clinico inaccettabile. |
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E.4 | Principal exclusion criteria |
a) Extensive-stage SCLC. b) Mixed SCLC and NSCLC histology. c) Brain metastases or spinal cord compression. All patients will have an MRI (preferred) or CT, preferably with IV contrast of the brain, prior to study entry. d) Patients who received sequential chemoradiation therapy for LD-SCLC (no overlap of RT with chemotherapy). e) Receipt of consolidation chemotherapy after radiation. (Treatment with etoposide and platinum after radiation is acceptable as 1 regimen for 1 to 2 cycles; chemotherapy regimens other than etoposide and platinum as consolidation are not permitted.) f) Patients with Grade =2 pneumonitis from prior CRT g) Active or prior documented autoimmune/inflammatory disorders, uncontrolled intercurrent illness or active infections h) Prior exposure to immune-mediated therapy. |
a) stadio esteso di SCLC b) istologia del tumore mista tra SCLC ed NSCLC c) metastasi cerebrali o compressione del midollo spinale. Tutti i pazienti dovranno eseguire una risonanza magnetica (è preferita) o una tomografia computerizzata, preferibilmente con mezzo di contrasto endovenoso per l’encefalo, prima di essere trattati con il farmaco di studio. d) pazienti che hanno ricevuto chemioterapia e radioterapia sequenziale per la LD-SCLC (senza sovrapposizione tra chemioterapia ed RT) e)Pazienti che hanno ricevuto chemioterapia di consolidamento dopo la radioterapia (Il trattamento con etoposide e platino dopo la radioterapia è accettabile come 1° regime da 1 a 2 cicli; regimi di chemioterapia di consolidamento diversi da etoposide e platino non sono permessi). f) pazienti con polmonite di grado 2 dovuta a precedente CRT g) patologie infiammatorie o autoimmuni in atto o precedentemente contratte h) esposizione precedente a terapia immuno-mediata. |
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E.5 End points |
E.5.1 | Primary end point(s) |
- PFS using BICR assessments according to RECIST 1.1 - OS |
- PFS usando valutazioni BICR in base ai criteri RECIST 1.1 - OS |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
- PFS: On-study tumor assessments begin at baseline, then occur q8w ± 1w for the first 72 weeks (relative to the date of randomization), followed by q12w ±1w until up to 96 weeks relative to the date of randomization, and then q24w ±1w thereafter until RECIST 1.1-defined radiological progression, plus one follow-up scan - OS: every 4 weeks during treatment period at least every 8 weeks (±2 weeks) following treatment discontinuation - OS and PFS will be made periodically until end of study. |
- PFS: la valutazione del tumore in studio effettuata al baseline, poi effettuata ogni 8 settimane (q8w) ± 1 settimana (w) per le prime 72 settimane (a partire dalla data di randomizzazione), poi ogni 12 settimane (q12w) ±1w sino alla settimana 96 a partire dalla data di randomizzazione, e successivamente ogni 24 settimane q24w ±1w sino a progressione radiologica secondo RECIST 1.1, insieme ad una tac di follow-up. - OS: ogni 4 settimane durante il periodo di trattamento ed almeno ogni 8 settimane (±2 settimane) a seguito della discontinuazione del trattamento - OS e PFS: saranno effettuati periodicamente sino alla fine dello studio |
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E.5.2 | Secondary end point(s) |
- OS - ORR, PFS18, PFS24, and TTDM using BICR assessments according to RECIST 1.1, OS24 and OS36, PFS2 - PFS and ORR using BICR assessments according to RECIST 1.1, OS - EORTC QLQ-C30 and QLQ-LC13: change in symptoms, functioning, and global health status/QoL - Concentration of durvalumab and tremelimumab in serum (such as peak concentration and trough; sparse sampling) - Presence of ADA for durvalumab and tremelimumab (confirmatory results: positive or negative) - TMB relative to response/efficacy outcomes (ORR, PFS, and OS) - Safety assessment: AEs; laboratory findings including clinical chemistry, hematology, urinalysis; physical examinations; vital signs including blood pressure and pulse; and electrocardiograms |
- OS; - ORR, PFS18, PFS24, TTDM usando valutazioni BICR in base ai criteri RECIST 1.1, OS24 ed OS36, PFS2 - PFS ed ORR usando valutazioni BICR in base ai criteri RECIST 1.1, OS - EORTC QLQ-C30 e QLQ-LC13: variazioni della sintomatologia, del funzionamento fisico, dello stato di salute generale/QoL - Concentrazione di Durvalumab e Tremalimumab nel siero (come il picco più alto e più basso di concentrazione ; campionamento ridotto). - Presenza di anticorpi anti-farmaco (acronimo ADA) per Durvalumab e Tremelimumab (risultati di conferma: positivi o negativi). - TMB relativo ai risultati di risposta/efficacia (ORR, PFS ed OS) - Valutazioni di sicurezza: Eventi Avversi, risultati di laboratorio compresi i risultati ematochimici e delle urine; esame obiettivo; segni vitali inclusa la pressione arteriosa e la frequenza cardiaca; ed elettrocardiogrammi. |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
- ORR, PFS18, PFS24, TTDM, PFS. ORR: tumor assessments begin at baseline, then q8w±1w for the first 72 weeks (relative to the date of randomization), followed by q12w±1w until up to 96 weeks , and then q24w±1w thereafter until RECIST 1.1 radiological progression, plus one follow-up scan. - OS: Every 4 weeks during treatment, at least every 8 weeks (±2 weeks) following IP discontinuation - EORTC QLQ-C30, QLQ-LC13: Every 4 weeks (±3 days) relative to randomization until study termination or death - PK at C1 (post dose) and C2, C5, C26 (pre dose) and week 12 post IP discontinuation - ADA at C1, C5, C26 (pre dose) and week 12 and 24 post IP discontinutation - TMB at screening (tumor) and C1, C2, C3, C4, C5 (blood) - Safety: screening and each treatment vist and up to 12 weeks post treatment. |
-ORR,PFS18,PFS24,TTDM,PFS.ORR:valutaz iniz tumore al baseline,poi effett q8w±1per le prime72sett(dalla data di randomizz),poi da q12w±1w fino alla sett96e successiv a partire dalla q24w ±1w sino a progress radiologic secondo RECIST 1.1,con agg di1tac di follow-up -OS:ogni4sett durant il per di trattam ed almeno ogni 8sett(±2 sett)a seguito della discontinuaz del trattam -EORTC QLQ-C30 e QLQ-LC13: ogni 4sett(±3 gg)a partire dalla randomiz sino alla fine dello studio o alla morte -PK alC1(post dose)ed alC2,C5,C26(pre dose)ed alla sett12dopo la discontinuaz dell’farmaco di studio. -ADA alC1,C5,C26(pre dose),alla12sett ed alla24sett dopo la discont dell’IP -TMB allo screen(tumor)ed alC1,C2,C3,C4,C5(sangue) -Sicurez:allo screening e ad ogni visita di trattamento e fino a12sett dopo il trattam |
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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 | Yes |
E.6.11 | Pharmacogenomic | Yes |
E.6.12 | Pharmacoeconomic | No |
E.6.13 | Others | Yes |
E.6.13.1 | Other scope of the trial description |
Tolerability, Healthcare resource utilization, Quality of life |
Tollerabilità, utilizzo delle risorse sanitarie, qualità della vita |
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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 | 3 |
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 | 7 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 48 |
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 | Information not present in EudraCT |
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 |
Argentina |
Belgium |
Canada |
China |
Czechia |
Germany |
India |
Italy |
Japan |
Korea, Republic of |
Netherlands |
Russian Federation |
Spain |
Taiwan |
Turkey |
United States |
Vietnam |
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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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The end of study is defined as the last expected visit/contact of the last patient undergoing the study. A patient is considered to have completed the study when he/she has completed his/her last scheduled visit or last scheduled procedure |
Lo studio è considerato terminato quando l'ultimo paziente partecipante allo studio stesso avrà effettuato l'ultima visita prevista/l'ultimo contatto previsto. Lo studio può essere considerato portato a termine, e quindi completato, per quei pazienti che hanno effettuato l'ultima vista prevista o l'ultima procedura prevista. |
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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 | 5 |
E.8.9.1 | In the Member State concerned months | 0 |
E.8.9.1 | In the Member State concerned days | 0 |
E.8.9.2 | In all countries concerned by the trial years | 5 |
E.8.9.2 | In all countries concerned by the trial months | 0 |
E.8.9.2 | In all countries concerned by the trial days | 0 |